The suicide of a fourth-year student last summer has prompted leaders at the Icahn School of Medicine at Mount Sinai in New York City to do some soul-searching and determine how they can change the school's culture to better support medical trainees.
In an essay in the New England Journal of Medicine titled “Kathryn,” the name of the 27-year-old student who jumped to her death from her eighth-floor apartment, David Muller, M.D., the school’s dean for medical education, wrote about the changes Mount Sinai is making to help support both students and residents.
While the school is looking at ways to expand mental health services and well-being resources—along with changing aspects of its competitive grading system—Muller said that conversation alone won’t fully address the problem.
“In my opinion they will fall far short of addressing one of the root causes of this national epidemic of burnout, depression and suicide: A culture of performance and achievement that for most of our students begins in middle school and relentlessly intensifies for the remainder of their adult lives,” said Muller.
From their earliest achievements, “we never let up on them—and it’s killing them,” he wrote, about the expectations placed on medical trainees’ performance.
Perspective by David Muller, MD: "Kathryn" https://t.co/9K2uocnv5Z pic.twitter.com/iouOCyEuWX
— NEJM (@NEJM) March 23, 2017
Several months before the death of Kathryn, a female medical resident also committed suicide at the school’s West Side campus, according to The Wall Street Journal, which described efforts by medical schools to make training programs more compassionate. In 2014, two other young doctors-in-training at two different New York-area medical schools committed suicide.
The deaths underscored the problem of young doctors and medical students facing grueling academic pressures and experiencing high rates of burnout, depression and psychological strain. To raise awareness about the problem of physician suicide, a group of doctors organized a national Day of Solidarity last summer.
At the same time medical schools are trying to relieve pressure on doctors-in-training, the Accreditation Council for Graduate Medical Education earlier this month reversed its policy and will allow first-year doctors to work longer, 24-hour shifts in hospitals starting July 1.