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What’s up, doc?

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Who wants to be a doctor? Well, quite a few people, apparently, with more and more of our best and brightest enrolling in medical school. The rate of new applicants in the US has risen by 30 percent this year, a new peak for a trend that has been growing inexorably since the start of the new century.

Medical students are prepared to go through years of stress, bullying and lack of sleep—and then around three years in residency (in the UK, these young interns are often lovingly referred to as ‘pond scum’)—to qualify. They also leave medical school with a mountain of debt.

But it’s all worth it, newly qualified doctors often report when quizzed. Medicine is everything they thought it would be, providing them with the opportunity to make good money and giving them status in society, intellectual challenge and a chance to help their fellow men and women.

Yet, something happens along the way. Compared to other professions, medicine’s rates of suicide, alcoholism and early retirement are the highest, suggesting it’s not all a hospital bed of roses.

The sensitive and the questioning are often the first to go. Dr Valerie Jones retired at the age of 37, just seven years after she had completed her residency at Johns Hopkins University in Maryland.

In a blog, she explained how she began to re-evaluate the ‘hamster wheel’ of medicine after she lost a large section of her lung to remove a benign mass. She became disillusioned with the healthcare system, including the red tape, rules, emphasis on productivity and the litigious nature of medicine in the US.1

Those who opt to stick it out—and many do, because they’ve gone through so much to get qualified in the first place—choose this path at the risk of their own health, wellbeing and even life.

Female doctors are four times more likely to commit suicide than women in the general community, and this is likely a consequence of the much higher rates of mental illness and depression among doctors.

In the US, one doctor commits suicide every day, and often it’s the result of untreated or under-treated depression, says Dr Deepika Tanwar, a physician at Harlem Hospital Center in New York, who has studied the problem. The rate is higher even than among ex-soldiers returning from war zones.

Those who don’t take their own life are far more likely than folk in the general population to turn to booze or illicit drugs. Around 12 percent of doctors are ‘heavy drinkers’ and 16 percent ‘hazardous drinkers,’ a survey of European physicians has discovered.

In Mainz, Germany, 17 percent of the city’s doctors drank ‘hazardously’ at least once a month, and 6 percent at least once a week.2

Some go to the next level. Around 13 percent of male doctors and 10 percent of female doctors use illicit drugs, and 36 percent of male doctors and 20 percent of female doctors use cannabis, according to a survey of junior doctors in Newcastle, UK. As the questionnaire was voluntary, and as doctors would, by and large, prefer not to reveal they were regularly taking illicit drugs, the true figure could be far higher.

The British Medical Association (BMA), effectively the trade union for doctors in the UK, estimates that one in 15 doctors, or 7 percent, are dependent on alcohol or drugs, which means around 13,000 doctors in the UK are addicts, and 500 new cases are added to the ranks every year. As the BMA points out, addiction is not only endangering the lives of the doctors, but of their patients too.

Finally, after all of that, doctors are also more likely than people in other professions to take early retirement. One survey has discovered that the rate of early retirement among UK doctors has tripled in a decade.3

But why? Doctors cite red tape, litigation and tight regulation as the major cause, but, beneath all of that, could it be that doctors become disillusioned with medicine and the way they are allowed to practice it? They can’t try any non-drug approach that doesn’t comply with the practice guidelines of their regulatory body, for instance, but instead must follow tick-box medicine.

It’s enough to drive any intelligent person to drink, or worse—and, sadly, it does.



CMAJ, 2018; 190: E449-50


Ger Med Sci, 2005: 3: Doc07


BMJ, 2019; 365; l4360

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Article Topics: Physician, Suicide
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