First in your class, first in your grave

Recent findings indicate that medical school
presidencies are bad for your health

by Jason Gondziola

A recent study by University of Toronto researchers is raising some concerned eyebrows among Canada's medical students. The study, which compared the life expectancy of graduates from the University of Toronto's medical school over the past century, found that class presidents are living shorter lives than their classmates.

"On average the life expectancy for a medical school class president is 49 years following graduation," says Dr Donald Redelmeier, lead author of a recent paper on the subject in Social Science and Medicine and professor of medicine at the University of Toronto. "On average the life expectancy of the average classmate is 51.4 years following graduation."

The study made use of simple methodology to attain its ends: the class yearbook. Dr Redelmeier and co-author Dr. Jeffrey Kwong, himself a former University of Toronto class president and now a community resident at the university, used the yearbook to compare the life expectancy for each of the 507 class presidents against 1,014 students who appeared alphabetically before or after them in the yearbook. Using mortality information from licensing authorities, medical obituaries, professional associations and alumni records they compared the life expectancy of each group, yielding a difference of 2.4 years.

"This difference in survival did not relate to death during school or for the first decade thereafter," says Dr Redelmeier. "We also know that the difference in survival was even larger when we adjusted for age, gender, and subsequent specialization. We know that it's unlikely due to chance and, most importantly, we know that although presidents lead somewhat shorter lives they are still remarkably productive in society."

As proof, he cited the Canadian Who's Who guide, which lists Canadians of national importance. One out of every 14 class presidents from the study was listed, all of them well after they completed medical school. By contrast, only one out of every 200 non-presidential students was listed. Similar trends were found by comparing professional achievements from the two sets of graduates.

It is specifically this productivity and status-seeking behaviour that can cause professionals to neglect their health, according to Dr Redelmeier. "It suggests that the types of professionals who sacrifice themselves for this kind of prestige and ongoing career productivity may also be the types who either fail to look after their health or are otherwise prone to early mortality," he said.

Kathy Lo, current president of the University of Alberta Medical Student's Association, agrees with the findings, but is quick to point out that these trends are not exclusive to medical students. "I could see how it could be valid," she says. "But at the same time I don't think it's just the presidents of the organizations; it's anyone who has a lot of responsibility and has to be accountable for what they do."

But Shane English, the Ontario regional representative for the Canadian Federation of Medical Students, disagrees, saying he doesn't feel that there is anything particular to his duties that could lead to a shorter life. "I don't think being a class president means being any busier than any people in our class," says Mr English, adding that other students are equally occupied with other duties. "Priorities are just different with different students."

Dr Redelmeier said that his findings shouldn't discourage ambitious students from pursuing class presidencies, but rather to serve as a warning. "We're not suggesting that people stop running for election or that presidents deserve special medical care during their terms," he said. "What these results suggest instead is that individuals need to be a bit more mindful about becoming overworked and spread too thin trying to fulfil worthwhile intentions."