How This Medical School Is Making Training More Compassionate
Tragedy sparks important changes.
It’s no secret that medical schools, and the medical field in general, are facing serious problems with stress, burnout and depression among doctors and physicians-in-training. Now one medical school is taking initiative to actually address these issues. After a 27-year-old medical student at the Icahn School of Medicine at Mount Sinai jumped to her death last summer (a few months after a medical resident at the institution took her own life), the school is making important — and overdue — changes in the name of mental health.
In an essay published in the New England Journal of Medicine and expanded up on in this Wall Street Journal piece, dean for medical education David Muller explained the massive challenges facing medical students. He says, “Medical school is a cauldron,” adding that residents “feel very often helpless and hopeless, the machine is intense and churns on relentlessly.” Icahn is far from the only school facing these problems though: As the WSJ highlights, two other doctors-in-training committed suicide at other New York-area medical schools in 2014. “We are all in the same very, very, scary boat,” Muller told the WSJ.
Before you assume that medical students — a notoriously high-achieving bunch — are simply more stressed because they’re wired to aim for perfection, consider this: Liselotte Dyrbye, professor of medicine at Mayo Clinic in Rochester, MN, tells WSJ that it’s medical school itself that seems to cause problems. “We found at admission that the kids look fine,” she says. “It is as if they go through our training process, and they develop worsening mental health.”
Icahn has formed a task force full of medical students, fellows, residents and faculty members focused on three specific problems facing students: mental health, physical health and the psychologically demanding academic environment they’re thrust into. They’ve looked into making it easier for medical students to access mental health services by finding providers who’ll offer reduced rates and instituting regular mental-health check- ins (which students could choose not to participate in), according to the WSJ. To reduce academic pressure, the school has changed it’s system so more students can achieve the ranks of “honors” and “high-pass,” and may one day do away with these distinctions altogether.
We’ve written before that more humane hours and expectations for doctors benefit patients too, and Arthur Caplan, a bioethicist at the NYU School of Medicine, agrees, according to the WSJ. He explained in a video posted to Medscape that burned-out doctors may be more likely to make mistakes.
If doctors-in-training can be taught and encouraged to prioritize their personal well-being early on, they’ll not only be more likely to get through med school mentally intact, but to keep those priorities up as they go into residency, another notoriously difficult stage. Muller phrases the goal in hearteningly humane terms too: “The same kind of compassion and humanism we are teaching them to show patients,” he tells the WSJ, “they should be showing each other and we should be showing them.”