DocsWithDisabilities Podcast #26
Doctors with disabilities exist in small but measurable numbers. How did they navigate their journey? What were the challenges? What are the benefits to patients and to their peers? What can we learn from their experiences? My name is Lisa Meeks, and I am thrilled to bring you the DocsWithDisabilities podcast.
Join me as I interview Docs, Nurses, Psychologists, OT’s, PT’s, Pharmacists, Dentists, and the list goes on. I’ll also be interviewing the researchers and policy makers that ensure medicine remains an equal opportunity profession.
Hello everyone, and welcome back to the Docs with Disabilities podcast. This is Sofia Schlozman, one of the show’s co-producers. Today, we bring you Part 1 of a three-part series on psychological disability and wellness in medical education. I learned so much from this conversation, and I am honored to have the opportunity to share the insights of our host, Dr. Meeks, and our three incredible guests with our audience. Before we begin, I’d like to make a brief statement; This episode is dedicated to Karen Headrick, the mother of our host, Dr. Meeks, who died November 16th after battling COVID. We encourage our listeners to continue vigilant safety practices, wear a mask, wash your hands, and continue to practice social distancing. And now let’s begin by hearing from Dr. Meeks.
Welcome back listeners, as you know I have a deep commitment to learner wellness and access to medical education for individuals with a psychological disability. Unfortunately, my research suggests that despite a high prevalence of depression in learners, a mere .03% disclose depression as a disability. This, coupled with research showing that only 15% engage in forms of help-seeking like therapy or counseling suggests that something is amiss.
In addition to my work, I also keep connected to the heart of this topic by reading first-person stories shared in commentaries. Today’s show will be informed by the authors of two such commentaries that stand out as bookends. They showcase the varying levels of disclosure of psychological disability across the medical education continuum.
On the one hand, we have a commentary in Academic Medicine titled: In My Experience: How Educators Can Support a Medical Student with Mental Illness. The author is known only as anonymous--on the polar opposite rests Dr. Bullock, a 2nd year medicine intern at UCSF and a fierce advocate for mental health and systems change. He is the author of the New England Journal of Medicine article, titled Suicide: Rewriting my story.
Salient to these two articles is the fear and stigma associated with disclosing a mental illness and engaging in help-seeking behavior. Yet very real downstream consequences of disclosure are ever-present concern, and one that may tip the scales between silent suffering and engaging with program or community resources. That’s where my other guests come in.
Dr. Jessi Gold, is an assistant Professor and the Director of Wellness, Engagement, and Outreach in the Department of Psychiatry at Washington University School of Medicine. She is an “it’ girl on social media, advocating for topics related to physician wellness. She is refreshingly honest in her approach, and says what most people are thinking. She is joining the conversation today to discuss these downstream consequences.
Erene Stergiopoulos, 2nd-year psychiatry resident in Toronto Canada, is an up and coming change agent who straddles research and advocacy for the inclusion of disabled learners in medicine and her work is informing and shaping policy on disability inclusion and wellness. She is going to talk to us today about her work and what we can do to radically reboot how we address mental health in medical education.
Welcome to the show everyone, it’s certainly a powerhouse episode.
Let’s begin with anonymous….
anonymous writes, “a couple of weeks before I started medical school, I admitted to a trusted mentor that I was worried about my post-traumatic stress disorder and how it would affect my education. He looked me in the eyes and he said, don't let anyone find out that place will eat you alive.”
Now I'm going to stop there for a second and open this up for kind of our first question for the panel. And my question is: Do we perpetuate the silence that is ever present in medical education by this encouragement that students hide any kind of mental health related disability? Is this still a problem in 2020?
I'll start. Yes, it is certainly a problem in 2020. In medicine we're so often taught that we have to have this be completely sort of perfect, um, and have no flaws. And that, for some reason, we, as physicians wouldn't suffer from the same conditions that our patients suffer from. To me, what this mentor is saying is like, basically you can't have any weaknesses if anyone knows you have any weaknesses, like you won't be allowed to like succeed in medicine. And I actually think that's a narrative that is that I definitely feel like I got, and it's something that I've been very actively trying to like fight even within myself.
it's a horrible problem. I think it starts early and it starts probably as a pre-med frankly, we weed out people who would be amazing doctors, if you can't fit this specific mold and you struggle, you are not for lack of a better word worthy of entering this hallowed profession. And if you can't check these specific boxes and meet these perfect criteria, you can't either. and we, you know, have attempted to change that narrative by being somewhat open, to taking people who come from different backgrounds and have different experiences then you go to medical school and it's not much better. You can very easily struggle and people will say, you know, why are you struggling? That should be easy. You can deal with this. Why is this hard? This culture is a culture where you don't complain and this is the way that it is. I even remember that when I was on my surgery rotation, somebody made fun of me for, um, my dad being a psychiatrist. They were like, what, what are you going to do? Like go into the same field as your dad and be a psychiatrist? And I think we in, you know, making fun of mental health as an option of a career and belittling psychiatry as a field, and saying things about patients that have mental health issues or saying “that's just another mental health patient” or “that person's got a personality thing” or whatever we do that perpetuates that within our own culture, it makes it additionally hard to then say, well, I fit that, that's me, like, why would you ever want to say that you are someone who struggles when we're repeatedly, disparaging that mold in a patient. We have many ways that we make it impossible to feel comfortable and safe being someone that struggles or someone that is even like stable and fine with a mental illness because that narrative isn't taught or shown or encouraged because people don't think it's safe. You should be allowed to talk about whatever you want to talk about in your own history. It's your story.
Well, you make so many good points. And the reality is- if this were any other type of medical condition, people would not hesitate to talk about it and they might even seek counsel being that they're surrounded by physicians, it wouldn't necessarily be as big of a secret or something to hide. And I know Erene, we've discussed this for hours on end at various points, the reality of, of being in the field of medicine and would we even disclose, like I said, and I, I readily say all the time, which I think is a terrible sign of what is out there that I don't think that I would disclose a mental health concern, if I were experiencing one, I would be very fearful. And there are lots of reasons for that and that's bad, that's terrible, because if somebody that has the privilege that I have in, in that space is afraid then what does it feel like to be a learner who has far less power to bring their authentic selves into this space.
Yeah. I think that the thing that's so unique about psychological disability is that institutions question someone and their ability to make decisions and their ability to provide “quality or unsafe care”. The second that there's any kind of psychological disability, whether that's depression or addictions or trauma or personality disorders and it's fundamental to the way that our culture, our society frames, mental illness, the way they view, what happens to you, to your judgment, to your insight. That's so tragic to me because the second someone has a diagnostic label, those labels are chronic and they stick onto someone's file for a really long time and so the second someone discloses, they know that they're entering into that realm where they can't take that label off and they will always be looked at with that eye of “Oh, well, we have to keep an eye on that person to make sure that they're okay to practice.” And so, it's so understandable when people decide not to disclose for that reason.
Anonymous goes on to write in the article.
"I have run into a number of problems related to misplaced good intentions. There are not many of us with visible yet well-managed mental illnesses. And my advocates have had to learn how to offer guidance and flexibility without compromising my autonomy or the high technical standards of the program. Though, my experiences have largely been positive that is far from universal friends and classmates have experienced discrimination or even been forced to leave their programs. I write anonymously in acknowledgment of that implicit threat, but also with the hope that the individual support I have received may become standard throughout the larger medical education system."
First of all, let's just talk about how beautiful this writing is and I think within a few sentences, the author has really encapsulated a feeling. I know from being in meded, you all know from being in meded, this is absolutely true. And I think that so often there are well intentioned individuals. I know Justin, you and I have talked about how that works in real life. And I think, you know, this student, despite the positive experiences still felt compelled to write anonymously, even though this person was well supported in their program, there's so many things in our system that keep people in a fearful place. Because of the way that you've disclosed, looking at anonymous writing and their words. What does that feel like for, for you as someone who has been so forthcoming?
Yeah so, the first thing it's looking back now with the experience of the last, um, eight months or so I think anonymous is, um, smart. I understand where they're coming from and, you know, one of the things that I, this my favorite line actually is “there are not many of us with visible yet well-managed mental illnesses.” And I think, I think that medical education does not understand that you can have active disease and be well-managed and, and well-managed does not mean that you don't suffer or you're not disabled in some way at some times. I assume that anonymous wrote this as anonymous, both in some ways of self-protection, but also to really say that like, you kind of have to do this anonymously, right? Like you can't really be super visible, otherwise you're just like susceptible, anytime you falter at some point in the future, because humans inevitably falter, you know, whenever you falter, people attribute it to this one thing. I totally understand why someone would write this as anonymous.
But it's still not safe. I think it's still incredibly vulnerable to submit this piece to a journal because someone sees this person's identity, even if they write it as anonymous, you know, and it still takes so much strength from my eyes to write all the things that they wrote. I definitely do not view it as an act of cowardliness at all.
No, absolutely not. In having talked to anonymous several times over the course of the last two weeks, I can tell you that they wrote this with the genuine hope for a different future for the cohorts that come after them. And I think wrote it as well to push an agenda, to push a conversation, to occur that wasn't happening quick enough to be able to create a space that was safe for them.
So, Jessi, I'm actually curious because you see in, and in clinic, you see providers, you see learners, you see students and you more than anyone would have firsthand knowledge of the fear of repercussion, uh, professionally. Maybe you could give us some insight. Is this an anomaly where people are afraid of disclosing or is this pretty standard across all of the health professions?
It's pretty standard. What happens too, is people delay care because of it. And they don't come until way too late. I mean, we have lots of other reasons for that, like we have completely normalized illness. Like, you know, we look across and we're like, that guy looks like they're not sleeping and that guy's not sleeping, so we must all not sleep, that must be the way we are. And actually, that's our baseline is completely often unhealthy for the most part. So, it takes a really long time for people to notice that they need help, because we've normalized what is probably already not good behavior. A lot of people struggle and they wait a long time to get care because of it. And they worry what it means to get care because of it. And don't want to get care in their institution because of it.
I work, in a facility where I could technically bump into people that I see quite regularly see, or students, I shouldn't, I never see people that I grade or anything like that, but I could teach a seminar or something where there's a lot of people and I could recognize a face of a faculty member or something, and I think that makes people nervous for mental health a lot more than it does for any sort of physical health.
I have a lot of friends that are OB-GYNs and we make a joke a lot about how people are very comfortable having babies in, in the system that they work in and are totally fine with people seeing that happen and witnessing that, which is beautiful, but also very intimate, um, and have no problem with that person, seeing them around but are completely uncomfortable with ever possibly bumping into me. And so, we, we do a lot of things to overly protect people in these scenarios and try really hard to do that. And I think we do a really good job and sometimes I think we do a little bit of a disservice to people to do so, so much because it just continues honestly, to perpetuate mental health stigma, to be like, okay, we have completely segregated mental health as a field, and now we're all the way over here.
And we are the field that nobody talks about and now you're good.
People are so uncomfortable talking about it by the time they talk about it it's a lot of like, what if people notice, what if it affects my work? What if it becomes a reason why I can't go to work? And I have to tell someone if I file for disability from work and they see the reason, what does that mean? Can I file for disability for the fact that I have hip pain from five years ago, instead of the fact that I'm depressed right now, do you think that I can go ask my primary care doctor to do that instead? And you're sort of like, no, you can't, you know, but it comes up a lot because people are so uncomfortable with mental health being the reason. And I hope someday we get past that. I think it's a societal thing, only worsened in all fields of medicine, but we're not there yet at all.
I think it's even stigmatizing to seek the service and, in some respects, that it may be slightly different for counseling. I'm curious, Erene, what you hear from your peers. I know we had talked, uh, earlier about what was happening really in your kind of near peer group.
Yeah, it's really interesting because ever since I started residency, I think at least 50% of the medical students that I've worked with have disclosed to me, like, uh, specifically like a mental illness. And it was, I think part of it is because I always disclosed that I had accommodations in medical school so they feel like, oh my God, okay. I'm actually in a safe place to talk about, you know, what I've been going through because a lot of them haven't, uh, access to accommodations, oftentimes because they're afraid to, um, they're afraid of the downstream consequences. They don't have any idea how it's going to affect the match. They have no idea what accommodations are available.
In Canada, if you are a medical student or a resident or a physician, um, we have these things called physician health programs. I think there's something very similar in the States. they're moderated by the medical regulatory authorities. So, like we have our Royal college of physicians in Canada. And those basically when a physician is in distress or they need a psychiatric assessment, especially there are psychiatrists who can see any kind of medical trainee or staff physician urgently for an assessment, and it's not supposed to be this punitive duty of fitness to practice assessment, but actually just if someone needs the assessment, they can get it quickly. But then I also have talked to people who've had those assessments before, but it turned out that this person, like the person who was assessing them was also a psychiatrist involved in teaching in the program.
