Why Doctors Are Killing Themselves: The Sad Reality of Medical Resident Suicide

Every year, medical residents across the country face increasing levels of stress and burnout, which can lead to depression and, in some cases, suicide. Medical school is a demanding environment that can affect one's mental health. Being a doctor is a high-stress job. Long hours, on-call shifts, and the pressure to save lives can be overwhelming. Despite the challenges, most medical residents persevere. However, some struggle to cope and turn to suicide as a way out.

According to the ACGME, suicide is the number two cause of resident death, the number one cause of death in male residents, and the second cause of death in female residents. In 2017, there were 105 resident suicides. This is a rate of 12.6 per 100,000 residents.

Many factors contribute to suicide in medical residents. The pressure to succeed in medical school can be overwhelming. The cost of tuition and the debt that comes with it can be stressful. The demanding nature of the job can also lead to burnout. Residents often work long hours and are on call, which can be tough on relationships and family life. Medicine also still struggles with the problem of systemic racism and sexism, contributing to inequitable and mentally challenging experiences for medical residents.

Coping and Perseverance

Despite the challenges, most medical residents persevere. However, some struggle to cope and turn to suicide as a way out. Consider this: perseverance is soldiering on, no matter what, including failure and opposition. What if that failure becomes a constant? One NIH survey found that 31.3 percent of physicians reported ongoing remediation in one specialty. Further, of those remediating, only 59.9% will be successful.

Talent and intelligence abound, but some residents will face opposition during training; this can impact their mental wellness. Workplace bullying has emerged as a severe issue for medical residents, with minorities and women often being the target of the behavior by the very people tasked with educating them. According to MDlinx, "Residency bullying can cause depression, anxiety, substance abuse, or even lead to a cycle of abuse." If you persevere while suffering the mental effects, where do you arrive? Statistically, mentally damaged doctors either suffer in silence or must be very careful while seeking help. How can we help save the lives of doctors in a way that's safe for them?

How to help residents cope

Resident suffering burnout

According to a National Academy of Medicine study, 400 physicians die by suicide yearly in the United States. That number is startling and tragic, underscoring physicians' need for effective coping mechanisms. There are several ways to help doctors cope with the demands of their job and lessen the risk of suicide. One way is to provide access to counseling and mental health services. Many hospitals and clinics now offer on-site counseling services, and many employee assistance programs offer confidential counseling at no cost to employees. Another way to help physicians is to provide resources on suicide prevention. The National Suicide Prevention Lifeline is a free, 24/7 hotline that provides crisis counseling and emotional support to people in suicidal crises or emotional distress. Additionally, many online resources offer tips on identifying the warning signs of suicide and what to do if someone appears to be in danger. By providing access to counseling and mental health services, as well as education on suicide prevention, we can help reduce the risk of physician suicide. Here's a list of valuable resources for healthcare organizations, medical residency programs, and the public to help fight the problem of physician suicide.

1. ACME Physician Suicide Toolkit
2. AMA "After A Suicide" Toolkit
3. American Foundation for Suicide Prevention AFSP.org
4. PAMED
5. The Sharp Index

As always, here are some stats for your consideration

• Most resident suicides occur in the first year of post-graduate education (PGY1).
• The most common way residents commit suicide is by gunfire.
• Physicians who take their lives are less likely to have been receiving mental health support before the act.

Let me know your thoughts, or let's talk about physician suicide prevention on Twitter, and remember,

if you or someone you know is struggling with suicidal thoughts, please call the National Suicide Prevention Lifeline at 1–800–273–8255. If you are a medical resident in crisis, please call the ACGME Wellness Center at 866–743–3880. You are not alone. help is available.