Medical School Depression
I don’t know where MedPundit went to medical school, but her experience couldn’t be different from mine. Other med students, are you on my side or MedPundit’s? Comment below.
It shouldn’t be surprising – medical school is a crucible of change.
Students leave their homes, their families, their friends.
It’s definitely a big change, and not without its stressors, but most of us have gone through this before when we went to college. Clerkships are, without a doubt, lonely. It’s nice to be on a service with a classmate, but I barely see anyone these days. Just more encouragement for me to do a better job with time management and setting some time aside for a mild, tempered social life.
They lose the academic standing they had in college and high school, and with it sometimes, self-esteem and respect.
Yet another reason to make things pass/fail like we are here.
They see and learn things they’ve never seen or heard of before. They learn, in fact, a whole new way of being. It is a completely transformative process in a way that few other processes (except perhaps joining the military) are.
Absolutely, but what an amazing transformation it’s been! There’s good parts to it, and bad as well, but I think my mind has been made 100 times sharper.
It is not a pleasant process. I remember one of my medical school classmates describing it as “the shrinking of her soul.” The reasons for this are all those mentioned in the above article, with the exception of one glaring omission – the role of the teaching process. The third year of medical school, when students enter the hospitals and see patients, also marks the moment that their teaching is handed over entirely to practicing physicians – and they are brutal. The brightest and best students are treated as know-nothing scum and burdens to be born by the rest of the medical team. There is never, never, any praise – only denigration. At least, that’s the way I remember it, with few exceptions. It’s like being stuck in a House episode.
This sounds like some other world she’s describing. Are clerkships hard? Yes. Do some of them suck? Yes. Is there some degree of scutwork involved? Sure. Do they turn your view of medicine on its head, and teach you the frustration of paperwork, hierarchy, and difficult patients? Absolutely. There are definitely days where I feel down, feel like I’ve worked hard and haven’t felt appreciated. There are days that I think, “This is medicine? I seriously signed up for this?” But my soul is not shrinking, and the attendings are not brutal. I’m given praise by attendings and residents, my family and boyfriend, and I dole out some healthy self-praise, too. Do I feel stupid for not knowing things? Sometimes. Do I feel loved and needed by the attendings and residents? Not always. But more often than not, I feel like I’m respected as a member of the team, feel like I contribute and can teach residents and attendings things they’ve forgotten, and I get feedback that is constructive about how I can do a better job. It’s natural for me (and probably med students in general) to beat myself up over not knowing an answer to pimping session question, but that’s because we have such high self-expectations. I don’t think the attendings are purposefully trying to shrink our souls or denigrate us.
So, how do we get through it? Our hides grow a little thicker (or is it that our souls shrink?); and if we’re lucky we meet some good roll models along the way. But, at some point, we come to the realization that our teachers are not gods, but frail, flawed men and women with bad management and teaching skills.
My skin is definitely thicker after 2 months of surgery already, and I’m thankful for it; I’ve been through the worst already. I’m less intimidated, and more willing to just do my best, keep up on my reading, and accomplish the goals I have set for myself during the rotation. My attendings are not gods either, but they’re hard-working, incredibly intelligent men and women with somewhat-decent management and pretty good teaching skills.
Let the record show that I’m in between clerkships while writing this, and just finished a relatively low-intensity month on pediatric neurology. This is also not to say that there are no depressed students here; I know of several.
I have to agree with Grahamazon here … MedPundit’s experience was not mine either. My surgery and Ob/Gyn rotations – classically the most brutal – were quite benign. In fact, the attendings were some of the best teachers and generally pleasant people. The residents were tired and stressed, but never took it out on me. Nor did I witness any other med students getting berated.
The one time I did get a stern lecture was my very last rotation when I wrote a couple of sub-par notes on a patient I was following. I realized they weren’t great, and I should have probably rewritten them (they were written prior to rounds, so they didn’t reflect the discussion on rounds), so the critique was quite well-founded in my view. It wasn’t a personal attack, but a challenge to be the best student-doctor that I could be.
From some of her postings, it’s apparent that MedPundit practices in the Akron, Ohio, area. That makes it likely that she also went to school in Ohio. And that’s my explanation for her perspective of medical schools. To paraphrase Bart Simpson, I didn’t think it was possible, but Ohio both sucks and blows. (At least, that’s my opinion of the place:
http://www.livejournal.com/users/medipol/29938.html)
The most emotionally draining part of med school for me was in the middle of the winter of 2nd year. Despite not having gone for a run for a couple of days, I didn’t feel like going. Immediately, that rang alarm bells in my head — I was beginning to lose interest in something that I enjoyed.
(Granted, my lack of interest could have been related to the fact that it was 30 degrees outside, which makes running a little less fun.) But luckily, I did go running, and doing so made me feel better.
I was a little lost through my first couple of rotations, but once I started at the county hospital, I felt welcomed, included and appreciated for my contributions to the team. 3rd and 4th year were enjoyable, though not without occasional disappointing evaluations. But I cared more about the patient care I was delivering than proving to my team that I was a good little med student.
One of the times that should have been the most lonely — an away rotation in an unfamiliar city — was one of the most enjoyable. It was a blissful four weeks when I did my hospital duties, then was free to explore the area, drive the Pacific Coast Highway, read the news and just be with myself. Only in the last week did I wish I could have shared the pleasure with some of my suffering classmates back in Cleveland.
(Note: for the record, that blissful experience was at Grahamazon’s hospital, so it may just be that it is a wonderful place to be. Not every med student gets to have that experience.)
I found this article utterly ridiculous. Doctors are there to save lives, not sulk and get homesick. Sack up.
hey grahamazon, great site, want to link exhange or something?
-Joel [at] c1d1t1.com
I have to laugh here.
First of all, “anhedonia” is not a desire to sit on your ass and not run one cold, winter day…. it’s finding yourself surrounded by a lack of interest in everything, all the time. Everyday you don’t want to run, everyday you don’t want to read, everyday you don’t want to even walk outside and enjoy the sunshine – simply because it’s no longer enjoyable… nothing is enjoyable.
Secondly, depression and being “homesick” are not synonymous.
Clearly, everyone’s rotational (and classroom) medical school experience is different – whether it be in California (you smart, lucky bastards) or long-live-the-East-Coast Ohio. The point of the article, I believe, was not to be a spokes-person for 99.9% of the medical students; rather, it was to highlight the fact that depression is more common in medical school than one would believe.
Compassion is what will make us good doctors. Learn to look (and live) outside your own boxes. Just because you have Fabulous! rotations, Fabulous! attendings, and Fabulous! grades does not mean that every other single medical student is in the same boat. School can be rough, and a tendency towards a depressive personality can make it all the more difficult.
Sympathy is one thing… but empathy is another. The days I have lamented over why medical school was so rough for me are the same days that I have been thankful that I can be empathetic to others who have walked in my shoes – albeit a different setting.
But oh well… who cares about learning to be a well-rounded doctor – we all gotta put that sulking aside and just sack up, eh?!
So, “name required” means cybername!I’ll change mine. The stress of rotations has not changed since 1956. Med students sometimes need to intervene, or explain what arrogant specialist don’t to patients. Loss of souls? Except for the absence of women (10 of 160 in my class;6 graduated)the passel of dweebs that started began to look like competent caring physicians by the third year. Wehad a mandatory quarter of the 4th year with a small town GP, which really put reality instead of Ivy institutionalism in the mix.