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Mithril

The Story Of Kathryn

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

 

...

 

- G

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

It's a good thing you went into dentistry.

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

Yeah... mental illness doesn't work that way.

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

Can't tell if being serious or being faceitous.

 

Counsellors at medical schools are pretty lack luster, and student affairs is often a game of lip service.

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

 

 

Are you joking?

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567765 successfully diverted the discussion from its merit.

 

The important point  in this unfortunate story is that one of the root cause of epidemic of burnout, depression and suicide is "a culture of performance and achievement that most of our [medical] students begin in middle school and relentlessly intensifies for the reminder of their adults lives...".

 

Sadly, Canadian medical schools greatly contribute to this culture.

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567765 successfully diverted the discussion from its merit.

 

The important point  in this unfortunate story is that one of the root cause of epidemic of burnout, depression and suicide is "a culture of performance and achievement that most of our [medical] students begin in middle school and relentlessly intensifies for the reminder of their adults lives...".

 

Sadly, Canadian medical schools greatly contribute to this culture.

 

How would we fix that - that is ultimately the point I suppose. We all know we have a system where vastly more people (even with our current very high requirements) apply than there are spots. That isn't going to change as it stands. That creates a bias from the get go - in order to achieve what is required to get in you have to have to at least manifest a certain drive. Hard to turn that off - particularly as the competition really doesn't end (fellowships and jobs are competitive things). 

 

Honestly I am not really sure where to start. There is a big carrot at the end, and a lot of people trying to get there. We can adjust things to test for reliance to stress in the application process but that is hard to do and assumes that those stresses simply cannot be removed and thus must be dealt with. Seems suboptimal  

Edited by rmorelan

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How would we fix that - that is ultimately the point I suppose. We all know we have a system where vastly more people (even with our current very high requirements) apply than there are spots. That isn't going to change as it stands. That creates a bias from the get go - in order to achieve what is required to get in you have to have to at least manifest a certain drive. Hard to turn that off - particularly as the competition really doesn't end (fellowships and jobs are competitive things). 

 

Honestly I am not really sure where to start. There is a big carrot at the end, and a lot of people trying to get there. We can adjust things to test for reliance to stress in the application process but that is hard to do and assumes that those stresses simply cannot be removed and thus must be dealt with. Seems suboptimal  

 

I'd say to give people chances. We're bad for this in medicine. 

 

If you fuck up your GPA, tough. If you don't match, tough. 

 

Dusting yourself off and improving enough to achieve something is part of what made this side of the world so great. If you fuck up your GPA it shouldn't be used against you if you take the next few years to dominate. We're losing that day by day in medicine. Everything's so rigid now.

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I'd say to give people chances. We're bad for this in medicine.

 

If you fuck up your GPA, tough. If you don't match, tough.

 

Dusting yourself off and improving enough to achieve something is part of what made this side of the world so great. If you fuck up your GPA it shouldn't be used against you if you take the next few years to dominate. We're losing that day by day in medicine. Everything's so rigid now.

A lot of med schools already do this though. Taking the best two years, dropping the worst year, only looking at prerequisite courses, etc. Plus med schools in Canada have remediation where it doesn't show up on final transcripts that you needed remediation. I'd rather that med schools continue using these objective markers than moving onto more subjective ones.

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A lot of med schools already do this though. Taking the best two years, dropping the worst year, only looking at prerequisite courses, etc. Plus med schools in Canada have remediation where it doesn't show up on final transcripts that you needed remediation. I'd rather that med schools continue using these objective markers than moving onto more subjective ones.

 

Providing more chances creates a situation where even more people could and would apply. There is a good chances that still all those people would be great doctors - I don't believe because you messed up at one point that automatically means you would be a worse doctor (the ultimate criteria is getting good doctors). Yet now you are left EVEN MORE people to process. At some point it becomes basically random - we cannot realistically accurate process say 7500 people for 150 spots.

