In Reply: Dr Helmich and colleagues comment on the importance of early clinical exposure for medical students in developing appropriate professional values and behavior. We believe that the key issue is not the nature or timing of the experience but the nature of the associated role modeling, mentorship, and supervision that can help students process, integrate, and learn the optimal lessons from such experiences. Medical students are exposed to a stunning array of emotionally charged experiences, both positive and negative, and often process these experiences in isolation, without support from fellow students, teachers, or advisers. The lessons that medical students frequently learn from such experiences are that they have to suffer the consequences of these events alone, that this is the nature of the practice of medicine and the life they have chosen as a physician, that seeking help or support implies weakness or inadequacy, and that the burnout or depression that may result from feelings of weakness or inadequacy is viewed with suspicion by many fellow students and possibly even some faculty members.
Schwenk TL, Davis L, Wimsatt LA. Medical Students and Depression—Reply. JAMA. 2011;305(1):38-39. doi:10.1001/jama.2010.1887