Icahn School of Medicine works to change its academic culture following dean's letter on student's suicide

Officials at New York City-based Icahn School of Medicine at Mount Sinai are on a mission to change the academic and behavioral cultures at the medical school following the death of a fourth-year medical student last fall, according to The Wall Street Journal.

In a letter published in The New England Journal of Medicine last month, David Muller, MD, dean of medical education at the Icahn School of Medicine, commented on the immense pressures that often leave medical students feeling helpless and burned out. His letter was in response to the death of 27-year-old Kathryn Stascavage, a fourth-year medical student at the school who committed suicide in August.

Dr. Muller, along with roughly 30 faculty members, medical students, fellows and residents, took part in a task force to examine and remedy various cultural aspects at the medical school. The group was split up to address three areas: mental health, physician well-being and the academic learning environment, according to the report.

Dr. Muller said the school has already begun to implement one of the task force's recommended changes to its academic culture. The group discovered one of the leading sources of anxiety for students was the high-stakes grading system. The school had a quota system in place for each class, which limited the number of third- and fourth-year students who could obtain an "honors" or "high pass" distinction to 25 percent each. The other 50 percent would receive a "pass" grade. The system promoted intense competition among students, according to the report. Following the task force's recommendation, officials altered the quota system, allowing one-third of students to be eligible for each of the "honors," "high pass" and "pass" distinctions. Dr. Muller said officials hope to eventually create an educational system that will drop the quotas all together, according to the report.

Other changes the school is working to implement include making it easier and cheaper for students to consult a therapist and for students to have regular mental-health checkups with the option of opting out if necessary. Officials are also working to allow students to take a break from their work and meet with trusted peers and faculty to discuss stressful incidents such as the death of a patient.

Dr. Muller told The Wall Street Journal he hopes the tragedy will inspire significant change to the medical school culture not only at Mount Sinai, but across the U.S. "The same kind of compassion and humanism we are teaching them to show patients, they should be showing each other and we should be showing them," he said.

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