Episode 104: Silent Struggles – Mental Health and Medical Education

Content Warning: 

This content addresses mental health issues, including research and narratives on suicide. Please take care while engaging with it and only proceed if you feel safe doing so. If you, or someone you love, is having thoughts of suicide, please contact 988. Help is available.

 

Episode 104: Silent Struggles – Mental Health and Medical Education

Interviewer

Lisa Meeks

 

Interviewees

John Ruddell

Jennifer Ruddell

Roja (friend of Jack Ruddell)

Dr. David Muller 

Dr. Justin Bullock

Dr. Jessi Gold

 

Narrator

Dr. Joseph Murray 

 

Transcript

Keywords: Mental health, Medical training, Stress, Well-being, Competitive environments, Performance, Self-care, High-stakes exams, Residency match, Learners with disabilities, Jack Ruddell, Depression, Suicidality, Dr. Jessi Gold, Dr. Justin Bullock, Dr. David Muller, Imposter syndrome, Research, Publications, Fitness for duty, COVID pandemic, Identity, Physician identity, Self-harm, Vulnerability, Stigma, USMLE Step 1, Dr. Catherine Lapidus, Docs with Disabilities 

Description

In this deeply impactful third episode of our series on mental health and suicide in medical training, we delve into the unique pressures and challenges that medical students face including high stakes exams, aggressions in training, lack of safety, and fear of help seeking. This episode is a continuation of our exploration into how the demanding environment of medical education can contribute to mental health struggles, including depression and suicidality.

Description of Series 

DWDI Special Series: Suicidality in Medical Training dives into the critical conversations around mental health, well-being, support systems, and the intense pressures faced during medical training. Through the power of storytelling, the series intertwines these broader themes with the deeply personal story of Dr. Jack Ruddell, a promising medical student who tragically died by suicide. Jack’s journey—his strengths, struggles, and the complexities leading to his untimely death—forms the emotional core of this five-part series, giving voice to the loved ones often excluded from these conversations.

Alongside Jack’s story, the series incorporates expert insights and data from the literature, offering a human perspective on burnout, depression, and suicide among medical trainees. With a commitment to improving mental health awareness and reducing the stigma around seeking help, the series presents a novel approach by centering personal narratives alongside expert analysis. It also explores actionable strategies for improving medical training environments and highlights the importance of institutional responses after a loss by suicide.

Our mission is to reduce shame, encourage help-seeking among medical students struggling with depression, and ensure that every medical school is aware of the postvention resources offered by the American Foundation for Suicide Prevention (AFSP).

Experts for the Series 

• Christine Moutier, MD – Chief Medical Officer, American Foundation for Suicide Prevention

• Jessi Gold, MD – Chief Wellness Officer, University of Tennessee System; Author of How Do You Feel?

• David Muller, MD – Director, Institute for Equity and Justice in Health Sciences Education; Dean Emeritus, Icahn School of Medicine at Mt. Sinai; Author of the NEJM essay, Kathryn

• Srijan Sen, MD, PhD – Director, Eisenberg Family Depression Center; PI of the Intern Health Study

• Justin Bullock, MD, MPH – Fellow, University of Washington; Author of the NEJM article, Suicide, Rewriting My Story

• Stuart Slavin, MD, MEd – Vice President for Well-Being, ACGME

Episode Release Schedule:

• September 17: Episode 102 – Honoring Dr. Jack Ruddell: A Story of Joy, Compassion, and Mental Health in Medical Training.

• September 17: Episode 103 – Suicide and Suicidality in Medical Training: Understanding the Crisis and its Causes. 

• September 24: Episode 104 – Silent Struggles: Mental Health and Medical Education.

• September 26: Episode 105 – Repairing the System: How Do We Create Safe Environments?

• September 30: Episode 106 – Responding to Loss: Postvention and Support After a Suicide.

Executive Producers:

• Lisa Meeks
• Rylee Betchkal
• John Ruddell
• Jennifer Ruddell

Sound production:

• Jacob Feeman
• Mark Koha
• Next Day Podcast

Consult Psychiatrist

• Joseph Murray, MD

 

Resources: 

24/7 Suicide & Crisis Hotline
Call or text 988 or chat 988lifeline.org. 

 

The American Foundation for Suicide Prevention

https://afsp.org

 

Intern Health Study

https://www.internhealthstudy.org

https://www.srijan-sen-lab.com/intern-health-study

 

How are you? By Jessi Gold

https://www.drjessigold.com/how-do-you-feel-book-by-jessi-gold-md/

 

Make the Difference: Preventing Medical Trainee Suicide

https://www.youtube.com/watch?app=desktop&v=I9GRxF9qEBA&feature=youtu.be

Time to Talk About It: Physician Depression and Suicide” Video/Discussion Session for Interns, Residents, and Fellows

https://www.mededportal.org/doi/10.15766/mep_2374-8265.10508

 

Action Collaborative on Clinician Well-Being and Resilience

National Academy of Medicine

https://nam.edu/action-collaborative-on-clinician-well-being-and-resilience-network-organizations/

 

References: 

Lapedis CJ. Murky water. Annals of Internal Medicine. 2018 Sep 18;169(6):415-6.

 

Meeks, L. M., Case, B., Stergiopoulos, E., Evans, B. K., & Petersen, K. H. (2021). Structural barriers to student disability disclosure in US-allopathic medical schools. Journal of Medical Education and Curricular Development, 8, 23821205211018696.

 

Mirza, A. A., Baig, M., Beyari, G. M., Halawani, M. A., & Mirza, A. A. (2021). Depression and anxiety among medical students: a brief overview. Advances in Medical Education and Practice, 393-398.

 

Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., ... & Mata, D. A. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. Jama, 316(21), 2214-2236.