Testifying in support of medical student mental health

The following is Dr. Pamela Wible’s testimony in support of medical student mental health to the Missouri State Legislature for House Bill 867.

I’m Dr. Pamela Wible, a family physician in Oregon. I’ve submitted my CV, witness form, and transcript of my testimony to Chairman Frederick. My schedule prevents me from traveling to Missouri for today’s hearing; however, I thank Vice Chairman Morris and the Committee for allowing me to testify remotely in support of House Bill 867, legislation that would require Missouri medical schools to screen students for depression and offer mental health referrals for those at risk.

Medical students face enormous stress. Their workload and debt load are immense. They witness incredible human suffering with no emotional support or debriefing. Routinely sleep deprived, they’re groomed in a medical culture that rewards self-neglect and often condones bullying.

Medical students are afraid to seek help for fear of retaliation or discrimination. Medical students are afraid to seek counseling because medical boards like the one in Missouri ask applicants if they’ve ever been treated for mental health issues. Checking the “yes” box can lead to a subpoena of one’s “confidential” medical records.

Medical students enter medical school with their mental health on par with or better than their peers. Up to 30 percent develop depression, and 10 percent become suicidal during each year of medical school. Both men I dated in medical school died by suicide. Depression and suicide are known occupational hazards in medicine.

More than 400 U.S. doctors die by suicide annually. Widespread underreporting and miscoding of death certificates suggest the number is closer to 800. That’s like losing all 391 medical students enrolled at the University of Missouri-Columbia School of Medicine plus the 433 students at the University of Missouri-Kansas City School of Medicine — every year.

Please join me in support of House Bill 867.

House Bill 867 benefits medical students. This bill will de-stigmatize mental illness and normalize medical students’ rights to request and receive confidential mental health care. Student participation is voluntary, and student data remains anonymous unless students select otherwise.

HB 867 benefits families by making mental health data transparent across all 6 Missouri medical schools. In medicine, informed consent is the standard of care, yet medical students and their families have not been informed of the health risks of a medical education.

Last fall, I attended a funeral. Kaitlyn Elkins was a star third-year medical student described by her family as “one of the happiest people on this Earth.” She died by suicide, but the funeral wasn’t for Kaitlyn. It was for Rhonda Elkins, Kaitlyn’s mother. Unable to recuperate from her daughter’s suicide, Rhonda took her own life. I asked Rhonda’s husband, “If Kaitlyn worked at Walmart, would she and your wife still be alive?” He said, “Yes. Medical school has cost me half my family.”

HB 867 also benefits patients. The best way to care for patients is to first care for our doctors-in- training. Let’s practice what we teach. By truly caring for our medical students, we demonstrate how we expect them to care for patients. The cost of not caring for our young doctors-in-training is more tragedy. Each year nearly 1 million Americans lose their doctors to suicide.

Finally, I support House Bill 867 because it benefits medical schools. We teach medical students the value of evidence-based medicine, but if our medical schools are exempt from collecting evidence on medical student depression, how can we evaluate student mental health? How will we know the impact of medical school wellness programs? The psychological well-being of Missouri medical students is just as important as their academic performance. This bill finally gives us the data we need to properly care for and educate the future physicians of America.

On behalf of all medical students nationwide, I thank you for your support.

medical student depression

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor.

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