Action Needed: Mental Health Care for Medical Students
Class rank, board exams, clinical rotations, research, budget balancing, and an occasional few hours of sleep and bites of food to stay afloat. Juggling even two of these responsibilities is a major feat for most people, yet medical students seem, and often manage, to pull it all off. One can only imagine what kind of grave effects doing so has on the body and mind of these individuals. It goes without saying that every profession comes with its own forms of stress, but medical students have consistently demonstrated a higher rate of mental illness onset than the general population . Society may be inclined to attribute this glaring discrepancy to the fact that mental health issues often pervade the most in highly competitive academic settings. However, researchers at the University of Pittsburgh have shown that this inconsistency is due to more than just that .
Medical schools and established physicians are constantly on the hunt for flashy new equipment to efficiently streamline procedures and simplify their professional lives. However, there is nowhere near a similar amount of monetary or humanitarian investment in developing mental health care initiatives that benefit these budding physicians who will go on to embody the future of medicine. Although the Association of American Medical Colleges outlined recommendations for providing mental health services to each medical education institution as early as 1992, research has shown that schools have routinely failed to allocate the resources needed to make this happen . How can we even begin to justify approaching 27 years of such oversight? When it comes to prioritizing mental health care, medical students are burdened by social stigma, lack of access to appropriate care, and minimal financial support, among many other factors. But these students are putting their lives on hold in numerous respects, from being absent for milestones of their loved ones to delaying the establishment of a family of their own, and many may eventually shape the way in which mental health care is administered, leaving no excuse for providing them with subpar health services during their educational commitment.
In April of 2017, a 4th-year student at Icahn Mt. Sinai Medical School jumped to her death from the top of a high-rise building, prompting significant discussion within the medical community as to what led her to do so and how this may be prevented henceforth . An immediate attribution was the inherently high academic pressure, which raised the proposition of demeriting MCAT and Step 1 exams that have conventionally been used to quantify the academic potential of rising and current medical students. Some medical schools are even trying to withdraw from the U.S. News and Report’s Annual Medical School Rankings so that the emphasis on academic performance is not as salient of a burden . As the saying goes, hindsight is 20/20, but it is encouraging to see that such retrospective reflection is occurring.
Financial stress is such a significant deterrent that medical students find themselves devaluing health care and, more specifically, mental wellness treatments. A considerable portion of minority medical students are on Medicaid insurance coverage, which is frequently not accepted by mental health therapists . Additionally, the extensive debt and low income of training doctors have been discussed frequently with respect to the gradually diminishing number of students that go on to become primary care physicians. However, the effects of these financial constraints on individual well-being, an arguably more important consideration, have been overlooked. Given such limiting financial circumstances, it is crucial that medical students are provided with mental health checkups that are affordable and covered by health insurance plans.
Robyn Symon’s recent film Do No Harm: Exposing the Hippocratic Hoax gives viewers a firsthand look at the grueling conditions imposed upon medical residents that often culminate in extreme sleep deprivation and contribute to the estimated 400 physician suicides annually . Though the training process appears to be the worst part of the journey for aspiring physicians, Symon raises the important point that the situation is no better when residency is over, as there is a constant pressure to see as many patients as possible and continually build your reputation as a competent doctor in your given specialty. Symon and the actors in her film promote a petition that calls for an increase in the number of residents in any given program, decreased hours for each resident, and routine confidential psychological evaluations by all medical institutions.
Evidently, success in mental health care provisions is multi-faceted, with numerous considerations, from cost to confidentiality to continuity, needing to be accounted for. As daunting as this feat may seem, it is no reason to shirk away from this responsibility without valiant effort. Medical students are often dedicated to this noble profession from the beginning of their undergraduate career, and occasionally even earlier, and are owed proper care and consideration with respect to their mental and physical wellbeing at the very least. They are some of the most talented and intellectual individuals who generally enter medical school with no detectable mental health issues whatsoever compared to many of their peers . Preserving their wellbeing in this respect and allowing them to become the capable doctors they set out to be should be of top priority for medical schools across the board.
Jordan Karp and Arthur Levine, “Mental Health Services for Medical Students - Time to Act”, The New England Journal of Medicine, September 27, 2018.
Allison Bond, “Medical student’s death highlights high rates of physician suicides”, ACB News, April 25, 2017.
Symon, Robyn (Director & Producer). (2018). Do No Harm: Exposing the Hippocratic Hoax [Motion Picture]. United States: Symon Productions, Inc.