An exploration of medical student attitudes towards disclosure of mental illness (Medical Education Online)

For all it's worth I am a family doc with 35 years experience in practice and many years mentoring medical students. I also served 8 years on my state's medical licensing and discipline board and 10 years on my community hospital's bioethics committee.

Needless to say physicians are human beings too and have the same array of frailties as the rest of humanity. These days in addition to 'ordinary' mental illness and the awesome assumption of responsibility for life and death the docs carry every day, there is the burden of student loans (>50% looking at $200,000 or more) and the health system 'disarray' contributing to burnout. From the individual doc's point of view it would be so valuable to be able to seek out and benefit from support and therapy at any time of stress, distress, or illness. Nonetheless, the individual stalwartness and fortitude built into every doc and our culture mitigate against this. Thus we have the higher incidences of alcoholism, substance abuse, and suicide among us. All practicing docs know how hard it is to admit mistakes, confusion, ignorance, errors, or personal needs and I bet few of us can name one professional colleague we could intimately turn to at a time of need.

On the other hand, there are few institutional channels of receptivity to offer support and assistance. Who among us knows whether they can trust "physician wellness committees?"

I will testify that state licensing boards are very blunt instruments, only able to deal with (punish) deviants at the extremes of malfunction. We tried to create an idealistic 'diversion program' to provide therapy and assistance to psychologically ill physicians - and while it was a first in the nation model and widely emulated it only lasted here as long as its idealistic creators were around. Practice association and hospital privilege committees also find it easier to protect against harm rather than nurture with understanding and support.

I agree with the students. I would find it both naive and difficult to be honest about my problems until professional culture learns how to accept and mitigate the human frailties among its members.