Association for Surgical EducationThe stress of residency: recognizing the signs of depression and suicide in you and your fellow residents
Section snippets
Educational goals and objectives
The goals and objectives of this educational intervention are to increase resident self-awareness of the signs and symptoms of stress, depression, and suicidal ideation and to recognize these signs and symptoms among their colleagues. An interactive seminar using varying educational approaches was designed as the curricular tool.
The major topics discussed were depression; physician suicide; drug and alcohol abuse; and the effects of stress on our family, our friends, and our goals (both
Results
The pretest revealed that the 17 surgical residents were correct in only 46.8% (standard deviation [SD] = 25.4%) of their responses, suggesting a significant lack of understanding of stress and related issues. The immediate postseminar test showed an improvement to 89.7% (SD = 6.1%, P < .001, paired Student t test = 5.37). The same test administered 4 months later (ie, the long-term post-test) to 17 of the 21 learners revealed 76.9% (SD = 18.7%) of correct answers (Fig. 2). The detail of the
Comments
The “early warning system” that a resident may be teetering on the brink of depression or suicide must come from those closest to them—their fellow residents. This study found an alarming lack of resident recognition of the signs and symptoms of stress, family problems, depression, suicide, and even the institutional guidelines aimed at combating these issues. This lack of recognition of a possible impending disaster is surprising given that these are highly selected and highly achieving young
Conclusions
As a group, highly selected and highly trained residents are poor at identifying the signs of depression, stress, and potential suicide among fellow residents. This surprising lack of recognition can and occasionally does have disastrous consequences. Because residents who are experiencing stress, depression, and suicidal ideation rarely self-identify,13, 14 it is incumbent on medical educators to arm residents with the tools to identify emotional and/or psychological impairment among their
Acknowledgments
This article is dedicated to the memory of A. John Erdmann, M.D., 1942–1980.
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Supported in part by grants from the Josiah Macy, Jr. Foundation; the Arnold P. Gold Foundation; and The Arthur Vining Davis Foundations.