It does not take long for physical and mental exhaustion to overtake a young doctor. A 2006 study at the University of Pennsylvania demonstrated that over the course of the first post-graduate year of training, commonly known as “intern” year, rates of burnout–a triad of symptoms comprised of emotional exhaustion, depersonalization, and a sense of decreased personal accomplishment–soared from 4.3 to 55.3 percent. Not surprisingly, increased rates of burnout were associated with increased rates of moderate depression, affecting nearly one-third of interns by the end of the year.

Physician training can be an extremely stressful undertaking, from managing crushing education debt while receiving a minimal salary, to an 80-hour workweek, to having to keep up with the frenetic pace of evolving medical knowledge, all while being responsible for life-and-death decisions. However, none of these reasons–individually or combined–can fully explain why doctors have significantly higher rates of suicide. The complex issue is made only more complex by silence among medical professionals.

One recent study found that only half of depressed interns obtained mental health services. How can it be that physicians, whose lives are spent providing care, are not seeking their own necessary care? Responses for avoiding help include lack of time, lack of confidentiality, a desire to manage their mental health independently, and professional stigma. Nearly half of the interns in the study believed their colleagues would have less confidence in them as medical providers if they sought psychiatric treatment. Threat of judgment from other physicians serves as one of the largest roadblocks to seeking psychiatric care. And yet, there is not one doctor I know who would ever want a colleague to suffer. How can the medical community begin to rectify this self-destructive paradox? As physicians, we believe that initiating a dialogue with our patients is the best way to enact healthy behavior changes. The profession would do well to adopt this same technique to best care for our own.