Medical Education’s Dirty Little Secret

Mental illness in medical education is not often talked about, but is rampant. I had recently read an article, which I unfortunately cannot find, about a dean of a medical school giving a grand rounds detailing his own struggles with depression and addiction. The article detailed his surprise that his colleagues gave him a standing ovation, as he kept quite for many years in regards to his mental illness. I was excited to see that finally CNN publicized a study published in 2016 by Dr. Rotenstein et al. in JAMA which was a meta-analysis of depression rates in medical students all over the world. The study is disturbing. Medical students are four times as likely as the general population to be depressed (27% of students were found to be depressed), with suicidal ideation present in about 11%, with those seeking help only 15%. Of note, many of the studies in the meta-analysis found up to twice as much depression in female students as compared to male students. It is unclear if this is due to higher rates of reported depression in females in general or if this is due to some systemic gender biases encountered in medical education. The study did not suggest ways of tackling depression in medical training as well as clear reasons as to why depressive symptoms are so prevalent. I do find it upsetting that there have been studies done to assess if interns working <24hr has an impact on patient outcomes but there has been little to assess how decreasing duty hours impacts resident’s wellbeing. There has been no systematic study determining what type of schedule will be least distressing to residents while still meeting the necessary educational requirements. I hope medicine will show some compassion towards its young physicians.

  1. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical StudentsA Systematic Review and Meta-Analysis. 2016;316(21):2214-2236. doi:10.1001/jama.2016.17324

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