'Burnout among medical students isn’t just an individual problem; it’s systemic.'
I was just at the AAMC [Association of American Medical Colleges] meeting this past week and Darrel Kirch, the president and CEO of the AAMC, was giving his final address. He actually talked about one of the crises in medicine, and that is burnout, depression and suicide among physicians at all levels—from student, to resident, to attending.
Dr. Tutty and Dr. Buckley both talked about the high risk of depression, burnout and poor work-life balance. All ages, stages—challenges are not unique. Nurses and other health care professionals also have significant issues around this.What I find interesting is that most medical students report to medical school with high quality-of-life scales, lower depression symptoms, those type of things. I remember the altruistic medical student that I was in the first three months.
What are the stressors for medical students? Well, getting into medical school. The imposter syndrome. The feeling of: “My God, the admissions committee must have made a mistake. What am I doing here?”I mean, it's all about for the first time in your life you're not in the top 10% of your class. You might actually be in the bottom half of your class. Can you imagine that? Keeping up, test anxiety, having the right stuff, do I belong here, stigma and reluctance to ask for help.
Now, the industry is realizing that physicians that are not happy—that are burned out—they actually produce less, they make more errors, their satisfaction scores, patient reviews and all that type of thing. It's like, “Whoa, hey, we've got to score high on our scores. Maybe we ought to actually do something about it.”Where physician burnout starts—and how to help stop itWell, this is what happened to us.
Went to his church that weekend where again his churchmates—it was a young church—his churchmates were all talking about he was the one that was always checking in with you. He was always the one that was concerned about you. Apparently, he couldn't do that for himself, and so obviously, it hit us like a ton of bricks. We just couldn't believe that this had happened to us. I'd always bragged about how we have happy medical students. We have a happy medical school.
It was amazing watching the interactions, and so we've tried to get people out of their offices, and out of their classrooms, and out of their programs in order to do that on a regular basis with wellness events. Whether it be ice cream socials or yoga in the atrium or whatever it might be. ... We've had learning communities that students will participate in that I consider it their homeroom—someplace where they can go and each of the learning communities has a kitchen and has four small group rooms where they can do individual study. They can get together, they can do the type of things we're trying to build the community that we want.
Stress... is anything that causes you to need to react. It's distress. That is stress, that's overwhelming to you, that causes you to break down. As you heard from my bio, I was in the military for a whole lot of years. We talked about stress fractures and stress issues and how do they happen? We'll it's from overloading a bone that's not ready to be overloaded.
What contributes to resilience? Basically, what your mother said: taking care of yourself, exercise, sleep, nutrition, mental exercise, humor, taking away time from work, having passion, having purpose, optimism. Are you a half full, half empty person? Having people smile at you, as suggested, is really a good thing. Face your fear, understand what it is.
Let's talk about the good things that happened today as opposed to focusing on the negative. Fearing change, welcoming change, kind of the idea of the Darwinism issue is we have to learn to change. We have to learn to adapt.This is the message you were trying to take to our medical students all the time and to our staff and our faculty too is: be a friend, work with others, avoid isolation.
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