“Medicine is not for the faint of heart.” As pre-medical students, we repeat this to ourselves daily to push through the nearly impossible expectations required to get into medical school. We tell ourselves that if we take a break—even for a week or two—from the many activities, difficult classes, and jobs we are involved in, we are not strong enough to continue in the field of medicine. After all, acceptance rates to medical school are extremely low, and the reality of life after getting into medical school just becomes more challenging. For instance, medical students are under continued pressure to perform well and keep up with activities such as jobs, shadowing, research and service in order to match into competitive residency programs. Then medical “residents in America are expected to spend up to 80 hours a week in the hospital and endure single shifts that routinely last up to 28 hours”, according to The Atlantic.
It is due to these extreme pressures during school and continued pressures during residency and beyond, that students at various stages in the medical field suffer from mental health issues including suicidal ideation, as was the case with first-year resident Dr. Jing Mai. In early September this year, Mai took her own life following feelings of anxiety, inability to sleep, and feelings of inadequacy in her residency program, according to her partner Justin Tang’s Instagram post.
A close friend of Mai, Dr. Phat Tan Nguyen, also expressed his deep grief in a Twitter post while discussing the conditions that led to Jing’s suicide, including his thoughts that reform in residency can prevent suicides like this. These posts sparked a larger conversation across social media between medical students, residents and physicians about the lack of attention to mental health in the medical field. While this topic is trending on social media right now due to current events, this issue is not new. According to an article by Mental Health First Aid called “When Medical Professionals Face Mental Health Issues”, “nearly one in three doctors is clinically depressed, and approximately 400 physicians take their own lives every year. These numbers are doubled compared to that of the general population.”
Considering these high rates are considerably unique to the field of medicine, it is fair to say that there are aspects of this field itself that foster poor mental health outcomes for medical students and physicians. This is exactly what Dr. Jonas Attilus discusses in his article “Remember Dr. Jing Mai On National Physician Suicide Awareness Day”. Dr. Attilus writes that while he acknowledges the biological components that lead to mental health issues, he believes “we need to question the culture of medicine as well as the learning environment.” He continues on to say, “The individual may be suicidal, and the environment homicidal.”
Curious to hear other physicians’ perspectives on this, I reached out to Dr. Monika Sanghavi, Associate Professor of Medicine in the Department of Cardiology at the University of Pennsylvania. She recounted her feelings of isolation and anxiety while in medical school and the immense sacrifices she made when working as a doctor while transitioning into life as a new mom of a 6-month-old.
While Dr. Sanghavi made sure to express that she loves her profession and patients, she also shared, “I think as a profession we need to find a way to ease the burden and pressure on the learner/trainee/physician so we don’t keep losing incredible individuals prematurely and unnecessarily. Dr. Jing Mai’s untimely and tragic death is just a recent reminder of this fact.” In a field where we are told to “be strong” and that feeling inadequate, overwhelmed, sleep deprived, and exceedingly stressed are normal, it is difficult to admit to having mental health issues or outwardly discussing them. At the heart of medicine is service and tending to the needs of others, but it seems that medical students and professionals are ignored in that process at alarming rates when they face challenges of their own.
It is disheartening to watch medical professionals pour their lives into this field only to face immense internal pain in the end. However, as Dr. Nguyen expressed in his Twitter post, with cultural changes within the medical community, mental health issues like this can be prevented. We can learn from Tik Tok content creator Riya who wrote a response to Jing Mai’s suicide with a story of her own. She discusses her own struggles with suicidality during medical school, but unlike Dr. Jing Mai and many other doctors who lose their lives to suicide each year, she is still with us today and uses her story to share what helped her decide not to take her life. After learning what helped her the most, I have narrowed down a few takeaways that are relevant and useful for everyone in the medical community. I also talked with Saikeerthana Chodavarapu, a first-year medical student at VCU School of Medicine, who shared what has helped her mental health the most during medical school so far.
- Recognizing when to take a break, and that taking a break is healthy, is lifesaving. In her article, Riya said, “I got a medical leave and spent months and months in PHP and IOP psych programs confronting my childhood trauma and picking up the pieces of a person I no longer recognized.” Although taking breaks is highly stigmatized in the medical field, it is an important skill that everyone from pre-medical students all the way to practicing physicians can learn.
- Support from family and friends is crucial to improving medical students’ mental health. Riya attributes much of the opportunity she had to recover to her mother, who she says “put her pride aside to take care of her daughter”.
- We should look out for our peers and colleagues. Riya writes, “You do not know the internal struggle they might be going through.” Sai also discussed how relationships between medical students who look out for one another are extremely helpful: “Even now I still talk to my parents, my friends, my sister—people I already had in my corner and will always have in my corner—but it’s cool seeing how close I am getting to my fellow medical students. It’s different because they understand what we’re going through. If I didn’t have that support, it would be really difficult.”
Dr. Jing Mai must not become just another name we read on the news or scroll by on social media. It is the responsibility of each one of us to create a healthier culture in the medical field and to actively support our future physicians and the ones we already have. Physicians make it their life’s mission to take care of people. It’s time we create an environment where they are empowered to take care of themselves too.