Brian Bi - March 14, 2018
The adversities that come with the journey through the United States medical programs is never said to be an easy accomplishment. As students are endowed with masses of necessary assignments, the daily tasks of being a medical student involves more than just academic struggles. Students who enter their rightfully earned medical school programs are typically unaware of the impeding affects of depression or anxiety in which the U.S. medical school system entails. Each student is eventually met with personal and academic hardships when striving to reach the end of their program and that feeling of overwhelming pressure continues to escapade. The sad truth is that there are too many people feeling the need to take their own life due to the academics and the things they have to witness on a consecutive basis. Moreover, students feel the need to mask their mental health stability in order to avoid dire consequences within the medical field. These students who feel that they are unable to seek help due to other social and academic circumstances may harm themselves more due to psychological implications.
There is a high volume of medical students who in fact hide their mental illnesses due to, “multiple barriers that keep physicians and trainees from accessing mental health care—confidentiality concerns, time constraints, or uncertainty about whether treatment would improve things” states, Christine Moutier, MD, the Chief Medical Officer of the American Foundation of Suicide Prevention. Moutier explains that, medical students and physicians alike have been said to endure their personal issues in fear of being kicked out of their medical program and or future limitations of their professional licenses. This becomes an issue for not only the student or doctor but sub-sequentially their patients as well. Medical students and or physicians may show a social disconnection from patient- to resident and or patient-to-doctor due to the feeling of being burnt out or unmotivated to carry out their tasks to the best of their abilities. This results in a lack of adequate healthcare that could have prevented serious implications in their patients’ lives. Cheri Dijamco, a fourth year medical student at the UT School of Medicine in San Antonio, Texas, reported in 2015 that, “the pattern of unhealthy behaviors and thoughts persist into residency with 3⁄4 of residents [experiencing] burnout, leading to increased rates of medical errors and communication failures with patients.” Students and residents with the mentality of fear in receiving counseling or other alternative methods of treatment may inherently cause themselves to adopt habitual slack within their daily regimen.
Although there are some outlets for mental support engrossed within most medical universities, students continue to worry that records would be reported to medical licensing boards and critically hurting their odds of being licensed. Despite the American Disabilities Act of 1990 (ADA) that helped prevent medical schools and licensing boards from asking unnecessary questions pertaining to the history of one’s psychological instability, students continue to fear. This phobia continues to rise as statistics of U.S. medical schools and licensing boards have actually increased the amount of questions involving current mental illness and or substance abuse in pre-admission/ licensing tests that are administered within medical licensing boards. Sarah J. Polfliet, MD, in the article, A National Analysis of Medical Licensure Applications reports that, “compared with 1998, there has been a substantial increase in questions specifically asking if the applicant has any history of treatment (from 10% in 1998 to 56% in 2006) or hospitalization (from 2% in 1998 to 24% in 2006) for mental illness.” After the ADA was revised in 2010, the revision advised against asking direct questions pertaining to current and past mental illness in American medical schools and licensing boards. In contrast, these schools and boards are still able to ask if there are any psychological impairments keeping one from practicing their profession but in a broader context that doesn’t allow for discriminatory thoughts to arise from evaluators. Surprising enough, current reports show that most United States medical licensing boards still practice the use of these types of questions. Leah Samuel, writer for StatNews reported in 2017 that, “two-thirds of U.S. state [medical licensing applications currently] ask the broader form of the question(s) — despite the fact that groups including the American Medical American, American Psychiatric Association, and the Federation of State Medical Boards recommend against it.” With reports such as these continuing to escalate, students are left feeling the need to cultivate their distress inside a theoretical bottle. The bottle may continue to hold or eventually crack.
On another note, with personal issues always on the mind of medical students, academia, financial responsibilities, and social constraints can quickly cause an accumulation of depressive symptoms. And with the feeling of inability of obtaining the counseling and support needed, one can inevitably form suicidal ideation that may linger into postgraduate affairs. The American Foundation of Suicide Prevention (AFSP) published current statistics of death by suicide in physicians that had past history of untreated mental ailment that stemmed before or in medical school. The AFSP stated that, “an estimated 300–400 physicians die by suicide in the U.S. per year.” These statistics were based on medical professionals who felt overwhelmed with stress, anxiety, and depression. As talked about earlier, the fear of termination of education and or limitation of one’s medical license can inspire people to try and cope with their issues rather than seeking help. Also, as years go by and these issues are not sought out for treatment, it may be a waiting game before someone feels the need to take their own life.
On a side note, with new additions to the MCAT referring to the addition of more phycology and sociology information added in the revised version of the MCAT (2015), this addition begs the questions, “how will this affect the mental stability or instability of premedical students working for admission into a medical program?” and “How will this affect said admitted student in the future?”
Most importantly, with issues such as death by suicide caused from depression and or anxiety due to the more rigorous course load of med. school, pre medical students should be well informed of the actuality and challenges that are associated with the path of obtaining a medical license and after. In conclusion, one should critically assess their own psychological instability, seek help if needed, and if things are honestly too overwhelming, see if taking a break is possible and continue when the time is right. Although I am only a premed student and have not personally faced the same level of degree of mental hardship that medical and or post medical-grads have faced or are facing, I still believe the idea that one’s life is more important than financial burden to be a universal thought amongst others. One’s overall mental stability should be prioritized over anything else especially when there is always an outlet to a hard situation.
Lead Image : Pexels
References :
Dijamco, Cheri. “Staying Sane: Addressing the Growing Concern of Mental Health in
Medical Students.” AMSA, Amsasites, 8 Sept. 2015, www.amsa.org/staying-sane-
addressing-the-growing-concern-of-mental-health-in-medical-students/.
“Healthcare Professional Burnout, Depression and Suicide Prevention.” American Foundation for Suicide Prevention, AFSP, 23 Feb. 2018, afsp.org/our-work/education/healthcare-
professional-burnout-depression-suicide-prevention/.
Moutier, Christine. “Creating a Safety Net: Preventing Physician Suicide.” AAMCNews,
Association of American Medical Colleges, 29 Sept. 2016, news.aamc.org/medical-
education/article/creating-safety-net-preventing-physician-suicide/.
Polfliet, Sarah J. “A National Analysis of Medical Licensure Applications.” Journal of the
American Academy of Psychiatry and the Law, Journal of the American Academy of
Psychiatry and the Law Online, 1 Sept. 2008, jaapl.org/content/36/3/369.
Samuel, Leah. “Doctors Fear Mental Health Disclosure Could Jeopardize Their Licenses.”
STAT, Statnews, 16 Oct. 2017, www.statnews.com/2017/10/16/doctors-mental-health- licenses/.
Comments