Question:
Medical school and residency can be tough physically, mentally, and socially. What's the best way to get through those tough times when all I want to do is quit?
Response from Sheila M. Bigelow, DO
Resident Physician - Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio
Depression in Medical Students
Medical school and residency are some of the biggest challenges of our careers. Along with the good, exciting times come the hard, rough times. Long hours, little sleep, and a high-stress environment all create the perfect storm. These feelings can fall anywhere in the spectrum from burnout and depression to suicidal thoughts and suicide attempts.
In a study of more than 4000 medical students at 7 medical schools in the United States, 49.6% of participants experienced feelings of burnout and 11.2% had suicidal ideation. Another study, done at the University of Michigan Medical School, showed a prevalence of 14.3% for moderate and severe depression. Women had a higher rate than men (18% vs 9%).
Even more startling, this study found that those students who were moderately to severely depressed were more likely to believe that their peers would respect their opinions less and faculty would view them as unable to handle their responsibilities if their depression became known. First- and second-year medical students more often than third-and fourth-year students agreed with the statement that seeking medical treatment for depression would make them feel less intelligent.
As physicians and medical students, we are trained to interpret numbers, and these statistics are truly scary. Burnout, depression, and suicidal ideation are unfortunate parts of our training, but they don't have to lead to tragic consequences. First and foremost, if you (or a friend) are feeling depressed or having thoughts about hurting or killing yourself, you must seek medical help. Many medical schools and hospitals have mental health programs for students and employees, and others can at least direct you to the proper resources. The notion that seeking help is not respectable or that it reflects badly on you is a ridiculous idea that we all should resist. We should seek to create an environment in the classroom, on the wards, and in the clinic that is supportive and educational, not demeaning and belittling, especially when it comes to mental health. We learn to take care of our patients both physically and emotionally, and we should also take care of ourselves and each other.
Staying Positive
When we are "feeling blue" but are not clinically depressed, it is still important to address those emotions in a positive way. Go for a run, take a walk; do anything that will get your body moving and switch your mind to something other than the Krebs cycle. Remember to eat nutritious food that will make you feel good from the inside out. (Don't worry, sometimes a little ice cream is okay as well!)
Figure out what it takes to perk yourself up. Is it reading a good book? Checking out some tabloid websites? Whatever it is, find something to do when the last thing you want to do is to read another medical chapter -- find something that offers some feel-good moments. It is not at all selfish or a waste of time to pay attention to how you feel and address those feelings in a positive way.
Surround yourself with a social net to catch you when you're having one of "those days." Step 3 may be right around the corner, but talking to your favorite aunt about what your crazy cousin wore to the 4th of July picnic will leave you refreshed and ready to attack those books. Family and friends who are not involved with medicine can be great help when you need to decompress and relax. We have all been to parties with just medical students and residents and know that most of the conversation revolves around medicine and work. My family and nonmedical friends know me outside the hospital and can offer a unique perspective on what is important in life and a view of life that doesn't revolve entirely around medicine. It's important to realize that, yes, your life is all-medicine-all-the time right now, but there is a world outside of the walls of the hospital or library.
That being said, sometimes you need your medical school friends or co-residents to support you through your first patient's death or other difficult medical career moments, because they have been there and they know what it's like. Going to a happy hour after a long day on the floors with your colleagues to blow off some steam is sometimes what gets you through the rough days. Ten years from now you won't remember your in-service training exam score, but you will remember the colleagues and friends who hugged you after the death of a patient who was close to you.
Focus on the Goal
With the hustle and bustle of medical school or residency, it can be hard to remember why you are doing all that you do. You can easily get lost in the hours you have spent at the hospital and forget about all the patients that you are helping. Finishing that discharge paperwork a little quicker so that your oncology patient can make it to his last senior basketball game is worth the effort. Running behind in your clinic schedule to find that your 5-year-old patient used the waiting time to color a picture of Cinderella for you is why you do it. Examining the screaming 3-year-old who has a fever to correctly diagnose him with an ear infection and treat him appropriately is why you do it. You are working this hard to learn how to make people's lives better and make them feel well.
So, yes, it's hard. It's really, really hard sometimes. But allow those who love you to support you. Allow yourself to take a breather when you need it. Remember that you are not doing all of this for nothing, but for every patient you will take care of in your career.
Don't be afraid to seek help from mental health resources if you feel like you need it, and please listen to your friends and family if they suggest that you need support that they aren't able to offer you. By learning to help ourselves and each other through the tough times of training, we will learn more about ourselves and how much we can accomplish, and that we can accomplish so much more than we ever thought we could.
