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.
