A message to learners,Posted on December 19, 2019
From Dr. Jonathan DellaVedova, Wellness Lead Clinician, NOSM Postgraduate Medical Education:
Each December I am grateful for the twinkling lights, comforting foods and Christmas party invites. A festival of lights and togetherness seems fitting during this darkest time of year. December can be difficult, especially when the connections aren’t there and the sheen of the holidays fails to live up to its promise. We residents and doctors also sacrifice our own restoration time so others can be merry. Last December we faced our most difficult period as a school when we sadly lost one of our own.
A counsellor here in Sault Ste. Marie offered me a helpful analogy about suicide that I will never forget. She said suicide is like a puzzle. You might get a piece, and I might get a piece, but unfortunately no one ever gets all of them. If any reasonable person did, we would drop everything, swoop in to the rescue, and suicide would not exist. But that is not how it works. Even a person’s closest loved ones might only get a handful of clues, and all of the people left behind are surprised by all of the information they did not have, leaving feelings of sadness, devastation, regret, and guilt.
This past week we lost another medical learner to suicide. In this case I have absolutely none of the pieces, and you might argue that I have no business writing about it. But I say “we” because though the suicide happened at another school, our medical education family is small. We all share a common experience; one that outsiders cannot understand, nor would we necessarily want them to.
It may be that the pressures of medical training had nothing to do with this particular tragedy. But one need only glance at the stats to know that our profession and its trainees are particularly vulnerable. It is impossible not to speculate about the role of the high-stakes training environment, social pressures, financial pressures, repeated exposures to trauma, and what happens when we are not progressing as planned.
Our profession situates itself at the forefront of the advancement of health. We are singularly motivated by evidence and data. And yet we are stuck when it comes to suicide. We are humanitarians who fail to recognize our humanness.
When, according to the CMA, 8% of physicians have considered suicide in the past year, it’s clear that the entire system needs an overhaul. In the meantime what can one program or one school do within the larger context of the healthcare system and the education system? I look around at my colleagues, some of the most caring and influential leaders I have ever encountered. Can’t we, as a new school, unshackled by tradition and graced with innovators, take a few of these puzzle pieces off the table?
It’s Christmas time and John Lennon’s “Imagine” is on high rotation. Imagine a world where learners with academic challenges get the individualized planning and coaching they need in a timely way. Imagine that we have more than enough trained faculty to provide the extra attention our learners deserve. Imagine a world where learners struggling with mental health issues get time off or a reduced workload without stigma. Imagine a world where learners’ basic collective agreement protections are respected at a bare minimum, and without reproach. Imagine that all learners have timely access to primary care, psychiatric care and psychotherapy when needed, including debriefing traumatic events. Imagine a world where our learners enjoy the many benefits of distant rotations without having to worry about suitable housing or social isolation. Imagine a world where learners receive emotional, practical and financial support if they come to learn that clinical medicine is not for them. Imagine that we all learn in a climate of cooperation, collegiality, respect and kindness. All of this is within reach if we have the will.
I cannot help but observe the spike in learners requesting help before the holidays. For our first year residents, the veneer of residency is wearing off. For our senior residents a period of intense exam studying is beginning. And our mid-residency trainees are slogging through heavy clinical years. We are all affected by the scarcity of sunlight this time of year. All of our residents will be working some part of the holiday and I cannot remember a January 2nd during residency where I felt like I actually got a break. The togetherness and restfulness that the season is supposed to bring can easily get lost in the shuffle.
With all of that being said, if you are on solid footing this year, please take a few minutes to reach out to a colleague with an invitation, a card, a note, or a kind word. It goes a very long way. Meanwhile NOSM’s deans and other senior leaders have redoubled their commitment to changes that will achieve a healthier, more humane, more flexible and open learning environment. And so we have reason not just to imagine, but to hope.
Resources for students, residents and faculty at NOSM: