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October 14, 2020

Mental Illness and Stigma in Surgical Residencies—An Unspoken Truth

Author Affiliations
  • 1Department of Surgery, Michigan Medicine, Ann Arbor
JAMA Surg. Published online October 14, 2020. doi:10.1001/jamasurg.2020.2965

This year, 2114 graduating physicians matched into general surgery residencies across the United States.1 In many of these programs, incoming interns participate in orientation sessions discussing physician wellness. Residents are instructed to seek help when needed, and programs aim to encourage an open, nonjudgmental environment in which it is safe to disclose personal histories, challenges, and struggles. This ideal is often not congruent with reality as the systems in which residents learn and work are not stigma free.

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    1 Comment for this article
    Shining the spotlight on top-down necessity.
    Steven Reid, M.D., F.A.A.N.S. | Doctor Lifeline, Incorporated
    As the president of DoctorLifeline.org, an IRS 501(c)3 non-profit organization working to prevent physician suicide, I commend the authors for shining a spotlight on the problem of mental health stigmata and their role as barriers to obtaining help for burnout and depression. As we documented in our introductory video (1) the current practice environment provides multiple rational disincentives for doctors to seek mental health care. Sadly, on average, our country loses one or more doctors per day to suicide. We have advocated a multilayered approach to correcting this problem, including specific focus on cultural and institutional practices, as outlined in the last 5 minutes of the video.

    Interested physicians and health care stakeholders are encouraged to review and utilize our resources to mitigate the problems of physician learned-helplessness, burnout, depression, and suicide.


    1. https://www.youtube.com/watch?v=FfXtt_5U3TU
    CONFLICT OF INTEREST: I am the president of Doctor Lifeline, a nonprofit working to prevent physician suicides.