Healing Medicine's Future: Prioritizing Physician Trainee Mental Health

In this article, we discuss current perceptions of the model physician and how these perceptions conflict with stressful realities of training environments and contribute to the staggering rates of burnout and depression faced by medical students and residents.We suggest a multitiered interventional approach to address these problems, with innovations for individual trainees, programs, institutions, and the health care system.Finally, we discuss the medical community's ethical obligations to ensure that it is appropriately and thoughtfully investing in the wellness of medicine's next generations of practitioners.As they develop educationally and clinically, medical students and residents are also cultivating their professional identities.This can be a nebulous process, as our model of an ideal physician is not easily defined.In fact, what it means to be a "good doctor" has been discussed for decades, with physicians debating how that should be defined, assessed, and taught [1].Reviews of literature on professionalism in medicine have identified as many as 90 different attributes [2] and shown that there is no comprehensive, universally accepted definition of medical professionalism to date [3].Despite these complexities, professional identity formation is considered an important aspect of medical training [4], with trainees forming influential ideals about how they should think, feel, and behave as physicians.As relatively recent residency graduates, we (the authors) run a mental health clinic for medical students and residents at the University of Michigan, and we frequently hear the trainees speaking in the same language with which we were indoctrinated as trainees.Common across their stories seems to be a predominant core belief that one's own pain and suffering, occurring in service to the art or science of medicine, should be quietly tolerated.One of us was recently speaking with a resident who shared that the mantra among his cohort was to "tough it out" and "power through" any physical or emotional suffering.We routinely hear phrases like this, coupled with the fear that to do anything else would be to risk being seen by peers and supervisors as weak, vulnerable, or flawed in some way [5][6][7].