These were psychiatry residents who told me that they went to an assessment and one of the docs who assessed them also supervises residents. So, it gets really tricky. I think that there is a lot of fear that if the second you see a specialist, especially if you live in an academic center, which if you're a learner, you do that, you will run into a specialist who will then become your teacher or your supervisor, or who you'll run into in the hospital at some point, no matter what specialty you go into.
I would add one of the things that makes that fear, such an issue is like, if you have an emergency and I'm sure Justin can speak to this too, the fear of not running into people, you know, can make you not want to get hospitalized in the place where you work, and then you cannot get help. I've seen, and even when I was a resident, worked on a ward where we had multiple medical students and undergraduates, but multiple medical students that were admitted on the psychiatric unit and had complete extra precautions, there were no medical students assigned to their cases. We didn't let them be in the room when their cases were discussed, we tried really hard to do as best as we could to preserve their identities. But of course, if you are on the unit and you saw them, you knew they were there, right. So, there's only so much you can do. And I think that makes it hard because if you're in an acute situation and something happens in you're really in need and the closest place that is to you is the place that you work. They're going to take you there. And that has a lot of issues because you don't want to not go there because it also could be the best place in the whole area by far, there's a lot of issues, a lot of compounding factors there.
So recently, I had kind of a mental health meltdown. Basically, I ingested a large number of pills and I called 911 and they came, they asked me where I wanted to go. I told them to take me to my institution and actually ended up, causing a lot of problems for me with a fitness for duty evaluation, um, before that information was later kind of disproven. So, I mean, exactly what you're saying, Jessi. It's really like what I'd rather die or protect my confidentiality was really the decision that I was trying to make in my head in that moment. And that's really sad. Um, and I think it's because I knew that once that information was in the wrong hands, it would be used against me.
I don't know what the solution is for that, because I think that with any intervention it's always designed to be helpful. And then we find, you know, a year or two down the road, what portions of it are actually harmful. And then once those things are, squarely situated, um, people are really opposed to change, I think, especially in more rural areas where you don't have access to perhaps the amount of care such that you could find a provider that would be outside of your academic network. And so, it gets tougher and tougher for some residents versus others.
At UCSF, if a learner presented with a history of psychological disability and hospitalization was part of that history one of the things that we would do is say, “in the event that, you have an acute flare of your symptoms or your condition is exacerbated, where would you like to go?” You know, how can we support you in and not having to go to a specific site?
On the flip side, if a student was seen at our emergency room, um, or they were admitted to one of our hospitals one of the things that we would do is offer them the opportunity to complete their psychiatric rotation at another hospital, so that they're not rotating under the same attendings who may have been on their case.
Hearing about the experience from undergrads versus graduate medical students has been very different strikingly different with regard to the consequences and the level of protection and the level of support and that's very sad. So, it seems that even when you're in an environment where it's extraordinarily supportive, you're encouraged to seek help at the undergraduate medical education level. And, perhaps you are seen for an acute presentation of symptoms, that you are almost enveloped in this little safety nest. But even sometimes within the same institution, the consequences or the experiences or the support system looks very different once you become a physician.
I think that the argument that when people say, at least what I've been told is essentially, this is because of state licensing. learners are sort of protected because they're not yet physicians, but once you're actually treating patients, then there's this sort of specter of the state medical boards, which, tend to be very, very patient centric and not provider centric. I think there's a sort of disproportionately strong response, um, because of this sort of fear of the state medical board, it's like sort of punishing institutions, or sort of removing licenses from physicians.
I don't really know why there's a huge difference between medical students and residents? I mean, I do think there's a different level of coddling, um, for lack of a better word. Like there's just like a different level of support that we give in general. Right. I feel like we don't wrap people around with our arms as much. Like we'd have a lot less resources I feel like for mental health for residents. I've always felt like that. I think we're catching up, but I feel like the medical school was thinking about it before residencies were thinking about it, and way before faculty's been thinking about it. I feel like that's kind of the order of things. I don't know why that is.
The biggest risk, the biggest group that is at risk are the interns
Jessi Gold: Uh-huh
Lisa Meeks: statistically speaking. So, you would think that there would be concentrated focus and resources in that group more so than others.
