Guest Writer
Albany Medical College
Erin Ayala, PhD is a clinical faculty fellow in the Department of Psychiatry at Albany Medical College. She conducts research on health and wellness, does clinical work with medical students, and facilitates wellness initiatives and workshops at the college. When she’s not working, she’s training for triathlons, playing with her 2 dogs, and thinking of new ideas for personal hobbies and projects she may or may not actually finish.
Four years. I had gone four years without crying in a faculty member’s or an advisor’s office. And there I was, sobbing all over myself, as I tried to explain the situation. A couple of days prior, I received a terse email from the training director, saying I needed to come in to meet with her. She was not happy with my most recent feat as a doctoral student.
As I settle into my second year of medical school, I’m confronted with the fact that I’m one-fourth of the way to an M.D. — that an entire year has passed, and unsurprisingly, all those predictions my deans made at the very beginning came to pass: time flew, we learned more than we thought we ever could, and upon close self-examination, we’re very different from how we were this time last year.
You made it. You were finally there. After thousands of hours of studying, dozens of tests, numerous volunteer and leadership experiences (to say nothing of many other sacrifices along the way), you had reached the pinnacle of your education. You earned the title you had so desperately yearned for: medical student.
When I started medical school last August, I arrived on campus excited to fulfill my childhood dream of becoming a doctor, eager to learn more about the body and its mysteries, and more than a bit nervous. “Medical school,” the physicians in my life told me, “is no joke.” But “everyone survives” they assured me. While I clung to this promise as I made my way through the year, I did so perhaps for different reasons than I first imagined.
On March 4, 2015, JAMA Psychiatry published an article entitled “Depression and Suicide Among Physician Trainees: Recommendations for a National Response” calling for “[a] national commitment to support residents and fellows throughout the challenges of medical training.” However, we believe that the term “physician trainees” should also be inclusive of medical students.
I am a medical student, yes. I am also a survivor of sexual violence. With the recent Columbia University commencement, the surge of articles surrounding the narratives of Emma Sulkowickz and Paul Nungesser prompted me to reflect on this latter identity. When histories of sexual harassment at my school emerged last November, my survivor status edged its way into my path toward doctorhood. I know I will always carry the mark of my trauma with me, and I am learning how I will better empathize with patients because of it.
As medical students we’re told over and over to treat the whole patient, emphasizing unity of body, mind and spirit, recognizing the things that make us unique: upbringing, culture, values and beliefs. But on the way to achieving this holistic view of our patients, we often lose ourselves in the process. Barraged with metabolic pathways, pathological markers and exams, medical school tends to become a zero sum emotional game.
For most medical students, the third year of medical school is their introduction to life in the hospital. This results not only in exciting learning opportunities, but also emotional tolls — grief, fear, anxiety, exhaustion — that can lead to serious problems including burnout, depression, and anxiety.
There is another reason wellness is now stressed so heavily in medical schools, and it is one that is not often talked about — physician suicides. As many as 400 physicians commit suicide each year. That is equivalent to four medical school classes who take their lives every single year.
One of the things that I have struggled with most in medical school is depression. Not learning to recognize, diagnose or treat it, but actually dealing with the effects of this condition. I soon realized that this problem is much bigger than myself, and needs to be talked about openly. This is my story.
Within the next three years, ketamine, the popular club drug referred to as “Special K,” may replace the current generation of antidepressant drugs. By substantially reducing the latency of antidepressant effect, the use of ketamine as an antidepressant may hold promise and is in fact in Phase 3 trials for FDA approval. But, how does ketamine work to alleviate depressive symptoms, and how does this approach fit with our current understanding of depression? Do we currently understand depression?
Have you ever spent a night curled up in a ball of blankets rocking yourself, tears streaming down your cheeks, just wishing you could go to sleep and wake up a couple of months later? As a teenager, I had more of these nights than I did nights of restful sleep. There was no particular trigger. I had an idyllic childhood, growing up in a quiet suburb with a loving, supportive family.
Writer-in-Training, Columnist and in-Training Staff Member
Philadelphia College of Osteopathic Medicine
Aishwarya is a second year medical student at the Philadelphia College of Osteopathic Medicine. She relishes any opportunity to talk policy, social determinants of health, mental health parity and inclusion topics. Outside of school, Aishwarya enjoys yoga, green tea with lemon and copious amounts of dark chocolate.
Doctor of Policy
Doctor of Policy is a column dedicated to exploring and challenging contemporary health policy issues, especially in the fields of behavioral health, health care access, and inclusion, all from the eyes of a public health girl in a basic sciences world
