New resource advises how to prevent, respond to trainee suicide

Timothy M. Smith , Contributing News Writer

A doctor a day. No one knows exactly how many physicians in the U.S. commit suicide each year, but one per day is a common estimate. It means the medical school community has to graduate about three average-size classes every year just to replace the physicians who are taking their own lives. A new initiative aims to prevent suicides among physicians and medical trainees by encouraging help-seeking behavior. And in the tragic event of a peer’s suicide, it provides expert guidance on how to respond.

The initiative, launched by the Accreditation Council for Graduate Medical Education (ACGME), the American Foundation for Suicide Prevention (AFSP) and Mayo Clinic, does more than acknowledge high rates of depression, burnout and suicide among physicians. It seeks to change how residents and fellows talk to each other about the stressors of medical training.

“People want someone to ask. They want someone to care,” explains a four-minute video, “Make the Difference: Preventing Medical Trainee Suicide,” a cornerstone of the campaign. “Anyone can ask, ‘Are you thinking about killing yourself?’ And if she says yes, or maybe, or sometimes, here’s what you don’t say: ‘That’s crazy. One mistake isn’t worth killing yourself over …’ What you do say is, ‘I’m sorry you’re feeling so bad. How can I help? We’ll get through this together. Let’s get you some help.’”

“We want to be part of a national dialogue that addresses physician well-being and leads to transformational change—to a more humane learning environment for all medical education and a healthier culture for all physicians,” ACGME CEO Thomas J. Nasca, MD, said in a statement announcing the initiative.

Physician well-being has a direct impact on patient care. Evidence shows that burnout and depressive symptoms undermine quality of care and may contribute to medical errors. In addition, physicians who experience burnout are also more likely to reduce their clinical hours or leave practice altogether, both of which impact patient access to care. 

Fredric Meyer, MD, executive dean of education at Mayo Clinic, added, “For the welfare of patients and the next generation of physicians, the nation’s providers of medical education must strive to cultivate an environment that promotes both stress management and resilience.”

In addition to Mayo Clinic’s work on preventing and responding to trainee suicide, Mayo Medical School received a grant through the AMA’s Accelerating Change in Medical Education Consortium to pilot an educational model to prepare students to practice within and lead patient-centered, community-oriented, science-driven collaborative care teams that deliver high-value care. To help ensure students are well-equipped for a career in medicine, Mayo is developing curricula and tools to enhance student well-being and resiliency, one of which is the Medical Student Well-Being Index, which allows self-assessment of distress and immediate access to local and national resources.

At the ACGME’s Second Symposium on Physician Well-Being, the three organizations introduced a library of educational resources, which includes “After a Suicide: A Toolkit for Physician Residency/Fellowship Programs,” a comprehensive guide to help trainees and graduate training programs respond to a resident’s death by suicide. It features chapters on:

  • Developing a suicide crisis plan
  • Creating a checklist for after a suicide
  • Sharing the news
  • Helping residents cope
  • Dealing with news media
  • Memorializing the trainee who has died

Its appendix provides a variety of crisis response tools, such as sample scripts and a memorial service planning checklist.

The resource library also features a webinar, “Combating Burnout, Promoting Physician Well-being: Building Blocks for a Healthy Learning Environment in GME,” which details a hands-on approach for conducting a needs assessment for developing a resident well-being plan. The free webinar requires registration.

“Taking care of your mental health is the strong and smart thing to do,” said Christine Moutier, MD, chief medical officer at the AFSP. “Consider it a best practice for physicians and medical trainees … If physicians begin modeling proactive mental health behaviors, it will send a strong message to all of society.”

The AMA offers a free online training, “Preventing physician distress and suicide,” with tips for identifying at-risk physicians and facilitating access to appropriate care, as well as answers to common questions about physician distress and suicidal behavior. AMA PRA Category 1 Credit™ is available.

To reach out for help for yourself or someone else, call the National Suicide Prevention Lifeline at (800) 273-TALK.