Depressed medical students

An interesting article on depression among medical students in last week's NEJM (free full text).

Others have suggested that although the rate of depression among students entering medical school is similar to that among other people of similar ages, the prevalence increases disproportionately over the course of medical school.

I think there are several contributing factors, including:

1. Hard work, much of it not very rewarding (i.e. memorizing biochemical pathways or printing out lab results)
2. Sleep deprivation
3. Disillusionment. Medicine is a funny sort of career. Most people have no real idea what they are getting into when they decide to go to medical school. They work very hard to get good grades in hard classes and good MCAT scores as undergrads, then show up for 2 even harder years which have no relation to what they'll actually do. Then 3rd year, they start "clinical" work, but it is largely focused on inpatients who are generally old, sick and depressing (most people have no idea what a high percentage of medical care goest to the old/sick). They spend most of their time with even more tired (and often bitter) residents. They don't stay in one place long enough to bond, and are separated from all their classmates. Most people are able to find a specialty the can tolerate (or actually like) but if, say, you are destined to be an anesthesiologist and you do medicine and pediatrics as your first rotations, things can look a little bleak.
4. Learning to live independently. I think studies say undergrads spend 25-30 hours per week on school (granted pre-meds probably spend a bit more than average), and live in dorms with janitors and have meal plans. Even then they have trouble getting their laundry done. Now as a medical student you are working 2-3x as many hours and also having to be more responsible for things like buying groceries and paying the rent.

It is no wonder so many medical students are depressed. Of course, in many ways what comes next, residency, is worse.