Meet Chad Richards, the Med Student Standing Up to Physician Burnout

Note: Sharp Index hosted this year its first ever scholarship program for medical students, residents, and non-medical students who aim to improve physician well-being. We evaluated candidates based on their plans for a better system, dedication to the cause, and financial need, among other qualities. Chad Richards, a third-year medical student at Nova Southeastern University, is the recipient of the inaugural Sharp Index Scholarship. What follows is his story and vision for the future.Apply for our next round of scholarship funding here.Chad Richards stared into his bathroom mirror. “If I end this now, how long will my wife take to move on?” he thought. “Are my kids young enough that they won’t remember me?” So much, he reasoned, had gone wrong. After failing 14 courses and spending years trapped in undergrad, he left Brigham Young University on an academic suspension. He saw his dream of becoming a doctor crumbling. He gained 100 pounds. Although he loved his wife and two children, he felt intense pressure to provide for them, but the path to do so was murkier than ever. Chad had hit rock bottom. In that bathroom, he resolved to end it all.But something, somehow, changed in the next moment. He panicked and instead decided to seek help. He began attending counseling, briefly stepped away from his health care job, and resumed his education, earning a master’s degree in anatomy with a 4.0 GPA. It was all part of his plan to become the father, husband, and physician he knew he could be. To build the life he wanted and deserved.Now, after 12 years of striving to enter med school, Chad is a third-year medical student at Nova Southeastern University, living in Ocala, Florida. By any measure, he’s succeeding. He passed his USMLE Step 1, ranked in the top half of his class in pre-clinicals, and capped off several research projects. Along the way, he and his wife had two more children, the latest, a boy, born just two weeks before Chad started medical school. He intends to one day enter general surgery, helping to piece together patients when they need it most.But Chad hasn’t forgotten his struggles. His time in medical school has only reinforced the sad fact that many doctors and medical students face a considerable mental health challenge, as the prevalence of physician burnout and suicide continues to reap heartbreak and sound alarms in health care and beyond. Since enrolling in medical school, Chad lost three classmates to suicide. He has become a mentor to prospective med students, taken on a role as an advocate, and even proposed systemic changes to the health care system, all in pursuit of better physician well-being. His story—and his vision for the future—recently earned him the first ever Sharp Index Scholarship, a grant designed to make the road ahead just a bit smoother.“Hopefully, someday, I’ll be able to look back on the career that I’ve made for myself and say that I helped a lot of people who were sick and in need and also a lot of aspiring and practicing physicians,” he says. “I made it through all that, and I think it’s important for other people to be able to see that they can do that, too.”Shortly after high school, Chad spent two years on a church mission in Brazil. When he returned to the United States, he fell into a job that fit his newly minted persuasive skill set: sales. He hated the work, so he moved to customer service. He hated that, too, and decided it was time to move on.Medicine emerged as Chad’s desired career path through his older brother, an Arizona-based surgeon who became an expert at hand reconstruction after completing his residency at Stanford. “He’s always been super successful, and he’s extremely smart,” Chad says. “He kind of mentored me with wanting to go to medical school.”In 2006, he enrolled in Brigham Young as an undergrad physiology major and excelled in his first semester. But from then on, his grades started slumping, especially in classes such as physics and chemistry. He even failed a course that served as a preview to medicine—which was graded solely on attendance. A sadness that had long lingered in Chad had come to take hold of him. During that time, Chad met and married his wife. Despite building the foundation of a tight-knit family, he remained on academic probation for several years, before finally leaving school to focus on work and family. He faced intense pressure to provide. That’s when the walls closed in around Chad, and he narrowly avoided a tragic end.“I knew that I wanted to go to medical school and that I wasn’t going to be happy with my life if I settled for anything else,”’ he says. “A lot of people who end up in a situation similar to mine feel so hopeless, and they just see no sensible way of moving forward. And so, they end up doing something drastic, like taking their life.”So, what changed for Chad?He points to a “kind of serendipity.” He didn’t make a conscious choice to overhaul his life. Rather, being away from school and outside the clinic gave him time to work on his mental health. His wife allowed him the room to heal and grow. Together, they ultimately mapped a path forward for Chad to reclaim his life and his dream of becoming a doctor.But he was one of the lucky ones. Stories of resilience and recovery often grab headlines, yet these feel-good narratives fail to capture the dysfunction inherent in the flawed U.S. health care and medical education systems. Too often, the institutional barriers to physician well-being cannot be broken down by cries for individual perseverance or on-site yoga classes. Rather, improving physician lives requires removing or reducing the structural burdens placed on physicians and medical students. Consider the hours of electronic documentation, grueling residency schedules, and the dwindling amount of time spent delivering actual patient care. What’s more, stigma and professional backlash disincentivize physicians from asking for help. These challenges, and others like them, are so overbearing that the affected student, resident, or physician who pushes past the suffering might be deemed fortunate, blessed—lucky.“There’s clearly a much more significant issue at a systemic level within the way physicians are trained and the expectations that are placed on them,” Chad notes. “My point is that we need to develop systems for practicing physicians and residency programs that can help curtail this beyond online surveys and things of nature.”Here are some of his ideas on how to reduce physician and medical student burnout and suicide:

• Treat physician mental health like patient preventive care. “There should be a system in place to reward physicians who complete a yearly mental health eval with a psychiatrist. It should be a badge of honor to say that you are emotionally aware enough to receive help when needed,” possibly as part of a continuing medical education program, Chad writes. Don’t punish students, residents, and physicians who need and secure help.

• Expand medical student access to care. Every student should visit with a mental health professional in their pre-clinical years, he argues. Those who are suffering may receive additional care and leniency with a bias toward remediation over dismissal.

• Establish stronger reprimands for residency programs that lose a student to suicide. Hospitals should carry at least $500,000 in life insurance for physicians and residents, Chad says. These institutions should undergo thorough investigations when their residents die by suicide, with real means of accountability. Hazing, bullying, and unprofessional conduct should be systematically discouraged and punished.

 The push to change legacy systems for the benefit of doctors and students won’t come easy. Chad says he hopes to build a better environment for his colleagues over time. But until then, he’s working toward physician well-being by speaking out about his past and mentoring younger medical students.“It matters to me so much to be open about this,” he adds, “because I think that there are a lot more people who were in the position I was once in. I just want to help them realize that there can be a future for them, a bright and successful future.”If you or someone you know is struggling, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the Crisis Text Line at 741-741. Trained, supportive resources are just a call or text away. Help is free and confidential.— Jack Murtha