An Open Letter to the Stressed Medico – in Context of the Recent Suicide of an MBBS Student

I just came to know that a student of first year MBBS had committed suicide on 6^th July 2015 because he thought the course promoted rote learning and he did not find himself fit for the course. So he decided it was not worth living anymore.

The course of MBBS is a highly demanding one – both in terms of physical and mental toughness from the student. A study conducted by my friends at my institute found that 25% of medical students show signs of depression – which is highly alarming. So there are a huge number of students who would, at some point in the course, seriously consider ending their life.

My friend Sarath, wrote an article about his first year MBBS experiences, and he encouraged students to communicate to him by email. He received an email from such a student who was having trouble coping with the stress the course exerted on her. She was severely stressed and was not knowing how to go ahead with her life. So me, with my friend Sarath, sent her a reply explaining to her why it was normal for her to feel what she was feeling, and why she should hang on to it, like the rest of the medicos. With her permission, I am posting here the edited letter, and our original reply to her.

Hi. I am Neha(Name changed for privacy). I am a student of first year MBBS in XYZ college. My professional exams are coming up shortly. To be frank, I have been not interested in this course because I knew I would not be able to study so much by heart. I really have no idea how to learn. This college is the worst place I have ever been to. I was a good student – I had full A+ in my 10th boards. I secured 94.3% in 12th. I was ranked respectably in the PMT examination. Choosing XYZ College was the worst decision I have taken in my life. Reaching this place, I have never felt like reading. I cannot concentrate in my studies here. Till today, I have passed the internals only with my friends’ help. I think you can understand when I say like that. I have always tried to skip those small test papers whenever I can. So at the moment I feel like committing suicide. I have been doing a course which I do not like. I like studying, only if that’s interesting. I always liked to do something different and interesting. But my mother never allowed me to think of anything else. She is the one who have pushed me to do this. So, can you help me in anyway? I don’t want advices. Can u tell me whether there are any 3 year diploma courses? Can I stop this course here and continue this later? May be, after 3 years?

Here is the original email I sent her, as a reply to the email she sent to Sarath.

Hello Neha, 

Sad to know that you did not find MBBS interesting. In fact, it is extremely boring for the first year. During lectures, you may find that even a lizard moving on the wall will be more interesting than the subject the teacher is talking. I completely agree with you in that regard and I would say, it is the same for most people, even though they say it otherwise. However, the interesting part of it comes only when you are posted in clinics. The clinical postings are by far the best part of the course. Interacting with the patients, taking history, helping the doctors examine, assisting them in the procedures, help them in making the diagnosis, think with them, it is totally worth it. It has got an element of puzzle solving to it and is extremely enjoyable. You won’t know the fun involved in it unless you do it once.

You said no advices. Well, I was not planning to give you any, in the first place. For the questions you asked, there are a couple of options that immediately come to my mind. If you are into engineering, you may go to ITI and get a diploma course in that. If you want to stick with medicine, there are some other options as well. There are certain lab technician and OT technician courses available and some institutes do provide that. I cannot provide you with details, but a quick Googling will give you some. You may even go for BSc nursing, which is supposed to be far simpler, but that would mean you writing the entrance examination again. But there is one thing to keep in mind. When you go for all these courses, your career will be spent working under Doctor(s). And I can tell you, it is not at all fun. Doctors can be really arrogant. At that time, you should not regret the decision you have taken. So it is not an easy decision to make, it is an important and career twisting decision and I would recommend that you take your time in making it. If you want to stay away from this field at all, there are plenty of Degree courses available. Will you be able to continue once you return? I would say it is highly unlikely on a Govt Institute. Regarding your institute, I would recommend that you talk to your Dean on the possibilities of such an option. This is not an exhaustive list, and I am not a career consultant. You may be able to get better advices from other people.

However, there are things that I can say to you from my area of expertise. There was a friend of mine, the only Anatomy examination in which he was passed was the final examination, rest everything (including all internals, class tests, even small 10 mark tests) he failed miserably. But still he could pass the final exams and the reason he says is that he did not leave hope. He clung on to it, like a bat on a tree branch, under all pressure circumstances, and he did it finally, with comparatively good marks. So from your description, I am finding you in better position and I cannot think of any real reason why you have to quit. If he (91% marks in plus 2) could do it, you definitely can.

You are passing through a time where most of the people think of either quitting, running away to the Himalayas, suicide, etc and it is nothing new, because first year is supposed to be the toughest year of MBBS. And like most people say, “this too will pass”. What you are feeling right now is the same feeling felt by thousands every year(including me) and 99% of them somehow cross it and it is very difficult to be in that one percent people. The only thing you have to do is cling to it, and never let it go. It is up to you whether to do it. But I would say you do it, because if you won’t it is talent and resources going waste. You leaving the seat means one MBBS seat at your institute is going waste and along with it, goes all the money the government spent for you and more important than that, one talented person does not get to study the course she deserves, simply because she was not motivated. You said you cannot cram things up. So can’t many and they still pass the course with flying colors. There are ways to achieve it, but I cannot tell you because you said: “No Advices”. But there is one thing I can assure you: for somebody as talented in studies as you(evident from your marks), I can guarantee that MBBS is the most suited course, not because her mother told her to do it, not because her society told her to do it, but because she deserves to do it. Saving lives is one thing that only a handful of people in the world can do, and you should thank God that you got a chance to do that, because most people wishes to be one among them and still they don’t get a chance. It is that chance that you have in your hand and it is up to you whether to use it or to throw it away simply because you were afraid of one stupid examination.

If you still feel that you don’t want advices on how to crack the exam, then at least give me a reply and tell me that you are doing it yourself, without my help.
Best wishes for your exams and let me know your results once you get it.

We got a reply after 2 months saying that Neha had passed the first year mbbs examination with 57% marks, and is now continuing with her second year MBBS at her college.

Here is what we understood from this. It is natural and ok to have stress, but it is not okay to not talk to people about it. Apparently Neha was reluctant to talk to her friends or a psychiatrist about it, but still she got a listener who could understand what she was going through. Here is a word of advice for all medical students. Always talk. If you feel stressed, talk to a psychiatrist. Talk to anyone – it need not be your friends. It is not important to whom you talk to – what is important is that you talk. Just get it out of your system. You may find it difficult to talk about your feelings, but I guarantee you, in the end, you will feel much relieved that you did.

I hope you found this helpful. Please leave your comments below.