The Pendulum Swings: A Reality Check on Mental Hardship

Within the past ten or so years, our society has paid increasing attention to mental health. Challenges and disorders that were once stigmatized are now discussed freely - and people are more likely than ever before to seek support and professional help. 

On one hand, I am fully supportive. I believe that truly knowing yourself leads to increased empathy and emotional intelligence. Being honest about your mental health can be a tremendous step towards improving your mental health - and that is a journey I often commend. On the other hand, I cannot help but worry that the pendulum is swinging past center in a few crucial and concerning areas. 

I recently found myself at a dinner engagement with the head of a prominent academic medical center. He shared a prevailing trend that I personally find extremely worrisome. He shared that medical students are leveraging mental hardship as a defense mechanism against expulsion due to poor academic performance. The man I was breaking bread with has been practicing as and training medical professionals for decades, and he has noticed a sharp and alarming uptick in students claiming that their poor performance is a result of mental health struggles and therefore their failures should not be penalized. In fact, the way the institution stands, students cannot be penalized. If a student claims mental hardship in front of the expulsion committee, the committee is required to work with them rather than remove them from medical school.

This raises a profound question about the foundations of our future professionals. The current climate sees mental hardship being wielded not as a crucible for growth but as an excuse to avoid challenges. This begs the question: In a decade, do we wish to entrust our well-being to surgeons who navigated medical school in this way? There is a longstanding but biting joke that goes ‘What do you call the guy who graduated at the bottom of his class in medical school? You call him doctor.’ The subtext is that medical school is so rigorous that anyone who makes it through is qualified to take responsibility for your health. But will that be true of the next generation of doctors?

Medical school was designed to manufacture hardships to equip individuals with the resilience needed for the rigors of the real world. However, this delicate conversation surrounding mental hardship and responsibility cast a significant shadow. I firmly believe that mental hardship creates pressure, and that pressure creates stronger people. Medical school is meant to be an intense experience. The pressure was designed to weed out the people who cannot handle it.

I want to be clear about something, if someone cannot handle the pressures of medical school it says absolutely nothing about their value or their character. Not everyone is suited for everything, and if you judge a fish by its ability to climb a tree it will spend its entire life feeling like a failure. 

I would like to see our society continue to support mental well-being, but then go a step further and use that awareness to move people into the roles they are suited for. Mental hardship should not be used as a shield but as a tool, and I challenge you to examine your own hardships through that lens. Let them make you stronger.