Mental health in medicine– we need to look out for each other

By: Devyani Bakshi (c2022)

Medicine is a field which recruits people who are driven, perfectionists, goal-oriented, and caring. We often define our self-worth by the fact that we will one day be physicians as many of us have worked almost our entire lives to be here today. We are taught from the first day of medical school about the enormous sense of responsibility we have over our patients. The media, numerous malpractice cases, and professional competency sessions often reminds us that the medical system is overrun with “bad” doctors, and our generation, our class, needs to be better than the years before it. Yet I fear in this quest to always want to be better than our predecessors, we become overly critical of ourselves, even when no mistake is made.

The recent death of our colleague at the University of Ottawa, Ryan Séguin, has had me reflecting on mental health in medical education. After the feeling of grief, worry, and the overwhelming sense to call my family had passed, I felt a sense of relief as I remembered McMaster’s strong dedication to the mental health of its students. Just think about all the resources available to us and the sessions we’ve had with student affairs. However, while to their credit they have tried to address student needs, the system is far from perfect. I remember in my first session, I was unable to explain how I was feeling a sense of ambiguity and unease about becoming a physician, which I never expected to feel until much further down the line. My advisor tried to explain it away as imposter syndrome, which is a term that has been thrown around a lot quite lately. The thing was, it wasn’t imposter syndrome, I know I’ve worked hard to be here and I, just like everyone else, deserve to be here. But of course, I didn’t share this thought because I figured I don’t know enough compared to a practicing physician. Moreover, I felt a sense of judgment from him for even talking about it. And therein lies the problem, while we preach about mental health advocacy in medicine, we are less compassionate with our peers and colleagues than with our patients. 

The sense of guilt in medical school seems to be ever-present. Guilt over not being “above average” in a field of over-achievers, guilt over missing anatomy to attend a horizontal, guilt over not reading that extra resource when doing tutorial prep, even guilt over sleeping and taking breaks, guilt over taking the time to talk to our family or partner– the list is endless. While we tell ourselves it’s ridiculous to feel this way, the feelings don’t go away.  The pressure and self-criticism we have is something that propelled us to get to medical school, but it’s something that will facilitate burn-out if we don’t recognize it. 

I remember in almost every medical interview I had the privilege to attend, one of the most prominent questions asked was focused on resilience. While I was able to answer the question perfectly well, thanks to my well-rehearsed script, I never stopped to think, not deeply at least, about why we would need to have resilience. But, the first six months of medicine has taught me something important, we are each others’ biggest support system. Your success doesn’t have to equal my failure, and vice versa. So to my fellow colleagues, next time you’re going through something, or you don’t feel 100%, just know that I’m always here. Medicine is an extremely demanding profession, both emotionally and physically, and we need to do better to support ourselves and each other.

 

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