Working as a doctor is already a stressful job, but factor in the reality that we are living in a pandemic, then the job gets significantly more difficult. A study that surveyed 7,288 doctors found that “45.8% of physicians were considered to be experiencing at least 1 symptom of burnout based on a high emotional exhaustion score or a high depersonalization score” and “37.9% of US physicians had high emotional exhaustion”1. As a result of stress, demanding hours, poor time management, and lack of support doctors are at a unique threat of suicide. Research shows that physicians' suicide rates are significantly higher than the general population, one study showed that male physicians were at a 40% higher risk of suicide compared to the general population, and females at a 130% risk increase2. Physician suicide was also ranked among the top five occupations that commit suicide, and research shows that physicians have a higher suicide rate compared to individuals in law enforcement and individuals in the military.
This grant funding will go towards a couple of different avenues to address ACEs among UF senior year medical students who seek to work at Shands Hospital. The following will need funding
- Once a month one on one mentoring from retired Shands physicians for one year
- One time self-confidence training
- Bimonthly 1-hour therapy to discuss patient cases and experiences in the ER
The top 50 students with the highest ACE scores will be eligible for these resources, as they are clearly at an increased risk of suicide due to their ACEs and entering into the medical field as physicians.
We will recruit retired Shands physicians to participate in our one-on-one mentor training sessions. Each student will meet with one retired physician once a month to discuss the ramifications, and lessons learned, answer questions, and discuss their best tips, and expectations of the job. We will host a one-time confidence training for these medical students to boost their self-confidence and self-efficacy. Finally, we will host bi-monthly one-hour individual therapy sessions for each student. This field comes with a lot of stress and many malpractice cases so providing these students with an outlet where they can speak openly and freely about the events in their workplace will be very healthy for their mental health. These therapy sessions also offer a support system for them. These interventions will all be administered over a 2 year period.
All of these solutions for problems found from being a physician also are solutions to help address common ACEs. So these interventions techniques will not only help these students address their ACEs but also prepare them for a difficult workforce.
The two main principles that will be utilized in our grant proposal are 1. Trustworthiness and transparency 2. Empowerment, voice, and choice8. The first principle will be used in a couple of ways, first by asking the participants, during our planning stages, if they believe our interventions will be effective at addressing suicide and suicide ideation. We will ask for their feedback during the planning of this project as well as their thoughts on the effectiveness of the program. The next principle will be seen throughout our grant process by empowering our staff of therapists, couches, and mentors about ACEs and trauma. Each of these key players will be required to sit in training about ACEs and how to address them when helping our participants.
This intervention will be addressing a couple of different levels of the social-ecological model (SEM). And this particular project we’ll be looking at the CDC SEM. The CDC version has a total of four levels: individual, relationships, community, and societal. The way this intervention addresses the individual level is by changing the senior medical student's attitudes and beliefs through the self-confidence class training and the bi-monthly therapy offered. The two avenues of intervention are created specifically for the individual and work toward the root of the problem when addressing suicide, for a lot of people who test high on the ACE score, this root problem is their childhood trauma. The individual-level was chosen because how what an important role an individual’s own thoughts play when thinking about suicide. According to a 2006 research article, hopelessness is one the biggest primary motivators for suicide among a majority of participants interviewed. Hopelessness holds a large significance when reasoning suicide and this specific issue can be addressed through our therapy intervention. Another level of the SEM we address is the relationship level. This is addressed through our intervention avenue of building mentoring relationships with senior medical students and retired Shands physician staff. This new relationship will offer the student a support system which is key to suicide prevention. The reason for this level is to help build informational support, social support, and emotional support. All three of these forms of support have been proven to be significantly associated with a lower suicide overall total score.
This new intervention uses a public health framework when addressing our priority population of seniors at the UF college of medicine program. This intervention is addressing the secondary level of prevention, this is clear because our priority population is at a higher risk than the normal population, for depression and suicide. This is due to the jobs demand, high burnout rates, and lack of a support system.
Being in medical school already has higher rates of stress and anxiety but becoming a physician brings an increasing amount of these same mental health issues. As well as an increased risk of suicide. These outcomes are unique to this field of medicine.
By offering therapy we are using preventative measures to stop or decrease the current amount of stress these students are already experiencing. This will play a big role in how they handle emotions and actions in their future physician careers. By offering our mentor program we are preventing stress, depression, and suicide by equipping these students with realistic job expectations, tips, support, and advice on how to do their jobs well and in a healthy manner. And by offering our confidence training class we are preventing burnout rates and overall stress for these students by providing them with the necessary tools to know when to stand up for themselves at work.
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