Death rates of medical school class presidents.

Medical professionals often face many competing demands to contribute both to the clinical care of patients and to the public health of society. We studied the long-term survival of doctors graduating from one medical school over one century (n = 1521), comparing those who were presidents of their class to those who appeared alphabetically before or alphabetically after the president in the graduating class photograph. Statistics on long-term mortality were obtained from licensing authorities, medical obituaries, professional associations, alumni records, and national physician directories (follow-up 94% complete, median follow-up duration = 38 years, total deaths = 220). We found that most graduates were male (88%), white (93%), and younger than 30 years at time of graduation (93%). Presidents more frequently made contributions to society than their classmates, as recognized by professional alumni notices (21.9% vs. 13.3%, P < 0.001) and Who's Who directory listings (7% vs. 0.5%, P < 0.001). Nonetheless, survival after medical school was 2.4 years shorter for presidents than their classmates (49.0 vs. 51.4, P = 0.036). The decrease in life-expectancy was unrelated to medical school marks or early career mortality and was accentuated after adjustments for birth year, gender, race, and specialization (P = 0.001 ). We suggest that the type of medical professional who sacrifices themselves for this type of professional prestige may also be the type who fails to look after their health or is otherwise prone to early mortality.