 

The more competitive it becomes the more extreme people get - take mcat with is relatively new take it many times approach. I have run into people now that have taken that test a horribly large number of times. We made it easier to take the test (originally twice a year on paper and you can only take it once a year, 3 times max in total to many times a year on a computer with vastly more offerings allowed). The result didn't make it easier - cut offs jumped, and the average number of times you had to take it jumped. 

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Having goals and challenges is going to be a part of medicine, regardless of how we structure things, including admissions. While I would love to see an admissions process that cuts down on arbitrary cut-offs and emphasizes more soft-skills that are instrumental to being a good physician, medicine is going to be competitive no matter what and high achievement of some form or another is going to be a requirement. Lower the emphasis on GPA or MCAT scores and suddenly the pressure to do well at everything else skyrockets.

 

On the plus side, I think this article partially misdiagnosis the problem. High achievement and competitiveness aren't the problem, it's how they're handled. Intermittent and manageable stressors that test achievement are often elements to a positive work or studying environment - where medicine goes wrong is that it makes its stressors constant and generally unachievable. At my school, tests occurred every couple weeks with other evaluations thrown in the middle. Each one of these had to be passed, meaning there was really no "off" time - finish one assessment, and it's on to the next one. Being on a pass/fail system helps alleviate some of that stress by making it so we don't have to do amazingly well on each evaluation, but it also plays into the other way medicine mismanages stress, by preventing real achievement. Medicine is described as drinking from a firehose - it's impossible to get it all, so you just try to get what you can. Expectations are set above what's realistic. Most people in medicine accept this reality, but it means that there's always a way a student or resident is deficient - even if they're at or above where most people are at their level of training. It's hard to feel a true sense of achievement when the focus is constantly on what you haven't mastered.

 

Medical schools can address these problems, but it would take a rethink of how medical school is structured and what it aims to achieve. Take out the barrage of summative evaluations and useless make-work projects in favour of formative assessments that allow for corrective testing rather than punitive testing. Turn the firehose into a slow trickle that increases in intensity only as students master the lower volumes, even if that means students are exposed to less in medical school (though hopefully with higher competency of what they are exposed to).

 

There's plenty of other ways medical schools could improve burnout, but if we're focusing on how the stress of achievement impacts students, here's where I'd start - not by lowering the stress or expectations, but by portioning out the stress in more confined packets over time, and by better defining expectations so that they are achievable rather than always just out of reach.

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I totally agree with this.

I had no problem with the pressure to maintain my grades in undergrad, and I worked full time throughout. I really enjoyed it even though it was insane. Likewise, I've enjoyed jobs where I was in way over my head, under intense pressure and working long hours. I used to get downright high on ultra intense high pressure work.

 

Medical/Dental school? That made me depressed. Truly depressed. And it had nothing to do with it being hard. It was dehumanizing and I hated it within weeks even when I tried so desperately to enjoy it the way I had enjoyed hard work before. I hated the med school culture less than the dental school culture, which surprised me.

 

I watched a lot of my classmates get ground into paste around me. I go back every year and the graduating students always look so burnt.

 

I've written before how we were treated as if we had no internal motivation to learn, as though we weren't adults who cared about becoming professionals, as though we were petulant brain damaged children incapable of tying our own shoes. Humiliation could not be avoided, which resulted in learned helplessness. (Don't get me started on the sexual harassment, then I go insane)

 

I've worked in enough high pressure/high performance environments to know that it absolutely does not need to be like that. It's tradition, it isn't necessary.

 

Several thousands of dollars in therapy later and I'm still angry...

 

 

I agree. Working hard towards a goal is awesome. I love it. Whether that goal is scholastic achievement or merely bettering yourself at a particular skill, it's addictive.

 

The problem comes when no matter how much you work towards that goal, it's assumed to be out of your reach. Anything that puts you out of the game arbitrarily is wrong. There's a lot of that in medicine. It gets worse when residency applications come around. 

