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Medical training and the systematic creation of mental health sufferers

Douglas Sirutis
Education
September 1, 2022
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The COVID-19 pandemic has uprooted our lives, tilting them into imbalance and oftentimes severing our individual sense of inner peace. The newfound public initiative to combat these paralyzing challenges is welcome, especially to me. I’ve coped with major depression for as long as I can remember.

The grinding pursuit of my own inner peace led me to medical school. Medical training, I expected, would make a healer out of me, able to use my past experiences to help others heal. But the great irony is that medical school generates far more mental health sufferers than it does healers.

The demands of medical training are toxic to the mental health of its learners. However, the field’s characteristic conservatism prevents even progressive leaders in medical education from considering the most basic solutions to the question at hand.

How can you make a notoriously burdensome training, unanimously described as “drinking from a water hose,” less harmful?

Well, you turn down the water.

Physicians and trainees deserve more humane consideration of their lives, their time, and their inner peace.

The annual prevalence of depression in medical students and resident physicians is 27.2% and 28.8%, respectively. The prevalence in the general population is somewhere between 7.2% to 9.3% in similar age groups. In other words, medical students and residents are 300 to 400% more likely to become numb to their lives – experiencing poor sleep, low energy, and persistent sadness. How’s that for a recruitment pitch?

Medical students are also up to 250% more likely to contemplate suicide in comparison to their age-matched counterparts in the general population. Please pause lest our desensitized brains glide over that number. These are young people wishing to cease experiencing their very existence. Their loved ones, their dreams, their memories. None of them strong enough to overcome the mounting suffering they experienced during their medical training. Yet medical education maintains the status-quo 80-hour work week cap in a passed-down delusion that presumes there will be ample room for our personal lives and our wellness outside of our training.

The trend of poor mental health continues throughout a physician’s career. The majority of physicians experience burnout – emotional exhaustion, cynicism, and lack of fulfillment – and it costs us all. There are researchers who conservatively estimate that increased physician turnover and reduced clinical hours secondary to physician burnout cost the U.S. $4.6 billion annually. Put another way, productivity losses due to burnout are estimated to be equivalent to having 1067 fewer physicians. Not to mention, burnout is associated with increased medical errors that can harm patients. We are delusional to think the current physician, resident, or medical student workload works for anyone except those profiting from keeping staffing numbers low.

To our medical education leaders: You know our training threatens our happiness and, at times, our very existence. We need fundamental changes to our work culture. We deserve work standards that allow everyone to have whole, healthy lives outside medicine. Authentic leadership does not maintain a destructive status quo. Good leadership may push the status quo. But the time for good leadership is far gone. We have blood on the hands of our work culture. What we deserve is transformative leadership. Leaders who dream, envision, and create – leaders who will not shy away from the radical change we need so that we can indeed create mental health healers, not sufferers.

Douglas Sirutis is a medical student.

Image credit: Shutterstock.com

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Medical training and the systematic creation of mental health sufferers
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