I almost wonder if the interns are the highest risk group, because they go from that environment where there is still a lot of coddling to an environment where they're literally just thrown in and it's like, “Oh my God, where are my secure attachments?” I'm just lost, like in terms of the coddling. I certainly saw that during COVID where, I mean, the second COVID was announced as like a crisis, a global crisis, all the medical students were pulled off service. And thenthe very same day that happened all of the residents in Canada got an email saying that it was our duty to continue working and that we would have to make personal sacrifices to continue working. And there was no mention of course, of having a preexisting condition or being immunocompromised. It was sort of just expected that like, okay, we're, we're physicians now we have to, we have to sacrifice ourselves. And so, there's this immediate switch and, and shift in the discourse as soon as you get that MD after your name.
Yeah. And you think about the biggest life stressors that can occur, right? Moving, which many interns are moving across country, the lack of a support system, immediate support system, there’re financial stressors, right? And so, and, and lack of control over your time, which I think is a huge contributor. Um, and then of course, lack of sleep.
We've talked about the fear. We've talked about the barriers, um, a little bit to help seeking, but you know, Justin, you get into that a lot more. You're on the complete opposite side of the bookends from anonymous and, you know, you're unapologetic in your public facing approach to your mental health. And I think this is no more evident than when you were going through the fitness for duty and it felt like a play-by-play to some extent.
I know we talked about it a little, there's this fear too, when you have a specific diagnosis that any behavior, and so even this public facing behavior and transparency about what was happening, could be perceived as a symptom of your diagnosis. And so that had to be extraordinarily difficult, but in your article, you write, “despite my fear, I frequently speak out about mental illness. I'm not afraid of others knowing that I have bipolar disorder. I fear instead that I may encourage others to get help, but will ultimately kill myself.”
It's just such a juxtaposition of where anonymous is coming from and where you're coming from and I wonder if you can speak to why you have been so boldly and unapologetically public about your disability, perhaps even speaking to some of the system issues, why you felt like you could disclose this at the institution where you're training.
Yeah. Um, this is such a good question. There’re so many things I want to say. The first thing that I will say is I, you know, reflecting back on me sort of writing and then, you know, trying to get this piece published. I think I was very fortunate because I was in a very solid place with respect to my position in my institution. I'm very fortunate that there are many people who are very high up, who I know very personally and who have sort of been around through various parts of my journey. Um, and so anything that I was writing, they were sort of already well aware of.
I was talking with someone very, very powerful within UCSF and a very good person who I really look up to. And, um, basically, they said to me, Justin, if I were to find out tomorrow that you died by suicide, um, I would be very, very sad, but I wouldn't be shocked. Initially that statement can sound a little bit, like, I think it makes some people sort of like, like take a step back, but I actually think it shows a true understanding of mental illness. You know, if someone has really bad heart failure, you know, that they could die tomorrow, like they could have an arrhythmia and they could have a heartfelt exacerbation and up in the ICU and, and pass. He wasn't saying it in a way that was like, “Oh, like, there's nothing we can do about it.” But he was just saying like, I understand that you are suffering and that you have a serious mental illness.
The reason why I fought so sort of vocally against my institution is because I will, like, I will never, ever, ever deny that I have a serious mental illness. Um, but I very, very, very strongly believe that I'm a good doctor and I do not believe that I have done anything which has ever indicated that I am anything less than an average physician at my institution.
So, for me that it was so dramatically clear that what everyone was doing was solely based on my mental illness and had nothing to do with my performance. I really felt like people are very afraid of mental illness. That fear causes them and to harm people. And I really wanted people to know, like, I am not ashamed at all.
Actually, writing that piece was super liberating. I was like, well, the whole world already knows I'm bipolar. I literally said in the piece like everyone already knew, I tried to commit suicide and was in the ICU, you know? So, like, anything that happens sort of within my realm of normal. And so, I don't think that that makes one, not a good doctor. I actually think it makes me a better doctor. I know that I understand some of my patient’s way more than other people do because of my experiences as a patient.
You went on to say that there are these structural challenges, really for learners that are in medical education. And, and one of the things that I know we've talked about this before, and I think this line and your commentary has been repeated, I can't even say how many times, but you said:
"It should be easy for all trainees to go to therapy. But I have friends at other programs for whom it is challenging or even frowned upon our lives are worth more than the two hours we are gone each week."