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

 

I found a bro

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I think it's also important to create an environment where people can access mental health services without fear of consequences for their career/licensure.

hahahahahahahahahhahahahahaahahah

 

I'm laughing because i know this first hand, and through close friends - yep, not something that is yet acceptable to let people know outside your inner circle, contrary to what most office of student affairs will say or whatever student club of the month is tackling "mental health".

 

Maybe one day, but not currently, and unlikely any time soon.

 

What a backwards thought - that people who are supposed to be caring for others, have such issues in their profession

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Mental and physical health of med students/ residents  in such disregard? More than enough examples.

 

Sleep deprivation alone does considerable harm to  young doctors, and it's a risk to patients. But old guard would not have it any other way: we suffered, you should suffer too. We were tough, you better be tough. They don't notice that in  the meantime the world around changed and young doctors face considerably more pressures, both professionally (extreme competitiveness, sorry state of the health system) and privately (loads of debt, much higher living costs).

 

Focus on physical and mental health is necessary for survival. Otherwise, there will be more Kathryns.

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You're a health care professional, your job is to make people less depressed and anxious along with solving their problems.

 

So how is being anxious and depressed helpful in terms of treating patients? How can you make their lives better if you cant deal with your own mental illness?

 

If you can't deal with your own mental illness, then you shouldn't be in medicine. Pursue a different career.

 

No one wants an anxious person treating them, that's a scary feeling to have. I would expect my surgeon to calm me down before procedure, instead of being anxious.

 

This is really common sense stuff. Med school and residency should try to fail out anxious people to improve health care quality.

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There are counsellors in med school to prevent this stuff and many others. No need to worry about mental health. Worry about graduating. Worry about finding a job later ..etc, If you're anxious or depressed, make friends or go for a walk or be busy with something ..etc,

 

You're a health care professional, your job is to make people less depressed and anxious along with solving their problems.

 

So how is being anxious and depressed helpful in terms of treating patients? How can you make their lives better if you cant deal with your own mental illness?

 

If you can't deal with your own mental illness, then you shouldn't be in medicine. Pursue a different career.

 

No one wants an anxious person treating them, that's a scary feeling to have. I would expect my surgeon to calm me down before procedure, instead of being anxious.

 

This is really common sense stuff. Med school and residency should try to fail out anxious people to improve health care quality.

 

Seriously?

 

I guess you've never been anxious before during your training or even as a staff... and as if fear mongering among students for being anxious addresses the actual causes of anxiety... if anything most people would be even more anxious, depressed or otherwise.  

 

Isn't this whole discussion revolving around how we can better facilitate learners from becoming a victim of their environment? 

 

Who are you to tell people who are victims of mental illness they shouldn't be in medicine. Is that a joke? As if one's depression and/or anxiety can't be treated, or they not get the same chances to pursue their goals. And somehow mental illness definitively equates to poor physicians... I don't even...

 

... that's a scary feeling to have....

 

Something else that's scary are myopic opinions.

 

- G

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You're a health care professional, your job is to make people less depressed and anxious along with solving their problems.

 

So how is being anxious and depressed helpful in terms of treating patients? How can you make their lives better if you cant deal with your own mental illness?

 

If you can't deal with your own mental illness, then you shouldn't be in medicine. Pursue a different career.

 

No one wants an anxious person treating them, that's a scary feeling to have. I would expect my surgeon to calm me down before procedure, instead of being anxious.

 

This is really common sense stuff. Med school and residency should try to fail out anxious people to improve health care quality.

 

People with mental illnesses are entire people.  Who have some shortfalls (as do we all) and also some strengths.  Who can be really excellent physicians and well suited to medicine.  Mental illness can be managed and people with mental illnesses can often function perfectly well.  And there is something to be said for understanding the experience of being ill from the inside out.  Not everybody with a mental illness can be a good physician - but neither can everybody WITHOUT one.

 

I feel angry and sad that you could say something so outrageously ignorant and stigmatizing.  And I hope that anybody reading your post who might struggle with mental illness and might be in medicine or thinking about medicine will recognize how messed up that is and not let it sway them.

 

Edited because I shouldn't let my temper get away from me.

Edited by ellorie

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