Contributing Writer
Medical College of Georgia
Abigail Cline, PhD is a third year medical student at Medical College of Georgia in Augusta, Georgia. She received her doctorate from University of Georgia in 2012 in Biochemistry and Molecular Biology. Her current interests include Dermatology, Medical Ethics, Medical Education, and Translational Medicine. Her hobbies are baking, working out, and movies.
Too often medical students lose their motivation because of emotional exhaustion, depersonalization and a diminished sense of personal accomplishment. Medical students should no longer see their education as a challenge to overcome. They should see it as a game that can be won.
As medical students, we recognize that bias in medicine is doubly damaging: it burdens our peers and it harms our patients. In the opening narratives we see both of these at play: in Micaela’s self-doubt and frustration, and in the intern’s judgment of their older, Latina patient. Such clinician bias has been increasingly shown to contribute to widespread health inequities.
A fellow student writer recently wrote that she wondered if depression were “just part of life as a medical student.” One of her professors had given a lecture on depression asking students to “think of how many people we knew with the signs of depression listed on his lecture slide” — excluding medical students of course, “because you’ve all got some of these.” There is something so terribly and inherently wrong with that statement.
My medical school, Indiana University, is one of the largest in the country with over 300 students in each graduating class. Sadly, each year it seems we lose one of our classmates to suicide. The surprising part? These numbers might be lower than the national average. In the United States, approximately 300 to 400 physicians commit suicide each year. A 2009 study in Academic Medicine reported that 12 percent of medical students had major depression and nearly six percent experienced suicide ideation. To visualize these numbers, in my class alone, statistically, 18 students have experienced suicide ideation and approximately 36 have major depression.
Medical school is a notoriously challenging experience during which students undergo tremendous personal change and professional growth. Though the stressors that come along with this are varied and unique to each student’s context and experience, they may be categorized within a few common themes. Harvard psychiatrist Raymond Laurie has previously described the concept of “role strain” with respect to negotiating relationships with their families, friends, partners, peers, attending physicians and patients. Additionally, with regard to students’ concept of themselves, individuals who have high achievement may be challenged in new ways both intellectually and emotionally.
Throughout medical school and especially during our clinical rotations, students are often told to keep an open mind about choosing a specialty. This is sound advice, especially since many people change their minds once they are exposed to other fields. However, that does not mean that all specialties are perceived as equal — even in a primary-care focused medical school, third-year medical students often run into prejudice against FM. Worse, they may run into stereotypes about family med which could be enough to sway them away from the specialty they would really love.
With more applicants than ever, and a relatively static number of medical school and residency spots, there has been an increase in the use of metrics such as standardized test scores, GPAs and research publications to differentiate between applicants. Unfortunately, an emphasis on the unquantifiable attributes of physicians — the qualities that actually differentiate great clinicians from good ones — seems to have fallen by the wayside.
As young children growing up, we all called each other by first name. So did our parents, relatives, teachers, and anyone else we ran into that wanted a way to identify who we were. As adults, attending physicians are still called by their first names around the same group of people from childhood. However, patients and most of the clinical staff may not even know the physician’s first name. When transitioning from a senior resident to a faculty physician, some event occurs where that beloved first name is molted. After the right of passage is completed, the rookie doctor becomes a veteran doctor; free of restrictions, supervision, and a first name.
In the UK, there is currently a dispute over the new junior doctor contract. “Junior doctors” are defined as anyone in training and who is not a consultant. Many have deemed the new contract neither safe nor fair, and despite doctors striking, the Department of Health are intending to impose this contract in August 2016. On April 26, there will be a 48-hour full strike including emergency care — the first of its kind in the history of the National Health Services (NHS) — in the hope that the government will change their mind.
In light of this recent occasion, I would like to draw attention to the sexual harassment of a particularly vulnerable population that is a result of a unique power dynamic: they have no income, they have amassed significant debt and they depend on the subjective opinion of their abusers for validation of their work. Most frustrating, is that many of the corrective actions taken over the last 25 years have had a limited effect on changing this specific culture of abuse. This specific population is medical students.
Medical students are subjected to a barrage of advertising that inevitably leads to a physician-industry connection that can be harmful to our health care system. Medical students’ exposure to pharmaceutical marketing begins early, growing in frequency throughout their training.
To most students, physiology is a difficult and mind boggling subject. Thankfully, Dr. Tanaka and Dr. Koyama through Becom Co. Ltd. have poured their love and patience into an illustrated work of organ-based physiology, The Manga Guide to Physiology. Presented in the Japanese graphic novel style of manga, the manga follows nursing student protagonist Kumiko as she prepares for her make-up examination in physiology.
Medical Student Editor and in-Training Staff Member Emeritus
University of Florida Fixel Movement and Neurorestoration Institute
Nita Chen is a current movement disorders fellow at University of Florida Movement and Neurorestoration program. She is Class of 2017 medical student at Albany Medical College. To become cultural, she spent her early educational years in Taiwan and thoroughly enjoyed wonderful Taiwanese food and milk tea, thus ruining her appetite for the rest of her life in the United States. Aside from her neuroscience and cognitive science majors during her undergraduate career, she holed herself up in her room writing silly fictional stories, doodling, and playing the piano. Or she could be found spazzing out like a gigantic science nerd in various laboratories. Now she just holes up in her room to study most of the time.
