C.T. Veal is a fourth-year medical student, University of Vermont Larner College of Medicine, Burlington, Vermont; ORCID: http://orcid.org/0000-0001-6408-7713 .
Acad Med. 2021 May 1;96(5):629-631. doi: 10.1097/ACM.0000000000003991.
The author explores medical student depression and suicide through the lens of the author's personal struggle during the first 2 years of medical school. While the author's story is unique, other medical students have also faced challenges that have led them to consider a permanent solution to a temporary problem. Although resources are available, stigma represents a significant barrier for students as they decide whether to seek help. Students fear that showing the slightest hint of vulnerability or imperfection will be used against them in an advancement committee, a course evaluation, or the dean's letter for residency applications. This difficulty asking for help and the subsequent suppression of feelings can lead to burnout and ultimately to increased risk of suicide. The author calls for medical schools to make changes to their culture to preserve medical student mental health. These include committing to helping students who are struggling academically or psychologically, implementing an institution-wide program to screen for individuals at risk for suicide, educating members of the institution's community about depression to destigmatize seeking help for mental health, and ensuring confidential mental health services are readily available to those who need them. But, most importantly, medical schools must create a culture that normalizes the need for self-care and includes vulnerability as part of training in professionalism.
作者通过自身在医学院前两年的个人奋斗经历，探讨了医学生的抑郁和自杀问题。虽然作者的故事是独特的，但其他医学生也面临着一些挑战，这些挑战导致他们考虑用永久性的解决方案来解决暂时的问题。尽管资源是可用的，但耻辱感对学生来说是一个巨大的障碍，因为他们决定是否寻求帮助。学生们担心，表现出一丝脆弱或不完美，都会在晋升委员会、课程评估或院长的住院医师申请信中对他们不利。这种寻求帮助的困难以及随之而来的压抑情绪，可能导致倦怠，最终增加自杀风险。作者呼吁医学院改变其文化，以保护医学生的心理健康。这些措施包括承诺帮助在学业或心理上挣扎的学生，实施一个全机构的自杀风险筛查计划，教育机构社区成员有关抑郁的知识，以消除对寻求心理健康帮助的耻辱感，并确保那些需要帮助的人能够获得保密的心理健康服务。但最重要的是，医学院必须营造一种文化，使自我保健成为常态，并将脆弱性纳入专业精神培训的一部分。
