America is experiencing a mental health crisis. It is hard to know whether mental health is worse or perhaps people are just more willing to talk about it. Suicide is the second leading cause of death among young adults. Suicide is at the highest rate in 80 years, which corresponds to the start of World War II. While the start of WWII was a tumultuous time, it is hard to grasp why rates have been ticking up since the turn of the Century.
Suicide is also a problem even among those who are thought to be enjoying the good life, including young physicians, reports the Wall Street Journal:
“The fact that the medical profession has one of the highest rates of burnout and suicide, compared to other professions, speaks to the urgent need for change,” Mortimer told The City, a local news site, in November 2022.
Mortimer, a young anesthesiology resident, later died by suicide in early 2023.
Nearly a quarter of residents have considered self-harm, and a fifth know a peer or colleague who has considered suicide in the past year, according to a 2024 survey by the Physicians Foundation, an advocacy group.
Medical residency is an especially stressful period. Depression skyrockets – a 5-fold increase – during the first year of residency compared to the end of medical school. Many medical graduates claim they had thoughts of suicide for the first time during residency but were afraid to seek help out of fear for their future job prospects. There exists an institutional stigma within the medical community against young doctors seeking help.
Older doctors and hospital administrators consider residency’s trials a vocational rite of passage. After medical school, doctors are expected to work 80-hour weeks and shifts of up to 28 hours for several years to earn board certification.
The relentless schedule can drive depression, burnout and suicidal risk, said Dr. Srijan Sen at the University of Michigan. His research documented a fivefold increase in rates of depression during the first year of residency compared with the end of medical school.
The WSJ drew comparisons with other high stress professions, such as investment banking and law. Those professions too require new recruits to endure long hours in a high stress environment. WSJ made a point to explain that banking, law, and consulting begin paying high salaries immediately, while medical residents average less than $70,000 a year until they have completed their residency. This comparison is not a good one. Only a few college graduates are recruited into lucrative fiends like banking, law, and consulting. The competition is fierce; candidates know they can easily be replaced. Indeed, many are replaced after the first year, but the experience builds their resume. Investment banking, big law attorney and consultant is a job, whereas medical residency is still a training position. Failing residency could relegate young doctors to practice in a different specialty entirely or potentially derail their careers.
A primary concern is that the stress young physicians are placed under is mostly unnecessary. It is also a health concern for patients treated by them. Making medical residency especially brutal as a rite of passage serves no purpose other than to stroke the egos of older physicians who endured the process years earlier. The purpose of graduate medical education is advanced training. Making the process unnecessarily stressful just as a hazing ritual probably interferes with the learning process rather than enhances it.
The WSJ story is tragic, focusing mostly on a promising young doctor who took her own life within reach of finishing her goal. A medical career is a terrible thing to waste, whether it is through a shortage of residency slots or a sadistic ritual of initiation by making training as painful as possible for no valid reason.
Read more at WSJ: Suicide Reverberates Among Young Doctors