We Burn Out, We Break, We Die: Medical Schools Must Change Their Culture to Preserve Medical Student Mental Health.

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.