Two more and counting: Suicide in medical trainees

May 16, 2018|Psychiatry

In the immediate aftermath of suicide, feelings run high, as they should. But rather than wait it out – and fearing a return to “business as usual” – let me make only two suggestions:

1. We need to come together and talk about this – medical students and residents and training directors and deans. A town hall forum would be ideal. Although there are amazing innovations on wellness emanating from the Association of American Medical Colleges and Accreditation Council for Graduate Medical Education, many current medical students and residents feel frustrated – “This is taking too long” or “This is top down and being imposed on us” or “What about our voices … don’t they count?” Although students and residents have representatives on faculty committees, feedback is not universal, and not all residents believe that their senior peers truly convey their concerns to those in power. They want to be present at the table and speak for themselves. Too many do not feel they have a voice.

2. In psychiatry, we need to redouble our efforts in fighting the stigma attached to psychiatric illness in trainees. It is unconscionable that medical students and residents are dying of treatable disorders (I’ve never heard of a doctor dying of cancer who didn’t go to an oncologist at least once), yet too many are not availing themselves of services we provide – even when they’re free of charge or covered by insurance. And are we certain that, when they knock on our doors, we are providing them with state-of-the-art care? Is it possible that unrecognized internal stigma and shame deep within us might make us hesitant to help our trainees in their hour of need? Or cut corners? Or not get a second opinion? Very few psychiatrists on faculty of our medical schools divulge their personal experiences of depression, posttraumatic stress disorders, substance use disorders, and more (with the exception of being in therapy during residency, which is normative and isn’t stigmatized). Coming out is leveling, humane, and respectful – and it shrinks the power differential in the teaching dyad. It might even save a life.

Dr. Myers is a professor of clinical psychiatry at State University of New York, Brooklyn, and the author of “Why Physicians Die by Suicide: Lessons Learned From Their Families and Others Who Cared.”