Resident Wellness

It feels like yesterday when I was scrolling through Instagram and read the story of Dr. William West. West was completing his ophthalmology residency at GW Hospital when he died by suicide at the age of 34. Unfortunately, this is becoming too common among resident physicians and other medical professionals. According to the Accreditation Council for Graduate Medical Education (ACGME), suicide is the second overall cause of resident physician death and the first overall cause of death in male resident physicians. 

In 2017 alone, 105 residents died by suicide. 

So, what causes the rates to be so high? Deepika Tanwar, MD of the Harlem Hospital Center in New York City, noted that physicians who die by suicide often suffer from untreated or undertreated depression or other mental illnesses. But if only 15-30% of physicians screen positive for depression, then what are the other factors that contribute to the rates of suicide in medical residents? 

This stress often begins early in medical school with long hours, lack of sleep, and competitiveness that only further increases by the limited number of residency positions available after graduation. During residency, these stressors intensify even more as we navigate difficult patient interactions and emergency situations, all while working under intense pressure for 80+ hours per week. Despite these challenges, residents are expected to persevere and cope with a “superhuman” mentality that has entrenched medical training for the longest time. Because of this, there is often hesitation to reach out for mental health services because of the fear of losing opportunities or being viewed as weak or incapable of being a good physician. It’s a terrible irony that for a profession that is prone to so many stressors, there are such significant barriers to getting relief. 

So, what can we do to fix this? 

• First: we can work to destigmatize the narrative around mental health in the medical profession. It is time to dismember the “superhuman” mentality and remember that doctors are actually human too. We must focus on our own health because only when we are well, will we be able to truly do the most good for our patients.
• Second: we can work to supply resources on suicide prevention and provide access to counseling and mental health services without fear of repercussion. Identifying individuals at risk, creating connected and protective environments, and encouraging physicians to access mental and other health care are key components of prevention programs for all people. 
• Third: we can support the medical students and resident physicians we know. 

The medical education system does not fully equip us to process human suffering, trauma, or death, so we are often left navigating these difficult emotions alone. 

May we all strive to provide supportive environments for residents to train and learn while also providing opportunities for honest and transparent conversations around physician wellness and mental health.