Dr. Sarah Tulk, a family doctor in Milton, Ont., shown on Thursday, May 2, 2019, is drawing attention to the need for more awareness about high rates of suicide among physicians after her own issues with depression while she was in training. (Sarah Tulk/The Canadian Press)

Systemic change needed to address suicide among physicians in Canada: doctors

They write that suicide is an occupational hazard in their profession

Dr. Sarah Tulk remembers feeling hopeless while training as a resident, her energy sapped by the demands of a job that had her working 24 hours and more straight, until the depression that set in had her thinking she’d kill herself.

“I did feel suicidal,” she said. “That’s what sparked my interest and desire to talk about it.”

Tulk, who completed her residency in family medicine at McMaster University in Hamilton saw a system that was failing resilient people wired to succeed through hard work and a competitive drive — before they became victims of burnout.

“A lot of people do a pretty good job of hiding it,” she said of the high rate of depression among medical students, residents and doctors. She said they stay silent because they worry about their careers if they expose what they consider a weakness.

Tulk, who reached out for help in 2016 through a physician health program, is working to raise awareness and create change after hearing about too many doctors taking their own lives.

“I’m doing really well and I want people to know that recovery is certainly possible,” said Tulk, now a family doctor in Milton, Ont.

Tulk has joined psychiatrist Joy Albuquerque, medical director of the Ontario Medical Association’s physician health program, in outlining five key points about physician suicide in Monday’s publication of the Canadian Medical Association Journal.

READ MORE: BC Children’s warns of glamorizing self-harm on World Suicide Day

They write that suicide is an occupational hazard in their profession, with a rate for male doctors nearly double compared with the general public, and two and a half times higher for female physicians.

Access to drugs and expertise in their use means doctors know just how much they need to hasten death by poisoning, sometimes with benzodiazepines or with other methods, including firearms.

Thoughts of suicide can begin in medical school and are later associated with patients’ complaints to regulatory bodies, Tulk and Albuquerque say, adding doctors face unique barriers to care compared with the general public.

While stigma is generally pervasive, physicians have the extra burden of little time to access care and face concerns about confidentiality as they fear discrimination in licensing and applications for work at hospitals, the commentary says.

In a SoundCloud podcast on the topic, Albuquerque says their colleagues also tend to self-stigmatize because they are accustomed to being care providers, not those who receive care.

Self care is an important component of dealing with the challenges of the job and it’s starting to be part of the learning environment at medical schools but there’s a long way to go, said Tulk, who teaches undergraduate programs at McMaster University.

Dr. Stephanie Smith, who will be starting a two-year family practice residency at the University of Calgary in July, said that as a medical student, she was working at a hospital for up to 27 “dangerous” hours at a time.

“The majority of my class was burned out by the end of medical school,” she said of the pressure of the 14-month program without any breaks to recover mentally.

“After 27 hours I’m just not processing things the same way anymore. It adds a very complex layer of stress and anxiety and guilt” to the heavy workload of a medical student, she said.

Smith, who has been in the Canadian Armed Forces for 18 years and worked as a nurse in the military between 2004 and 2016, said medical students often end up taking on extra responsibility for patients when fewer regular health-care staff are working during evenings, raising concerns about safety.

“I have a lot of critical experience as a nurse and I worry when I’m so tired at four or five in the morning and I have not slept since the day before. But the person who is signing off on things, the resident, is also tired.”

READ MORE: Canadian research finds steep increase in suicide attempts by children

Dr. Gigi Osler, president of the Canadian Medical Association, said the well-being of physicians is a high priority and her organization is working with medical students, residents and provincial associations to create change for the sake of a healthy workforce.

“We’re in this position, sitting at those tables, where we are going to continue to try to be that catalyst and that connector to say we need to have change,” Osler said after meeting in Vancouver with her British Columbia counterparts, who she said shared their concerns about health and wellness among physicians.

The CMA hired a clinical psychiatrist in January to take the lead on that issue, and Dr. Caroline Gerin-Lajoie’s role will be to survey the needs of the health professionals across the country as stigma surrounding suicide is also addressed, Osler said.

“I can tell you, anecdotally, that there have been physician deaths that I’m almost 100 per cent certain have been suicides but nobody’s talking about it because the family doesn’t want to talk about it, colleagues don’t want to talk about it.”

Camille Bains, The Canadian Press


Like us on Facebook and follow us on Twitter.

Just Posted

Art and music at Summerland Ornamental Gardens

Second event of the summer will be held Sunday, Aug. 25

Summerland’s downtown has gone through numerous changes

Main Street has been commercial hub of community for many years

Motorcyclist involved in Westside Road crash

Air ambulance assists while motorists face lengthy delays

The Offspring and Sum41 ready to rock Penticton

The Offspring and Sum 41 will stop in Penticton to the South Okanagan Events Centre

Hawk chick that was cared for in the Okanagan euthanized

Public warned against keeping wildlife after hawk chick had to be euthanized

VIDEO: Canadian zoos’ captive breeding programs help preserve endangered species

Programs considered last-ditch effort to prevent local extinctions of turtles, butterflies and more

Man launches petition to bring charter schools to B.C.

The move could see up to 20 charter schools come to the province

Okanagan’s alleged “Deadpool” robber revealed

RCMP catch up with suspect following gas station robbery earlier this month

RCMP searching for missing Kelowna hitchhiker

Cody Kolodychuk was last heard from on July 31 and was thought to be hitchhiking in the Vernon area

South Okanagan pays it forward to BC Wildfire Service firefighters

Community members thank Eagle Bluff firefighters through Tim Hortons donations

Vancouver man arrested after pregnant woman’s SUV stolen, then crashed

Police are recommending charges against a 22-year-old Vancouver man

Elections Canada to assess ‘partisan’ climate change rhetoric case by case

People’s Party of Canada Leader Maxime Bernier has said climate change is not an emergency nor caused by human

Unseasonable snow forces campers out of northeastern B.C. provincial park

Storm brought as much as 35 centimetres of snow to the Fort Nelson, Muncho Lake Park-Stone Mountain Park

Most Read