We are training men and women to be competent and confident doctors and want them to treat their patients with kindness and compassion, for this is the kind of doctor we want to have for ourselves, we want to be for others, and that our profession needs. But is this the way we are treating them as medical students? How is medical school affecting our students?
The Australian Beyond Blue study looking at wellbeing amongst medical students says it all. Students self-reported high rates of minor psychological disorders (47% women, 36% men); these figures are higher than those reported by qualified doctors. Using the K10 measure of psychological wellbeing, 1 in 4 students scored in the high or very high psychological distress bracket. These figures were higher for female than male students, higher for rural students, for students over 25 and indigenous students. 1 in 5 students reported having suicidal thoughts over the previous 12 months. 1 in 2 students reported emotional exhaustion and 1 in 4 reported cynicism. These figures from Australia, shocking as they are, reflect those reported across several first world countries. What do these figures mean in reality?
Each one of these statistics is a man or woman whose dream is to be part of our profession and to care for people, and who has studied hard and made sacrifices, simply to get into medical school.
At entry to medical school, students do not score differently on psychological testing to other students or the general public, so what is happening in medical school and more importantly what can we do about it?
There are many factors contributing to medical student stress, but a significant part of the problem is medical training itself. We would like to explore how medical training could change if the foundation to that training lay in recognising that love and compassion are as integral to training as they are to Medicine itself.
After all, our aim in medical teaching is to train confident and competent doctors who work with care and compassion. Doctors suffering from even “minor” psychological distress are less likely to perform well and less likely to be able to care for themselves so that they are fit and able to fully care for others.
We need to carefully analyse the causes of medical student distress and make the necessary changes. Medical training is costly, and our young doctors are a precious commodity; let us treat them with the tender loving care we all deserve and need.
By Dr Jane Barker and Dr Anne Malatt