“The life so short, the craft so long to learn.” ~ Hippocrates
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This past week, I read an article by André Picard in The Globe and Mail, Suicide should not be an occupational hazard for doctors, where he shone a light on the harsh reality of suicide and medical students. Coincidentally, I had the pleasure of having a conversation with a first year medical student about physician health and wellness shortly thereafter. These two factors led me to ponder on my own time as a medical student, many years ago.
Having completed medical school in 1998, and residency in 2000, the world of medicine was different than it is now, but in many ways the same. More awareness exists around the challenges of medical training but the culture hasn’t progressed to the degree I would expect and hope for. A persistent stigma exists where asking for help, or admitting you need help, is a sign of weakness. I and many others disagree – asking for help is a sign of strength.
My medical school experience
As you may know, I grew up in New Brunswick, Canada, amongst the undeniable friendly charm of the people of the east coast. My first time living away from home was during medical school at the beautiful campus of The University of Western Ontario in London. In addition to being a 20-hour drive or two planes rides away from home, I soon realized that it was a completely different world from what I was used to. For some first year medical students, the learning environment may be quite similar to either the undergraduate or graduate program they previously attended. They may have even attended the same university prior to medical school. For others, like myself, everything was new and unfamiliar. I don’t think anyone could have prepared me for such a harsh reality, especially after striving so hard to get into medical school. I was immediately overwhelmed!
Fast forward a few months into my first year. I was constantly anxious and stressed with the content and volume I was being taught and had to know. I no longer felt confident about either myself or my goals. It turns out ‘imposter syndrome’, is not uncommon, especially in high achievers among other high achievers. Maybe I am not smart enough to be a doctor? Maybe they will realize it? For most of us, falling from top of the class to somewhere below in medical school can be an insurmountable blow to one’s ego.
Even though at that time in my life I cared deeply about what other people thought (so detrimental), I was fortunate enough to have known humility in my life, and therefore, knew to ask for help. My anatomy teacher was such a kind authentic man and successfully tutored me through a good portion of the year. He has since passed away and I often think of him as he gave me two great gifts – time and confidence.
Change can only happen with awareness and open dialogue
As part of my work and passion for physician health, I purchased a video from the American Foundation for Suicide Prevention titled Out of the Silence. We often struggle in silence for fear of the stigma of asking for help, but a video such as this sheds light on how overwhelmed a lot of medical students are with both their training and lives in general. The video discusses a peer mentoring program which I believe is invaluable. There is always something to be said for a shared experience with others. It also makes reference to the fact that life doesn’t get simpler, it gets harder as a resident and even harder as a practicing physician.
My hope is that the culture of medicine will continue to evolve so that medical trainees will consider it a sign of strength to ask for help, where trainees will support one another and know that suffering in silence is not the answer. We need to start this conversation early so that it can continue throughout a physician’s career.
Next week, we will discuss tips for maintaining and protecting your emotional wellness during medical training.