Schwenk says the difficulties involve an "atmosphere and culture" that must be changed. It is no easy task, he admits. The problems are woven in and around a budding physician's sense of duty, a false sense of invulnerability, coupled with a lack of understanding about their depression and its impact on themselves and the reaction of others around them.
Overall, "there is this extreme sense of professional duty," he says. "Physicians will work while they are sick. They know everything, they can never be vulnerable, can never show any deficiency."
Of course, strong professional obligations are essentially good, he says. "But it gets carried way too far."
The study showed 14.3 % of the students reported moderate to severe depression, which is higher than the 10 to 12 % usually found in the general population, says Schwenk. "These results show that students who are depressed feel highly stigmatized by their fellow students and faculty members," says Schwenk.
The report findings suggest that there is a perception by depressed students that "they are in fact viewed as less capable." It adds: "The findings may reflect a medical school environment in which depressed students are stigmatized because of their disease rather than on the basis of performance. In such an environment, revealing depression to friends, faculty members and residency program directors could have real and adverse consequences."
Inevitably, students with moderate to severe depression are concerned that fellow students would respect them less, Schwenk says.