One is too many: suicidality among general surgery residents

Area of Science:

• Medical Education
• Surgical Training
• Mental Health

Background:

• Suicide is the leading cause of death among residents from 2015-2021.
• General surgery residency presents unique stressors.
• Understanding factors contributing to resident suicidality is critical.

Purpose of the Study:

• Investigate the prevalence of suicidality among general surgery residents.
• Identify individual factors associated with resident suicidality.
• Determine program-level factors linked to resident suicidality.

Main Methods:

• A voluntary, cross-sectional survey was distributed to US general surgery residents.
• Data collected included demographics, learning environment perceptions, mistreatment, and past-year suicidality.
• Associations between individual and program characteristics and suicidality were analyzed.

Main Results:

• 4.4% of surveyed residents reported suicidal thoughts in the past year.
• Being single (OR 1.45) and identifying as LGBTQ+ (OR 1.67) were associated with higher odds of suicidality.
• Frequent duty hour violations (OR 1.47), blame-focused learning environments (OR 1.57), lack of meaning in work (OR 1.63), sexual harassment (OR 2.18), and bullying (OR 2.42) were significant risk factors.

Conclusions:

• Individual factors (e.g., marital status, LGBTQ+ identity) and modifiable program-level factors (e.g., duty hours, learning culture, mistreatment) are associated with suicidality in general surgery residents.
• Interventions targeting program-level improvements may reduce resident suicidality.
• Addressing systemic issues in surgical education is crucial for resident well-being.