Episode 103: Suicidality in Medical Training: Understanding the Crisis and its Causes.

Content Warning: 

This content addresses mental health issues, including research and narratives on suicide. Please take care while engaging with it and only proceed if you feel safe doing so. If you, or someone you love, is having thoughts of suicide, please contact 988. Help is available.

 

Episode 103: Suicidality in Medical Training: Understanding the Crisis and its Causes.

 

Interviewer

Lisa Meeks

 

Interviewees

John Ruddell

Jennifer Ruddell

Roja (friend of Jack Ruddell)

Dr. Christine Moutier 

Dr. Srijan Sen

Dr. Justin Bullock

Dr. Jessi Gold

 

Narrator

Dr. Joseph Murray 

 

Transcript

 

Keywords: Suicide, Death, Mental health, Jack Ruddell, Medical training, Depression, Suicidality, Burnout, Anxiety, Medical trainees, American Foundation for Suicide Prevention, Tourette's, Disabilities, Medical education, Medical school, Discrimination, Academic pressure, Clinical practice, Imposter syndrome, Perfectionism, Shame, Mental disability, Learning challenges, Accommodations, High-stakes testing, Inclusivity, Stigma

 

Description

In the second episode of our series on medical training and suicide, we explore the mental health crisis through the story of Jack Ruddell, a medical student who died by suicide. The episode delves into the pressures, stigmas, and barriers that prevent trainees from seeking help, combining expert insights with personal narratives. We also hear from Jack’s partner and parents, who stress the need for systemic change and de-stigmatization of mental health struggles in medical education. 

 

Description of Series 

DWDI Special Series: Suicidality in Medical Training dives into the critical conversations around mental health, well-being, support systems, and the intense pressures faced during medical training. Through the power of storytelling, the series intertwines these broader themes with the deeply personal story of Dr. Jack Ruddell, a promising medical student who tragically died by suicide. Jack’s journey—his strengths, struggles, and the complexities leading to his untimely death—forms the emotional core of this five-part series, giving voice to the loved ones often excluded from these conversations.

Alongside Jack’s story, the series incorporates expert insights and data from the literature, offering a human perspective on burnout, depression, and suicide among medical trainees. With a commitment to improving mental health awareness and reducing the stigma around seeking help, the series presents a novel approach by centering personal narratives alongside expert analysis. It also explores actionable strategies for improving medical training environments and highlights the importance of institutional responses after a loss by suicide.

Our mission is to reduce shame, encourage help-seeking among medical students struggling with depression, and ensure that every medical school is aware of the postvention resources offered by the American Foundation for Suicide Prevention (AFSP).

Experts for the Series 

• Christine Moutier, MD – Chief Medical Officer, American Foundation for Suicide Prevention

• Jessi Gold, MD – Chief Wellness Officer, University of Tennessee System; Author of How Do You Feel?

• David Muller, MD – Director, Institute for Equity and Justice in Health Sciences Education; Dean Emeritus, Icahn School of Medicine at Mt. Sinai; Author of the NEJM essay, Kathryn

• Srijan Sen, MD, PhD – Director, Eisenberg Family Depression Center; PI of the Intern Health Study

• Justin Bullock, MD, MPH – Fellow, University of Washington; Author of the NEJM article, Suicide, Rewriting My Story

• Stuart Slavin, MD, MEd – Vice President for Well-Being, ACGME

Episode Release Schedule:

• September 17: Episode 102 – Honoring Dr. Jack Ruddell: A Story of Joy, Compassion, and Mental Health in Medical Training.

• September 17: Episode 103 – Suicidality in Medical Training: Understanding the Crisis and its Causes. 

• September 24: Episode 104 – Silent Struggles: Mental Health and Medical Education.

• September 26: Episode 105 – Repairing the System: How Do We Create Safe Environments?

• September 30: Episode 106 – Responding to Loss: Postvention and Support After a Suicide.

Executive Producers:

• Lisa Meeks
• Rylee Betchkal
• John Ruddell
• Jennifer Ruddell

Sound production:

• Jacob Feeman
• Mark Koha
• Next Day Podcast

Consult Psychiatrist

• Joseph Murray, MD

Resources: 

 

24/7 Suicide & Crisis Hotline
Call or text 988 or chat 988lifeline.org. 

 

The American Foundation for Suicide Prevention

https://afsp.org

 

Intern Health Study

https://www.internhealthstudy.org

https://www.srijan-sen-lab.com/intern-health-study

 

How are you? By Jessi Gold

https://www.drjessigold.com/how-do-you-feel-book-by-jessi-gold-md/

 

Make the Difference: Preventing Medical Trainee Suicide

https://www.youtube.com/watch?app=desktop&v=I9GRxF9qEBA&feature=youtu.be

 

Time to Talk About It: Physician Depression and Suicide: Video/Discussion Session for Interns, Residents and Fellows

https://www.mededportal.org/doi/10.15766/mep_2374-8265.10508

 

Action Collaborative on Clinician Well-Being and Resilience

National Academy of Medicine

https://nam.edu/action-collaborative-on-clinician-well-being-and-resilience-network-organizations/

Suggested Readings

 

Baker, K., Warren, R., Abelson, J. L., & Sen, S. (2017). Physician mental health: depression and anxiety. Physician Mental Health and Well-Being: Research and Practice, 131-150.

 

Brådvik, L. (2018). Suicide risk and mental disorders. International journal of environmental research and public health, 15(9), 2028.

 

Bullock, J. L. (2020). Suicide—rewriting my story. New England Journal of Medicine, 382(13), 1196-1197.

 

Centers for Disease Control and Prevention. (2022). Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. https://webappa.cdc.gov/sasweb/ncipc/mortrate.html

 

Centers for Disease Control and Prevention. (2022). Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. https://webappa.cdc.gov/sasweb/ncipc/mortrate.html

 

Goldman, M. L., Shah, R. N., & Bernstein, C. A. (2015). Depression and suicide among physician trainees: recommendations for a national response. JAMA psychiatry, 72(5), 411-412.

 

Halperin, S. J., Henderson, M. N., Prenner, S., & Grauer, J. N. (2021). Prevalence of anxiety and depression among medical students during the Covid-19 pandemic: a cross-sectional study. Journal of medical education and curricular development, 8, 2382120521991150.

 

Hampton, T. (2005). Experts address risk of physician suicide. Jama, 294(10), 1189-1191.

 

Malone, T. L., Zhao, Z., Liu, T. Y., Song, P. X., Sen, S., & Scott, L. J. (2021). Prediction of suicidal ideation risk in a prospective cohort study of medical interns. PLoS One, 16(12), e0260620.

 

Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., ... & Mata, D. A. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. Jama, 316(21), 2214-2236.

 

Schernhammer, E. S., & Colditz, G. A. (2004). Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). American Journal of Psychiatry, 161(12), 2295-2302.

 

U.S. Department of Health and Human Services. (n.d.). Major depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depression