Robert Chus suicide sends a message medicine cannot ignore

If a suicide can’t shake the medical training system into action, nothing will.The motto of the Coroner’s Office is, “we speak for the dead to protect the living.” Unlike a police investigation into a homicide, say, coroners aren’t out to assign legal responsibility or solve a crime. The goal is to identify the system failures that led to a death, and help find a way forward so it doesn’t happen again.It’s work that seems out of place these days, pressured as we are to make maximally productive use of time. It demands time and careful thought, reflection and patience. The problems can’t be explored 140 characters at a time, any more than they can be addressed in a political news cycle. But because the work is on behalf of the dead, it’s wholly incorruptible.With a coroner’s eye and heavy heart, I read the devastating story of Dr. Robert Chu, who died by suicide in September 2016, having been twice unsuccessful at landing a residency spot after med school.Those closest to him will spend years wondering what signs they might have overlooked, or what offhand remarks they might have misinterpreted, his family members carrying that burden the rest of their lives. But the personal details never tell the whole story, and Robert’s death must be considered with the utmost seriousness by every medical educator and administrator in the country.Article Continued BelowAnd to those who might brush it off as “just another suicide, what makes a doctor so special?”, I would only point to the (admittedly crass) fiscal math. Canada invested roughly a half-million dollars — more than a decade’s worth of the average family’s total tax bill — to make Robert Chu a doctor, and he died before signing a single prescription.What questions come to mind when reading Robert’s story, and the accompanying piece in the Toronto Star about the plight of other unmatched medical graduates, outside of whatever personal factors played a role? Many that give pause for thought, and light the way for decision-makers to act.In his first go-around at the match, Robert was told he was too broad in choosing his electives, perhaps at the expense of focusing on radiology (the article isn’t entirely clear on this). Is an early narrowed focus something we should prize in medical students? What about people who discover a specialty late in medical school, or change their mind because of an excellent mentor?