Rashi Hiranandani is a medical student in the Class of 2019 at the University of Ottawa
Medical school is a stressful time in students’ lives. There are emotional, physical, and mental stressors; particular daunting is the stress of being in new clinical environments on a weekly or even daily basis and having patients’ lives in our hands. Medical students are sleep deprived and over-worked. We have the stress of not matching to the residency of our choice or even not matching to a residency program at all. Medical students also experience significant burnout and compassion fatigue, with burnout rates ranging from 27 to 75% . It thus comes as no surprise that medical students suffer from rates of mental illness higher than the general population. This is not ideal for the health of the medical students, nor is it optimal for the health of the patients they care for.
A 2016 systematic review published in JAMA reported that, on average, 27.2% of medical students deal with depression or depressive symptoms . Among students who suffer from depression, only 16% receive help . ...continue reading →
Mohamad Matout is a Psychiatry Resident (R1) at McGill University
The debate regarding what should future doctors be learning during medical school is sensitive and convoluted. During the four years in which students learn basic sciences and acquire basic clinical knowledge, due to lack of time, little is taught with regards to major topics such as nutrition1, lifestyle changes, oral health2 and basic computer literacy3. One could argue that psychology is another field in which future physicians lack structured education. Our curriculum is usually centred around understanding the biology of pathophysiology and, when possible, the neurobiology of psychopathologies. While we may be introduced to the area of psychology and an understanding of pathologic defense mechanisms, the world of psychotherapy remains mysterious to medical students and physicians in general. ...continue reading →
Once an elastic band is stretched beyond its limits, it is difficult for it to return it to its unstretched state. Burnout represents a similar phenomenon: an erosion of one’s sense of self and a reflection of emotional over-exhaustion, leading to disinvestment and depersonalization. Years of intensive training, long working hours, increased managerial responsibilities, resource limitations, emotionally-involved patient and family encounters, fear of limited job prospects and litigation, and mounting clinical and non-clinical responsibilities, among other demands: physicians and other health care professionals represent a highly vulnerable group susceptible to burnout, with some estimates suggesting close to 50% of physicians being affected. Evidence suggests that physicians experiencing burnout are more likely to make poor medical decisions, share more tenuous relationships with co-workers, experience more individual and personal relationship challenges, and suffer higher risks of anxiety, depression, and suicidality. Physician burnout has also been associated with differences in overall quality of care, system-level costs, and rates of staff turnover and absenteeism.
This piece focuses on the compromise some residents and physicians make in placing themselves second while dedicating themselves to the care of others, and the silence that some encounter while struggling with burnout. It is encouraging to observe that dialogue around burnout and mental health is growing at individual, institutional, and systemic levels over time. This piece is part of that conversation....continue reading →
Hilary Drake is a medical student in the Class of 2021 at the University of British Columbia
On my first day in a new family practice, my preceptor asked me to take a history from a patient who had listed their “reason for visit” as a sore throat. I stood in the hallway and made a mental checklist of questions to ask and observations to make. Have they had any sick contacts? Does their voice sound hoarse?
When I opened the door and asked them if they could tell me what brought them in today, they responded as expected: “My throat is sore.” When I asked what they thought might be causing the pain, they unwrapped a scarf from their neck and stated, “I think it’s because the noose didn’t work.” At that point they started crying.
They had tried to come in before. They had recognized their pain and wanted to reach out for help, but they were unable to out of fear that their physician would not believe the pain if they could not see it.
Mitchell Elliott is a medical student in the Class of 2019 at the University of Toronto
Doctors are amongst the intellectual elite of society. In many cases, with decades of training and continuing education in clinical practice, our expertise grants us the opportunity to do things that would be deemed invasive and inhumane if performed outside of the context of medicine. Selectively poisoning people with chemotherapy; carefully dissecting fascial planes and removing organs; asking invasive and personal questions... all in the name of symptom management, remission of disease, and prolonging the inevitable: death. For physicians, these daily rituals become almost routine. In many cases, we have spent the majority of our lives training for the uncertainty of each day, rigorously memorizing each disease presentation and management principle, habituating to these processes and procedures. With the heavy clinical demands on physicians, it may be difficult to fully realize the impact of our actions on each patient. ...continue reading →
Abhishek Gupta is a research and medical sub-intern at CAMH who graduated from the Windsor University School of Medicine
The controversial debate over cannabis legalization has concluded on an official level, legally placing the drug in the hands of the Canadian public. Very soon, anyone over the age of 19 will be able to walk into a store and obtain it for personal consumption.
For mental health professionals, some aspects of this decriminalization effort are appealing. Conventional marijuana is often laced with far more dangerous substances leading to highly dangerous health outcomes. Furthermore, individuals with substance abuse issues are more likely to seek professional help when the consequences of drug possession are milder. Much like needle exchange sites, this move towards legalization provides consumers with a safer alternative for addressing their cravings for cannabis. ...continue reading →
Laura Kim is a medical student in the Class of 2019 at the University of British Columbia
I’m a 3rd year medical student.
But I’m not just a medical student. Before August 2015, I had a life that was full and rich and medicine-free. Today, my life is no longer medicine-free — but I refuse to allow it to be any less full or rich.
I’m not just a med student.
I’m a pediatrics gunner, a student politics junkie, and a francophone-wannabe.
I’m a dancer, a baker, and a knitter.
I’m a Harry Potter-fanatic, a Sav Blanc expert, and a nap-connoisseuse.
I’m a loving girlfriend, an overbearing older sister, and a fierce friend.
I’m loyal, compassionate, caring, sarcastic, and (often) a hot mess.
I’m a poor parallel parker, a clumsy clerk, and a top-notch procrastinator. ...continue reading →
Ruth Chiu is a medical student in the Class of 2018 at McMaster University
From 1975 to 1980, over two million Vietnamese, Laotian, and Cambodian refugees fled from Communist states to refugee camps across Asia and became known internationally as ‘Boat People.’1,2 In response to this crisis and under significant public pressure, the Canadian government accepted 60 000 Southeast Asians as government-assisted and privately sponsored refugees between 1979 and 1980.3
The exodus of Southeast Asian refugees was by no means the first of its kind in history. However, Canada’s response to this refugee crisis was unique in its magnitude from both a national and international perspective. Political drivers, such as the adoption of the more inclusive Immigration Act of 1976 and the recent election of Progressive Conservative Prime Minister Joe Clark after 16 years of Liberal rule, contributed to the unprecedented settlement of Southeast Asian refugees in Canada.4,5 Public interest in the crisis, heavily piqued by international news media, allowed for the success of the newly formalized private sponsorship program which supported two-thirds of the Boat People who settled in Canada.6,7...continue reading →
A little while ago my sons - who were in grade 5 and grade 8, respectively, at the time - came home deep in discussion begun on the school bus after Son #2’s first sex ed lesson.
I listened to them talk. You couldn’t really fault the accuracy of the information received. Male human… female human… different-but-complementary body parts, the names of which were correctly recalled…sperm, egg, uterus…
“But how do the egg and the sperm get together?” asked Son #2.
A week ago, André Picard published a column in the Globe and Mail entitled “How many people actually suffer from mental illness?” and later he tweeted his thanks to readers for making that column the publication’s most-read story of the day. The column may have been well-read - it certainly sparked controversy on social media - but it wasn't because Picard had anything very profound to say. In fact the piece was based on an epidemiological faux pas, which is why I called it a nothingburger.
Commenting on the findings of a poll commissioned by Sun Life Financial Canada, which found that 49% of Canadians have “experienced a mental health issue” at some point in their lives, ...continue reading →