AMA has published an article regarding a suite of resources for medical training programs dealing with the suicide of a trainee. Many of these came from the organizations listed below who are providing information regarding suicide prevention.
Three prominent medical organizations, the AGME, the AFSP and Mayo Clinic are joining forces to provide information and educational support to medical trainees in the arena of suicide prevention. ASAE is helping to publicize these efforts.
Kay Redfield Jamison, professor of psychiatry, writer and advocate for mental health who suffers severe bipolar disease, gave a keynote at AAMC's 2016 annual meeting. Her presentation is summarized here.
The American Association of Medical Colleges devoted part of its June 2016 Leadership conference to Wellness and Resilience in Medical training. Some of the videos of presentations on this topic can be viewed here.
A medical student reporter interviewed Pamela Wible for Huffington Post in March 2016, regarding a Public Health Crisis resulting from Physician Suicides. The interview references Pamela's excellent TedMed talk on the topic.
Residents and Students of Medicine are especially vulnerable to burnout, stress and depression, and less likely to be aware of available resources. Trainees may also worry that help-seeking may jeopardize their career choices.
JAMA's Dec 8, 2015 Medical Education Issue contained several disturbing articles regarding mental health issues in physicians in training. The prevalence of depression in a large meta-analysis averages about 29%. The practice of "pimping" is discussed in some detail in another article. A cartoon therapy class in one program resulted in large numbers of very disturbing cartoons, many relating to this practice of pimping (a form of harassment that has been adopted as a tradition and promulgated for generations by medical faculty.)
One editorial by Thomas Schwenk gives an overview of some of the issues and is open access. Says Schwenk "The profession has an obligation to provide appropriate medical and mental health care to all members of the medical profession. However, the best efforts fall short, mostly because of the high levels of stigma attached to seeking mental health care. Medical students and residents are acutely aware of the negative effects any record of mental health care could have on their future training opportunities. Physicians have the same concerns that their medical staff membership and licensing could be severely compromised by disclosure of mental illness and treatment." He calls for an overhaul of medical education not unlike that which followed the Flexner report.
Medscape also summarizes the article and editorial and adds comments by Schwenk. So did Reuters, Healthy Living and many other outlets. Perhaps the light of day is finally being shed on this pernicious problem.
TEDMED included a talk by Pamela Wible on Nov 18 2015 on physician suicide. The talk is now available, and there is an AMA interview with Pamela that covers many of the points and adds some ideas for improvement of the caring environment for physicians and medical trainees.
The AMA at its Interim meeting Nov 16 2015 addressed the increasingly apparent dual issues of burnout and depression in medical trainees. A list of links is included in this report from that meeting.
An article by Guille et al in Nov 4 2015 JAMA Psychiatry and an accompanying editorial by Charles Reynolds describe an interesting new approach to a confidential web based cognitive behavioral therapy system for trainees experiencing suicidal ideation.
TIME editor Mandy Oaklander took on the issue of physician suicide, with special reference to trainees in "Doctors on Life Support".
An article in March 4 2015 JAMA entitled "Depression and Suicide Among Physician Trainees" recommends that a national response to an epidemic of suicides in medical trainees be devised. Recommendations include Education, Screening and Treament. If this article is inaccessible, a Medscape article synopsis on the same subject can be accessed through a free subscription (open to consumers).
STAT news has done a series on depression and suicide in physicians and trainees. A resident's 2015 story can be found here.
"We Know How to Kill Ourselves" shouts a headline in Physicians News Digest Nov 5 2014. The article points out several reasons for the apparent increase in suicidal ideation and attempts during training in medicine. This was condensed from a JAMA review article (open access) by Rubin entitled "Recent Suicides Highlight Need to Address Depression in Medical Students and Residents"JAMA 2014;312(17):1725.
A resident, Pranay Sinha offers his opinion about the prevalence of suicide in resident physicians in an Op Ed in the New York Times Sept 4, 2014. He feels a principle problem is Aequanimitas, that quintessential Oslerian state of mind that residents are taught to emulate in order to be successful physicians.
A 2014 book published by the mother of a highly successful medical student who gave no evidence of experiencing depression prior to her well planned suicide is informative about the fact that there is a close connection between extremely gifted persons and a form of existential depression that can remain well hidden. The book, which is a highly personal account from the viewpoint of a bereaved mother, is called "My Bright Shining Star".
The Student Doctor Network has entries from the author of the above book and a number of students who are dealing or have dealt with aspects of Mental Health in medical school. It is an anonymous forum that does not claim to be therapeutic but could be a source of support and information.
An excellent article by Bigelow on Med School coping appeared in Medscape:
"What if I just Want to Quit?" It is full of excellent suggestions for dealing with stressors in training.
This 2011 webinar hosted by the AMA contains a wealth of information on this topic. (open access; sign in required)
This 2011 presentation on Burnout, Depression and Suicide Prevention in medical trainees and physicians includes helpful and not helpful responses if you feel a colleague may be depressed.
Schwenk et al reporting on a study of depression, stigma and suicidal ideation in medical students in JAMA 2010 that compared with students with low levels of depression, depressed students felt that their opinions would be less respected, that their coping skills would be viewed as less adequate, and that they would be viewed by faculty as less able to handle their responsibilities, and that telling a counselor or seeking treatment would be risky. An editorial in the same issue was devoted to understanding depression and distress among medical students.
The AMA has voted to mount a study of risk factors and incidence of medical trainee and physician suicide to garner recommendations to reduce the incidence of suicide at all levels of training and practice. See High Physician Suicide Rate Psych News July 09
A large 2009 study of interns shows considerable tendency towards development of depressive symptoms, see Sen et al, Arch Gen Psych April 2010
An excellent synopsis of the above article can be found in the AAFP News Now June 2 2010 by Bein.
See "White Coat, Mood Indigo--Depression in Medical School" in NEJM Sept 05
The ACP-ASIM has some superb materials addressing this topic.
AMA Virtual Mentor Sept 03
Other countries also acknowledge this to be a particularly vulnerable time in a physician's life: UK , Australia
Some reasons for this vulnerability from "Behavior in Medicine" by Shaw and Wedding, et al: Special Problems in Medical Students
British Medical Journal study shows depressed medical residents six times more likely to make medication errors. See AMN March 08 Depressed Residents Drug Errors
A recent study suggests that up to 50% of medical students experience burnout and 10% suicidal ideation at some time during their medical studies. See AIM Sept 08
Related article in AMNews Oct 08An informative article from the AAMC Reporter covered medical student and physician suicide in December 2008