When I was a resident, prior to contract renewal, I had to complete an online "education session" on depression.
They had a little scenario where a resident is presenting a patient and fumbles a little, resulting in getting completely reamed by the attending who says something like, "Hello? Anybody home?" Then resident bursts into tears, says, "I'm sorry, I can't do this anymore!" And dramatically runs off.
I'm not sure if that was supposed to be the "bad" scenario or simply the most realistic one.
In the second scenario, the attending is a little more understanding and talks to the resident privately after rounds about her recent decline in performance. The resident says that she's having some problems with her husband and the stress of work is too overwhelming. And she reveals that when her husband took her twins (!) out for ice cream the other night, she stayed behind and just cried. Then the attending asked her if she'd ever thought of hurting herself and she replied no, but that she sometimes thought she'd be better off dead.
What struck me about this exercise was how realistic the first scenario was compared with the second. If you, as a resident, fumble, most of the time the attending isn't going to sit you down and have a heart to heart. You're going to get reamed.
(I'm not sure why they were showing this to us anyway, considering we were residents. What were we supposed to do about this? Wish vehemently for Attending #2?)
The truth is, if you're at all inclined to get depressed, medical training is going to bring it out in you. Especially intern year. Interns have it really hard--you pretty much get dumped on by everyone and you're constantly exhausted. In retrospect, that was possibly the worst year of my life.
I personally know two interns who attempted suicide, one of whom succeeded. It's really horrible when someone you know does that, and it's hard not to get really angry at the culture that nurtures it. The culture of med school and residency is that when you start to struggle, things get infinitely worse. In the several programs that I attended, there were no resources readily available for trainees who were struggling.
I don't think the culture of medical training is going to change. It's not realistic to think the old school attendings are going to stop making interns cry. But I think having some mandatory (or at least very easily accessible) counseling might improve things. I don't think half-hearted group "wellness" meetings that get canceled half the time are really cutting it.