Medical students are put under intense pressure by society
I refer to the report on the death of a Chinese University of Hong Kong medical student (“Fears for Hong Kong students after fifth suicide at the Chinese University,” March 6).
The suicide is tragic, but it would be naive to believe it was related to difficulties in coping with studies, as media reports seem to suggest. True, the burden of studies medical students endure is tremendous. However, remarkable developments in educational technology facilitate learning and conveniently place learning resources in students’ hands. Modern methods of assessment in medical schools have reduced rote learning. Yet the expectations of being a medical student are often overwhelming.
The pressure of expectations begins years before medical school, given the fierce competition for entry. Medical schools compete to entice the best students into their programmes. Once admitted, it is difficult to shake off the elite label. The incessant demand for excellence is impossible to ignore as internship and postgraduate training placements depend upon performance.
The medical faculty has established advisory and mentoring schemes for students and many benefit. But not all students are willing to come forward. Some feel embarrassed at seeking help and perceive themselves as failures. Peer support is weak and students lack the life experience or maturity to cope with stress.
Society, including family and friends, expects doctors to be perfect. There is zero tolerance for human error in our otherwise excellent public health-care facilities. The most trivial of errors, often with no real dangers or consequences, get prominent media attention. Frontline health-care workers face enormous pressures in their efforts to meet the expectations of an error-free service.
Interns and medical students are astute enough to understand the burden of responsibility in a society with little empathy and intolerance for imperfection.
The practice of medicine is complex and requires a deeper understanding of society and a wider exposure to life. Unlike in Hong Kong, many international medical schools changed to a graduate entry programme, as mature students are better able to cope with stress and difficulties.
We must be creative in order to provide medical students with expanded opportunities to experience life. We also must ask serious questions about whether our current model of medical education is too narrow and merely caters to professional demands or should it, instead, nurture the broad and whole person development of future doctors.
Shekhar Kumta, professor, assistant dean, medical education,
Faculty of Medicine, Chinese University of Hong Kong