Residents and suicide: Lessons to be learned?
CMAJ 1997;157:647
I read with much sadness the article "Manitoba suicides force consideration of stresses facing medical residents" (CMAJ 1997;156:1599-602 [full text / en bref]), by Lynne Sears Williams. It discussed 3 recent suicides involving residents at the University of Manitoba.
Having recently completed residency and fellowship training, I can appreciate the comments expressed about stresses and anxieties faced by residents in the 1990s. These stresses are not specific to one area, although this recent rash of suicides happened at the University of Manitoba. Once is happenstance, twice is a coincidence, but thrice is enemy action. We have yet to identify the specific enemy in these cases.
It will not be easy to ascertain whether there are training-program flaws that precipitated these tragedies. Residents are unlikely to express concerns about their programs for fear of jeopardizing future references and employment. Attending physicians may be reluctant to investigate and expose program weaknesses because this might disrupt what they consider an acceptable status quo, endanger career advancement or draw attention to problems that will reduce the attractiveness of training programs. This means that any analysis will require input from external sources.
It is in the University of Manitoba's best interest to appoint external experts to assess these tragedies and possible precipitating factors. In this way, similar tragedies might be averted, and the lessons learned could be applied in other centres.
Robert J. Fingerote, MD
Windsor, Ont.
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