October 27, 2010
According to The New York Times, although decades of past research has shown that physicians have higher rates of suicide than the general population, two recent studies published in The Journal of the American Medical Association offers new information about distress among medical students.
The first study found that when medical students felt distressed, more commonly referred to as burnout, they were more likely to engage in unprofessional behaviors. AAFP News Now reported that a survey of 2,682 medical students from seven U.S. medical schools found that students rarely engage in academic dishonesty; however, when they experienced burnout, they were more likely to short-cut patient care, such as skipping a physical examination, but still reporting the findings as normal. HealthDay News reported that 52.8 percent of respondents had burnout.
Additionally, AAFP News Now stated that the survey also found that burnout often resulted in lower altruistic views about their responsibility, as physicians, to society.
"Students feel emotionally, physically and mentally worn down," said George Harris, M.D., M.S., of Lee's Summit, MO, assistant dean for year 1 and 2 medicine at the University of Missouri-Kansas City School of Medicine and professor of medicine in the school's department of community and family medicine. "They feel emotionally and mentally displaced from those around them. They are in survival mode."
The other study found that depressed medical students felt less worthy and less valuable. According to HealthDay News, researchers surveyed 769 students at the University of Michigan Medical School. Of the 505 responses, 14 percent reported having moderate or severe depression.
Interestingly, most students did not want to seek help. Although these students were more likely to know what they were suffering from and what kinds of treatments were available, more than 80 percent feared that reporting symptoms of depression would cause faculty members to lose faith in them.
Dr. Thomas L. Schwenk, author of the study and professor at the University of Michigan, explained that the competitive nature of medical school "causes students to feel like they have to be perfect. If they're not, they feel vulnerable and less worthy." As The New York Times pointed out, many students fear that others will perceive depressed students as less competent. Furthermore, this can also have negative effects on patients. "If this is the way that students view each other, how do they view their patients who are depressed or struggling with mental illness?" questioned Dr. Schwenk.
Both studies suggest that more needs to be done to support the emotional well-being and psychological health of medical students. "It is important to identify students early in their medical education who are experiencing signs of depression, unresolved parental separation, academic difficulty, limited peer interaction, poor coping skills and personal difficulties," said Harris to AAFP News Now. Dr. Liselotte N. Dyrbye, lead author of the first study and associate professor of medicine at the Mayo Clinic in Rochester, MN, also told The New York Times, "Until we know what really helps them and what works best, our learning environment will continue to eat away at our students' empathy and altruism."
Compiled by CityTownInfo.com Staff
"Depressed Med Students Seem to Fear Stigma More Than Most," healthday.com, September 14, 2010, Randy Dotinga
"Medical Student Distress and the Risk of Doctor Suicide," NYTimes.com, October 7, 2010, Pauline W. Chen, M.D.
"Unprofessional Conduct Among U.S. Medical Students Linked to Burnout, Study Finds," aafp.org, October 26, 2010, Barbara Bein