Is this the Cost of the Oath?

Tomi always wanted to be a doctor. He grew up in Ibadan, Nigeria, where the city’s rust-brown roofs and lively atmosphere shaped his dream of wearing a white coat. When he moved from pre-clinicals to the teaching hospital wards in South West Nigeria in 2017, his dream quickly became a tough and exhausting reality.
Clinical training in Nigerian medical schools is extremely tough, with strict hierarchies, heavy patient loads, and constant academic pressure. From 2017 to 2019, Tomi’s days were filled with early morning ward rounds, nonstop patient work, and public criticism from demanding consultants. The pressure was overwhelming. By the time he started his second surgery rotation, he felt something inside him break.
At first, Tomi just felt tired all the time and thought it was normal stress from medical school. But soon, he felt empty and numb. He couldn’t sleep, lost his appetite, and even thinking about going to the hospital gave him severe panic attacks.
In a cultural climate that frequently dismisses mental health struggles compounded by the societal expectation for young men to constantly “man up” and show no vulnerability, Tomi suffered in complete silence. He forced smiles through study groups and maintained a meticulously put-together outward appearance while actively battling suicidal ideation. It was a tragic paradox: he was spending his days learning the science of saving lives, yet he was quietly losing his grip on his own.
Everything came to a head in 2021. The pandemic delayed the academic calendar by one year; two friends died during it, and a strike by university lecturers prolonged the delay. The heavy weight of uncertainty and depression became too much. Fortunately, he had an aunt who had fought through depression on her own and understood. She was there for him. Though he refused to see a therapist out of fear of stigma, he gradually began to regain his joy. 
 Tomi was never officially diagnosed with clinical depression; he did not need to, he knew what he was dealing with, he checked all the boxes himself according to the ICD 10. He had to learn the difficult, daily task of untangling his self-worth from his academic performance and unburden himself from the pressure that came with medical school. It required immense courage to show up to the wards every day, to adhere strictly to his plan, and to forgive himself on the days the darkness crept back in. Slowly, the colour returned to his world. He developed healthy coping mechanisms, recognised his triggers, and tentatively confided in a few trusted peers who, to his immense surprise, shared similar silent struggles.
In 2022, Tomi finally took his Hippocratic Oath. As he stood with his classmates at the ceremony, tears ran down his face. They were not tears of sadness, but of victory after a long struggle. He had made it through medical school and through his own mental health challenges.
The True Cost of the Oath: An Urgent Call to Our Healing Community
We spend years learning the details of the human body and how to save lives. But while we work toward this important goal, our medical culture often harms the minds and spirits of those who are supposed to help others.
I made it through medical school and took my Hippocratic Oath, but it nearly cost me my life. The harsh mix of strict hierarchy, public humiliation, and the pressure to stay silent almost led me to become another statistic. It is tragic that hospitals, which are meant to heal, often become places where trainees experience deep depression.
This should not be what the next generation has to go through. We need to urgently change how we train future doctors. Here is what needs to happen now:
End the practice of teaching through humiliation. Instead of public shaming during ward rounds, we should create supportive environments where people feel safe.
Remove the stigma around mental health in medicine. We need to recognize that student burnout is a real job risk and stop expecting doctors to keep their struggles to themselves.
Set up confidential and easy-to-access support systems. Offer independent, stigma-free therapy and regular wellness checks that will not put a student's academic progress at risk.
Remind trainees that their worth is not tied to their clinical performance. Encourage them to talk about their struggles and help them see that their value is not based on grades or evaluations. 
 N:B- This story is true, but names and identifying details have been changed for privacy sake