I just read the piece in the New England Journal of Medicine… another medical student died. What a waste of talent.
This was “Second Look Weekend” at Yale, as at many medical schools across the country. As a member of the admissions committee, I was honored to be part of this event where students, staff and faculty try to woo the best and brightest talent choose our medical school over the many other options these top candidates have to choose from. I’m always amazed at the talent pool who get in to Yale Medical School each year. These students are not only brilliant, but caring, and full of potential. They lead orchestras, have played on national level sports teams, have started NGOs that are doing amazing things, and have worked in labs furthering the future of science and medicine.
And then, we hear that another one of these amazing individuals has ended their lives too early…. Long before they have had the opportunity to realize their true potential.
Some (in my view, the misguided few) may feel that these students were “weak”, that they “couldn’t take it”. They argue that medicine is a tough field, and medical school is preparatory for life thereafter. It is true that our time in training is the wondrous universe that peaks our interest in our chosen fields and lays the groundwork for our academic and professional futures. It is also true that burnout is common, not only in training but also amongst the medical workforce. But the answer is not that we should make medical school replicate the harsh drudgery of what is, for many, the reality of medical practice today. Rather, I would argue, what is required is a fundamental culture change.
What if physicians were happy? What if they embraced healthy lifestyles, supported each other, worked in enabling environments that celebrated team accomplishment? What if, instead of the constant pressure of producing more RVUs for less money, spending more time connecting with computers instead of with patients, medical practice reinvigorated those ideals that enticed us all to go into this field to begin with? And what if in medical school, residency and fellowship, our trainees were exposed to that environment? What if people were not constantly put down, but rather lifted up? Could we reduce physician burnout, improve engagement and stop the suicide epidemic?
Every year, 400 physicians commit suicide. Nearly 10% of trainees have thought about it in the last two weeks. I would argue that we have a choice in the environments we create in our academic medical centers. Will we create an oasis where our finest trainees are nurtured and flourish to become the next generation of physicians and scholars? Or will we embrace a dog-eat-dog hostile environment where we cannibalize our young? To be clear, this difference is not simply a “wellness center” or a website advocating psychological help so we can check the box for accreditation purposes. We require fundamental culture change. We need to set an example, and it needs to start at the top. How much do we tolerate negative behaviors that create a toxic environment, whether for our faculty or for our trainees? How much do we actively create a positive milieu of team spirit and higher purpose? Culture change is not easy… but the loss of talent from suicide, burnout, and plain old disengagement is a problem that needs to be fixed, and one that is well worth the effort.