Trigger Warning: suicide and depression
In the wake of a sharp increase of lives being taken too soon due to the mental health of future physicians not being prioritized, I feel it is especially important to highlight the struggles of students attempting to enter healthcare careers. At Saint Louis University alone, there were at least three suicides on campus that the general population was made aware of. While the increase in suicide can often be blamed on the increase in depression due to the COVID-19 pandemic, it is clear that students wanting to enter healthcare can be more susceptible to depression and suicide.
Speaking from my undergraduate education experience, students hoping to enter a healthcare profession are expected to succeed in classes, which are commonly referred to as “weed out” classes designed to fail a large percentage of students, volunteer in multiple community outreach programs, hold leadership positions in clubs and also develop into an interesting person with a multi-faceted personality intriguing enough to hiring organizations or medical school admissions committees. Despite the best intentioned professors, many of which I have been fortunate to have at SLU, some of the classes end up being weed out classes purely based on the content, and that is taking into consideration that professors will widely curve a class to try to pass more students. I can attest to this based on several curves that I have seen in my pre-requisite classes for medical school, including but not limited to the sequences of general and organic chemistry as well as microbiology.
I do not say any of this to complain about the predicament that aspiring medical students are in. As a whole, these students have chosen to pursue this career with the knowledge of all of these drawbacks, and I am no exception to this generalized statement. However, there is a very real conversation that should be had when considering all of these things, one about the mental health of the students pursuing a career in medicine.
In the past few years, the number of aspiring medical students committing suicide has increased dramatically. Whether this can be blamed on the COVID-19 pandemic or the lack of mental support of students is not vital to the point. The real question lies in why students are committing suicide more and why nothing is being done about it.
The lack of change can easily be disregarded by program directors and professors maintaining the same standard from years previous. There is a saying, “If it ain’t broke, don’t fix it.” While this sentiment is generally agreeable, when is it time to say that this system of future medical professionals is broken? How many students need to be placed in this frame of mind before we start genuinely looking for the root cause of their mental health and imposter syndrome struggles?
As an individual with no experience in medical school or residency, I cannot speak to the system that leads to the severely lacking mental health of students. However, I can address the issues that perpetuate the declining mental health of Pre-Med students during their undergraduate education.
The undergraduate curriculum for future physicians is difficult in itself, but there are external factors that make the situation even more strenuous. Despite some faculty’s best effort, there is still a competitive nature amongst students due to the desire to set the curve in the class. Moreover, some professors unintentionally bolster this competitive spirit by not providing a set curve for the class at the beginning of the semester. This has happened in many of my Pre-Med and engineering courses where a curve is promised at the end of the semester, but never clearly addressed until final grades are in. This lack of transparency has caused many students, myself included, to wonder where they truly stand in regards to a class. And in classes filled with overachieving individuals that are overly cautious about grades due to the competitive nature of medical school applications, this can lead to fierce competition that contributes to deteriorating mental health.
This competitive nature leads to a lack of empathy towards peers and an unwillingness to aid classmates in their studies. I have found that this toxic behavior of Pre-Med students encourages a lone wolf type of studying behavior amongst students to avoid the competition from peers. In my experience, there does not appear to be a middle-ground between the exclusion due to lack of merit and exclusion due to being perceived as peer competition. Thus, I have found it best to undergo the struggles of Pre-Med classes in solitude to avoid this behavior. And while I have generally succeeded and learned the merit of teamwork in extracurricular activities, this method of coping is not always beneficial to Pre-Med students.
This streak of competition between students becomes even harsher as application cycles turn the corner. Instead of being helpful and sharing personal anecdotes from failed experiences, students typically want to avoid sharing information that could benefit their peers in order to ensure their personal success. From my own application cycle, I have heard of students lying to peers about the number of interviews they received early in the application process as a way to distinguish themselves from the group. Not only is this cruel of students, but it produces a sense of inadequacy in other applicants. To avoid this cruel system, some applicants, myself included, resort to isolating themselves from their fellow applicants, which again, isn’t beneficial for one’s mental health.
There is something to be said about the cut-throat nature of aspiring physicians and how their actions do not align with the mission statement of any medical school or residency program. However, there appears to be no repercussions for this behavior as many of the students end up matriculating at schools in the fall.
Given that these attributes are propagated throughout undergraduate education, there is a necessity to change this thought process. Instead of hiding study materials from other students, there should be a willingness to share resources. As opposed to not sharing the pitfalls of the application process, Pre-Med students should support and be transparent about their experiences with their peers. I have participated and utilized many programs to aid in the application process. From receiving mentoring from current medical students to serving as a mentor for students going through the committee process, my first hand experience has given me a great insight into how important it is to give back to the next generation of physicians.
The toxic ideology of undergraduate Pre-Med education can result in a new generation of doctors that are unwilling to help their peers and suffer from extreme amounts of imposter syndrome if allowed to continue growing without consequences. Furthermore, a lack of genuine conversation has produced an unattainable viewpoint of what a future physician should have in their application to be accepted into medical school. As a result, perfectly suitable applicants have withheld submitting their application due to preconceived notions that their application is not good enough to secure admission to a medical school.
While there is nothing wrong with holding our future physicians to high standards, there is no need for the consistent peer manipulation that ultimately results in some medical school hopefuls falling into deep bouts of depression. Instead, future medical students should aim to support themselves and others. The goal should be to care for peers the same way a physician cares for patients. After all, self-care is more important than healthcare, and caring for others is more important than medical school acceptance.