Medscape Med Students © 2013 WebMD, LLC
Medical school and residency can be tough physically, mentally, and socially. What's the best way to get through those tough times when all I want to do is quit?
Resident Physician - Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio
Depression in Medical Students
Medical school and residency are some of the biggest challenges of our careers. Along with the good, exciting times come the hard, rough times. Long hours, little sleep, and a high-stress environment all create the perfect storm. These feelings can fall anywhere in the spectrum from burnout and depression to suicidal thoughts and suicide attempts.
In a study of more than 4000 medical students at 7 medical schools in the United States, 49.6% of participants experienced feelings of burnout and 11.2% had suicidal ideation. Another study, done at the University of Michigan Medical School, showed a prevalence of 14.3% for moderate and severe depression. Women had a higher rate than men (18% vs 9%).
Even more startling, this study found that those students who were moderately to severely depressed were more likely to believe that their peers would respect their opinions less and faculty would view them as unable to handle their responsibilities if their depression became known. First- and second-year medical students more often than third-and fourth-year students agreed with the statement that seeking medical treatment for depression would make them feel less intelligent.
As physicians and medical students, we are trained to interpret numbers, and these statistics are truly scary. Burnout, depression, and suicidal ideation are unfortunate parts of our training, but they don't have to lead to tragic consequences. First and foremost, if you (or a friend) are feeling depressed or having thoughts about hurting or killing yourself, you must seek medical help. Many medical schools and hospitals have mental health programs for students and employees, and others can at least direct you to the proper resources. The notion that seeking help is not respectable or that it reflects badly on you is a ridiculous idea that we all should resist. We should seek to create an environment in the classroom, on the wards, and in the clinic that is supportive and educational, not demeaning and belittling, especially when it comes to mental health. We learn to take care of our patients both physically and emotionally, and we should also take care of ourselves and each other.
Staying Positive
When we are "feeling blue" but are not clinically depressed, it is still important to address those emotions in a positive way. Go for a run, take a walk; do anything that will get your body moving and switch your mind to something other than the Krebs cycle. Remember to eat nutritious food that will make you feel good from the inside out. (Don't worry, sometimes a little ice cream is okay as well!)
Figure out what it takes to perk yourself up. Is it reading a good book? Checking out some tabloid websites? Whatever it is, find something to do when the last thing you want to do is to read another medical chapter -- find something that offers some feel-good moments. It is not at all selfish or a waste of time to pay attention to how you feel and address those feelings in a positive way.
Surround yourself with a social net to catch you when you're having one of "those days." Step 3 may be right around the corner, but talking to your favorite aunt about what your crazy cousin wore to the 4th of July picnic will leave you refreshed and ready to attack those books. Family and friends who are not involved with medicine can be great help when you need to decompress and relax. We have all been to parties with just medical students and residents and know that most of the conversation revolves around medicine and work. My family and nonmedical friends know me outside the hospital and can offer a unique perspective on what is important in life and a view of life that doesn't revolve entirely around medicine. It's important to realize that, yes, your life is all-medicine-all-the time right now, but there is a world outside of the walls of the hospital or library.
That being said, sometimes you need your medical school friends or co-residents to support you through your first patient's death or other difficult medical career moments, because they have been there and they know what it's like. Going to a happy hour after a long day on the floors with your colleagues to blow off some steam is sometimes what gets you through the rough days. Ten years from now you won't remember your in-service training exam score, but you will remember the colleagues and friends who hugged you after the death of a patient who was close to you.
Focus on the Goal
With the hustle and bustle of medical school or residency, it can be hard to remember why you are doing all that you do. You can easily get lost in the hours you have spent at the hospital and forget about all the patients that you are helping. Finishing that discharge paperwork a little quicker so that your oncology patient can make it to his last senior basketball game is worth the effort. Running behind in your clinic schedule to find that your 5-year-old patient used the waiting time to color a picture of Cinderella for you is why you do it. Examining the screaming 3-year-old who has a fever to correctly diagnose him with an ear infection and treat him appropriately is why you do it. You are working this hard to learn how to make people's lives better and make them feel well.
So, yes, it's hard. It's really, really hard sometimes. But allow those who love you to support you. Allow yourself to take a breather when you need it. Remember that you are not doing all of this for nothing, but for every patient you will take care of in your career.
Don't be afraid to seek help from mental health resources if you feel like you need it, and please listen to your friends and family if they suggest that you need support that they aren't able to offer you. By learning to help ourselves and each other through the tough times of training, we will learn more about ourselves and how much we can accomplish, and that we can accomplish so much more than we ever thought we could.
Medscape Med Students © 2013 WebMD, LLC
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