You would think that this two hours to go to therapy on a weekly basis is some sort of egregious action on the part of the student that they would be willing to miss two hours. And I'm with you and saying, you know, what is a life worth? Is it worth two hours? And, and so that point, and to our point up to now, we've been talking about mental illness versus some other sort of physical illness is that if the same student were going, because they had had an accident and had to go to physical therapy, no one would be questioning the need to go. And no one would be causing an uproar over the loss of time, we would figure it out. And some, some schools have gone as far as to say, everyone can leave for two hours a week and we're not going to police what you're doing, we're going to call it a wellness white space, and everyone can use it however they need to use it.
And so, we have these vastly different approaches to “wellness” or “mental health or physical health” and, and varying levels of support, as well. And you talk about the barriers that are presented for learners, the logistical challenges of coordinating if you need to go, we’ve talked about jeopardy. If you need to call in. And I know for my learners, the thought that one of their peers would have to jump in was enough to keep them from accessing healthcare that was so desperately needed because they knew that everyone needed it. And I think these are structural barriers that we have that we've known about for a very long time. And this is where Erene, I'm going to tap you in, we've identified the barriers. When are we going to fix them? When are we going to start doing something that's actually meaningful? And that reduces the stigma and gets people access, quick access to what they need.
I think one of the things that this conversation has been circling around is, um, professionalism, which is sort of the unspoken word in all of this. And it's such a double standard because wellness has been lumped into the competencies around professionalism in so many different ways. It's in the official, like I think it's in the ACGME ones. It's definitely in the CanMEDS competencies. Um, but at the same time, the second you show any kind of mental health distress, you become unprofessional. The second you're missing time on the wards to go to therapy. It becomes unprofessional. They're like, Oh, well, why are you missing so much time? So, it's this incredible double standard, which is, I think, why it's so hard to actually find the solutions because the second you actually stand up for yourself and say, Oh, I need this accommodation. Or I do need this time to focus on, you know, actually staying alive, you get all this pushback. And it's like, Oh, well, you're not being professional.
Circling back to your question how soon can we get this done? What needs to get done? What are some solutions, um, you already pointed to the universal design principles of why don't give everyone flex time, like two hours a week and have them do whatever they need to do to stay well? Other things would be things like, um, opt-out counseling. So that's been done. The University of Indiana had first and second year residents in internal medicine. they gave them all this sort of wellness day where they could participate in an opt-out mental health assessment. They called it a wellness assessment. and they also offered them protected time for follow up. and their participation rate was huge, it was in the nineties and the people who did participate were much more likely to use mental health services down the line if they needed them, because it completely broke that stigma barrier of like, Oh God, if I get this, if I get an assessment, I'll be seen as weak, I'll be, I'll be judged as someone who isn't cut out for medicine, because the fact was that everyone got the assessment.
Another barrier is, you know, where does funding go? What gets prioritized in the institution? That's like the whole hidden curriculum of, you know, what is actually valued, um, which comes back to Justin's point of, you know, what are we valuing here? Are we valuing a resident's ability to provide service or are we valuing their quality of life,there's so many contradictions in medicine, so many mixed messages?
That concludes episode 1 of our three-part series.
Thank you to our three fantastic guests, for their openness and thoughtfulness in discussing these important topics. And thank you to you, our audience, for listening or reading along.
We hope you will join us for Part 2, available now, for a discussion on the importance of supporting learners and a discussion of why it is so difficult, yet so important, to normalize discussions of mental health in medicine.
This podcast is a production of the University of Michigan Medical School, Department of Family Medicine, MDisability initiative. The opinions expressed in this podcast do not necessarily reflect those of the University of Michigan Medical School. It is released under a creative commons, attribution noncommercial, non-derivative license. This podcast was produced by Lisa Meeks and Sofia Schlozman.
