Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The hidden cost of medical training: debt, depression, and despair

Janet Constance Coleman-Belin
Education
December 28, 2024
Share
Tweet
Share

I imagined that medical school would be a challenging yet fulfilling journey—an opportunity to learn, grow, and ultimately make a difference as a physician or surgeon. We medical students dedicate over a decade of our lives, and many invest more than $200,000 (plus interest) for the honor of caring for patients. Yet, the surge of medical training-related memes and reels on social media captures our reality: “You have to laugh to keep from crying.”

For many of us pursuing medical careers, the journey oscillates between our calling and prestigious self-harm. We entered this profession with noble enthusiasm—far too often, we are met with poor teaching, bureaucratic hurdles, insufficient support, and a culture that prizes endurance over well-being. Many of my colleagues are crippled with exorbitant debt from this long path, which includes four years of undergraduate studies, possible post-baccalaureate pre-med programs, and four years of medical school. The first two years emphasize pre-clinical coursework with an ever-increasing volume of information; review for the USMLE Step 1 has expanded from under 400 pages to over 800 in nine years. The next two years are spent in clerkships with residents, fellows, and attending physicians. If we’re fortunate to match into a residency, we face an additional three to eight years of training, sometimes followed by further fellowship training, before finally becoming an attending.

Mental health struggles among medical students are well-documented; less discussed is the way institutions respond. Despite the prevalence of burnout and depression in this field, practical solutions are rare. In my case, I have wrestled with untreated depression throughout my time in medical school. I recently opened up to mentors at my institution and beyond; their well-intentioned responses included, “Half of the medical students are on antidepressants,” and “Your feelings are totally normal; my classmate killed himself.”

When did this become “normal”?

Resilience is taught as the “gold standard” for managing medical training. But, at what point does resilience become an excuse for institutions to avoid making meaningful changes? There is a gap between the support students need and what they actually receive. Until the gap is addressed, we will continue to lose passionate, capable future physicians to burnout and despair.

The Journal of the American Medical Association recently reported that physician burnout rates have dropped below 50 percent for the first time since 2020. Burnout—characterized by physical, emotional, and mental exhaustion from prolonged stress—can make health care professionals feel fatigued, detached, and cynical. While any progress is encouraging, can we really celebrate when nearly one in two doctors risk this fate? The American Academy of Family Physicians reports burnout rates as high as 60 percent among attending physicians and trainees.

Medical education is designed to be grueling, but it need not be so alienating and infantilizing. While many physicians sincerely strive to treat us better than they were treated, some still perpetuate the cycle of abuse. For instance, a resident told my classmates, “Don’t even bother reporting me; so many people already have.” Meanwhile, a chief resident publicly berated me at the nurse’s station at 7:30 a.m. for “not being confident” because “as a woman going into surgery, you need to be.” Even when our shift ends and our work is complete, we aren’t technically allowed to leave until we’re formally dismissed; I know classmates who have waited up to two hours to go home. Despite these challenges, most physicians are quick to remind us that conditions were even worse in the past.

How can medical schools train students to succeed not just academically and professionally, but as whole, healthy individuals equipped to make life-and-death decisions?

When leveraged to our strengths, medical students can be an exceptional resource. We can focus on fewer individuals to make a meaningful impact. If you want us to, we’ll trek across the hospital to find your missing dentures or hold your hand as you’re wheeled into surgery. I’ve even assisted patients with their Social Security paperwork when our Social Work team was overwhelmed. If I’m ever admitted to the hospital as a patient, I want an eager and kind student on my team.

As Dr. Pamela Wible noted in her TEDMED talk entitled “Why doctors kill themselves,” suicide remains an occupational hazard for all tiers of medical professionals. We urgently need to address the suffering of students and trainees with genuine empathy and practical support, rather than accepting it as a routine part of the career.

Recently, I attended a conference that reignited my deep love for reconstructive plastic surgery. But, when I evaluate the personal, mental, and spiritual costs of not just finishing medical school, but also thriving in residency and beyond, I wonder whether it’s truly worth it. I feel conflicted about pursuing a career path where antidepressants could be as essential as scrubs and stethoscopes.

There’s a saying that the only people in the hospital paying to be there are medical students and patients. We deserve better, and so do our future patients—yourself and your family included.

Janet Constance Coleman-Belin is a medical student.

ADVERTISEMENT

Prev

Why ADHD diagnosis in adults is often overlooked [PODCAST]

December 27, 2024 Kevin 0
…
Next

Through a physician's eyes: Living twice as long as your parent

December 28, 2024 Kevin 0
…

Tagged as: Medical school

Post navigation

< Previous Post
Why ADHD diagnosis in adults is often overlooked [PODCAST]
Next Post >
Through a physician's eyes: Living twice as long as your parent

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Janet Constance Coleman-Belin

  • Breaking the cycle of pain: practical steps to improve medical training

    Janet Constance Coleman-Belin

Related Posts

  • How the COVID-19 pandemic highlights the need for social media training in medical education 

    Oscar Chen, Sera Choi, and Clara Seong
  • Medical training and the systematic creation of mental health sufferers

    Douglas Sirutis
  • The first day of medical training during a pandemic

    Elizabeth D. Patton
  • Surviving medical school with depression

    Anonymous
  • Medical debt is the enemy of everyone

    Robert E. Goff, MBA
  • Improving medical specialty selection with pre-training examinations

    Deepak Gupta, MD and Sarwan Kumar, MD

More in Education

  • Bridging the rural surgical care gap with rotating health care teams

    Ankit Jain
  • Why tracking cognitive load could save doctors and patients

    Hiba Fatima Hamid
  • The hidden cost of becoming a doctor: a South Asian perspective

    Momeina Aslam
  • From burnout to balance: a lesson in self-care for future doctors

    Seetha Aribindi
  • Why young doctors in South Korea feel broken before they even begin

    Anonymous
  • Why medical students are trading empathy for publications

    Vijay Rajput, MD
  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why retail pharmacies are the future of diverse clinical trials

      Shelli Pavone | Meds
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • How school meals can transform health [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why would any physician believe that the practice of medicine will become less abusive for them in the future?

      Curtis G. Graham, MD | Physician
    • Why congenital CMV should be on every parent and doctor’s radar

      Kathleen Muldoon, PhD | Conditions
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why retail pharmacies are the future of diverse clinical trials

      Shelli Pavone | Meds
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • How school meals can transform health [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why would any physician believe that the practice of medicine will become less abusive for them in the future?

      Curtis G. Graham, MD | Physician
    • Why congenital CMV should be on every parent and doctor’s radar

      Kathleen Muldoon, PhD | Conditions
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...