A narrative review of suicide and suicidal behavior in medical students

Studies across different countries have consistently demonstrated high rates of several psychiatric disorders among medical students. These findings, in turn, may be correlated with the higher than expected rate of suicide in student doctors. We aimed to provide a narrative review of the literature concerning suicidality in medical students worldwide. A narrative review is not a systematic review. Using Pub Med, we identified articles including our defined search terms: ((suicide) OR self-harm) (attempted suicide, deliberate self-harm AND medical students) OR future doctors. Particular credence was given to review articles and original research conducted this decade. We find that medical student suicide is likely related to a number of social and environmental factors. Structural systems in medical schools may play a role, for example, curricula, accommodation, social support, and academic pressures. Interpersonal factors that may be implicated include social isolation, the competitive nature of learning, and being away from home at an early age. There may also be endemic factors unique to medical training, which may contribute to higher rates of depression and suicidality; these include simulation training, working with cadavers, and witnessing trauma throughout placements. The socio-cultural environment, for example, the role of ragging, expectations from teachers, and patients, may place extra pressure on vulnerable individuals. Rates have been shown to be higher among females, which raises further discussion on the nature of gender roles and gender role expectations within medicine. As the medical workforce of the future, today's students require a considerable emotional and financial investment. It is, therefore, crucial that educators and supervisors understand the needs of this student body while delivering the essential skills to be a doctor in a sensitive nonstigmatizing manner.