- “Aspire” by Scott Holmes
- “Donnalee” by Blue Dot Sessions
- “An Oddly Formal Dance” by Blue Dot Sessions
- “Li Fonte” by Blue Dot Sessions
- “The Poplar Grove” by Blue Dot Sessions
- “True Blue Sky” by Blue Dot Sessions
- “Positive and Fun” by Scott Holmes
Resources and References Mentioned in this podcast:
Anonymous. In My Experience: How Educators Can Support a Medical Student With Mental Illness, Academic Medicine: November 2019 - Volume 94 - Issue 11 - p 1638-1639 doi: 10.1097/ACM.0000000000002953
Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373-2383. doi:10.1001/jama.2015.15845
Meeks LM, Plegue M, Case B, Swenor BK, Sen S. Assessment of Disclosure of Psychological Disability Among US Medical Students. JAMA Netw Open. 2020;3(7):e2011165. doi:10.1001/jamanetworkopen.2020.11165
Stergiopoulos, Erene MD, MA; Hodges, Brian MD, PhD, FRCPC; Martimianakis, Maria Athina (Tina) MA, MEd, PhD Should Wellness Be a Core Competency for Physicians?, Academic Medicine: September 2020 - Volume 95 - Issue 9 - p 1350-1353
Martin A, Chilton J, Gothelf D, Amsalem D. Physician self-disclosure of lived experience improves mental health attitudes among medical students: a randomized study.JMed Educ Curric Dev. 2020;7:2382120519889352. doi:10.1177/2382120519889352
Additional Articles by Participants:
Erene Stergiopoulos, MD, MA
Stergiopoulos, Erene MD, MA; Hodges, Brian MD, PhD, FRCPC; Martimianakis, Maria Athina (Tina) MA, MEd, PhD Should Wellness Be a Core Competency for Physicians?, Academic Medicine: September 2020 - Volume 95 - Issue 9 - p 1350-1353
Stergiopoulos, Erene MA; Fernando, Oshan PhD; Martimianakis, Maria Athina MA, MEd, PhD “Being on Both Sides”: Canadian Medical Students’ Experiences With Disability, the Hidden Curriculum, and Professional Identity Construction, Academic Medicine: October 2018 - Volume 93 - Issue 10 - p 1550-1559 doi: 10.1097/ACM.0000000000002300
Stergiopoulos E, Fragso L, Meeks LM. Cultural Barriers to help seeking in medical education. JAMA Int Med, 2020, Dec. 28. [Epub ahead of print]
Dr. Stergiopoulos was a previous guest on this podcast see: https://medicine.umich.edu/dept/family-medicine/programs/mdisability/transforming-medical-education/docswithdisabilities-podcast-ep-2-erene-stergiopoulos
Justin Bullock, MD
He was previously a guest on this podcast see: https://medicine.umich.edu/dept/family-medicine/programs/mdisability/transforming-medical-education/docswithdisabilities-podcast-ep-17-justin-bullock
Bullock JL. Suicide—rewriting my story. New England Journal of Medicine. 2020 Mar 26;382(13):1196-7.
Jessi Gold, MD,
Calhoun AJ, Gold JA. "I Feel Like I Know Them": the Positive Effect of Celebrity Self-disclosure of Mental Illness. Acad Psychiatry. 2020 Apr;44(2):237-241. doi: 10.1007/s40596-020-01200-5. Epub 2020 Feb 25. PMID: 32100256.
Gold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015 Feb;39(1):37-46. doi: 10.1007/s40596-014-0202-z. Epub 2014 Aug 1. PMID: 25082721.
Anonymous In My Experience: How Educators Can Support a Medical Student With Mental Illness, Academic Medicine: November 2019 - Volume 94 - Issue 11 - p 1638-1639
Lisa Meeks, PhD
Meeks LM, Plegue M, Case B, Swenor BK, Sen S. Assessment of Disclosure of Psychological Disability Among US Medical Students. JAMA Network Open. 2020 Jul 1;3(7):e2011165-.
Meeks LM, Ramsey J, Lyons M, Spencer AL, Lee WW. Wellness and work: mixed messages in residency training. Journal of general internal medicine. 2019 Jul 15;34(7):1352-5.
Meeks LM, Murray JF. Mental Health and Medical Education. In Medical Student Well-Being 2019 (pp. 17-58). Springer, Cham.
Lee WW, Guillett S, Murray JF, Meeks LM. Wellness and Disability. In Disability as Diversity 2020 (pp. 83-102). Springer, Cham.
Lapedis CJ, Meeks LM. Burnout Contagion. Annals of internal medicine. 2019 Jun 4;170(11):816.
Murray JF, Meeks LM. Support medical students with psychological disabilities. Disability Compliance for Higher Education. 2016 Jul;21(12):7-.
Taylor NL, Miller M, Meeks LM. Physician Licensing, Career, and Practice. In Disability as Diversity 2020 (pp. 279-295). Springer, Cham.