About the Discussion

Preventing Depression and Suicide among Physicians in Training

Background Physicians in training are at high risk for depression, and physicians in practice have a substantially elevated risk of suicide compared to the general population. The graduate medical education community is currently mobilizing efforts to improve resident wellness.

Objective We sought to provide a trainee perspective on current resources to support resident wellness, and resources that need to be developed to ensure an optimal learning environment.

Methods The ACGME Council of Review Committee Residents, a 29-member multispecialty group of residents and fellows, conducted an appreciative inquiry exercise to (1) identify existing resources to address resident wellness; (2) envision the ideal learning environment to promote wellness; and (3) determine how the existing infrastructure could be modified to approach the ideal. The information was aggregated to identify consensus themes from group discussion.

Results National policy on resident wellness should (1) increase awareness of the stress of residency and destigmatize depression in trainees; (2) develop confidential systems to identify and treat depression in trainees in a confidential way to reduce barriers to accessing help; (3) enhance mentoring by senior peers and faculty; (4) promote a supportive culture; and (5) encourage additional study of the problem to deepen our understanding of the issue.

Conclusions A multispecialty, national panel of trainees identified actionable goals to broaden efforts in programs and sponsoring institutions to promote resident wellness and mental health awareness. Engagement of all stakeholders within the graduate medical education community will be critical to developing a comprehensive solution to this critical issue.


All authors are members of the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR). Timothy J. Daskivich, MD, MSHPM, is Chair, ACGME CRCR, and a Fellow, Department of Urology, University of California, Los Angeles; Dinchen A. Jardine, LCDR, MD, MS, is a Resident, Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center Portsmouth; Jennifer Tseng, MD, is a General Surgeon, Department of Surgery, Oregon Health & Science University; Ricardo Correa, MD, EsD, is a Clinical and Research Endocrinology Fellow, National Institute of Health; Brian C. Stagg, MD, is an Ophthalmologist, Moran Eye Center, University of Utah; Kristin M. Jacob, MD, is a Clinical Instructor and Resident, Departments of Internal Medicine and Pediatrics, Grand Rapids Medical Education Partners; and Jared L. Harwood, MD, is a Resident, Department of Orthopaedics, The Ohio State University.

Corresponding author: Timothy J. Daskivich, MD, MSHPM, Department of Urology, University of California, Los Angeles, 300 Stein Plaza, Wasserman Building, Third Floor, Los Angeles, CA 90095, 310.794.8248, fax 310.794.0987, tdaskivich@ucla.edu

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