Medical school dean writes touching letter about physician burnout after 4th-year medical student commits suicide

David Muller, MD, dean of medical education at the New York City-based Icahn School of Medicine at Mount Sinai, penned a touching op-ed in The New England Journal of Medicine addressing depression and burnout amongst physicians and trainees after a fourth-year medical student committed suicide in August 2016.

In the days following the incident, Dr. Muller said he couldn't "imagine what it must have felt like to be introduced to medical school with a suicide." He and his colleagues spent the next 48-hours putting 24/7 emergency mental health services in place and talked to students about the importance of self-care, reinforcing the notion the school "would care for them as people and teach them to do the same for their patients."

He said countless physicians and researchers from across the country shared research, data, their personal experiences coping with the suicides of medical students and condolences for the student's family and those at the medical school. The school also created a task force to brainstorm ways in which to improve students' well-being and to eliminate the stigma associated with asking for help.

But Dr. Muller said such plans fall short of addressing the root cause of physician burnout, depression and suicide — the "culture of performance and achievement that…begins in middle school and relentlessly intensifies for the remainder of their adult lives." He said every time a student achieves a significant milestone, he or she is faced with additional pressures to succeed or face feelings of failure and inadequacy.

"From their very first shadowing experience to their first foray in the lab; from high school advanced-placement courses and college admissions tests to grade point averages and the Medical College Admissions Test (MCAT); with helicopter parents, peer pressure, violins and varsity soccer, college rankings, medical school rankings, medical licensing exams and the residency Match, we never let up on them — and it’s killing them," Dr. Muller said.

He said to lessen the burden medical students face, the industry as a whole must commit to a paradigm shift in the way the industry defines performance and achievement and to "stop pretending that high scores on standardized exams can be equated with clinical or scientific excellence." Healthcare organizations, medical schools and hospitals must "ban together to change the culture [before]…another precious life is lost."

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