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Medical Student Suicide Rates

A Systematic Review of the Historical and International Literature

Blacker, Caren J., BMBCh, MA; Lewis, Charles P., MD; Swintak, Cosima C., MD; Bostwick, J. Michael, MD; Rackley, Sandra J., MD, MAEdHD

doi: 10.1097/ACM.0000000000002430
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Purpose Physician suicide rates are reportedly higher than those of the general population, but medical student suicide rates are not well studied. It is difficult to determine whether physician suicide rates can be predicted by medical student risk factors for suicide and difficult to identify those risk factors without knowing medical student suicide rates. The authors systematically reviewed the literature to collate data on medical student suicide rates.

Method The authors searched the PubMed, Web of Science, and Library of Congress databases for papers published in any language before November 11, 2017. They identified 3,429 papers; after the initial screening process, they assessed 82 full-text articles for eligibility. Twelve ultimately met the full inclusion criteria; meta-analysis was not possible. Data regarding medical student suicide numbers and rates were extracted and compared with contemporaneous general population suicide rates using public epidemiological data, when available.

Results Medical student suicide rates were infrequently reported in the historical and international literature, and data collection techniques were inconsistent. Generally, U.S. medical student suicide rates were lower than those of the contemporaneous general population. Proportionate mortality of medical students (number of deaths by a particular cause such as suicide divided by total number of deaths) was not reported in the literature.

Conclusions Gaps exist in knowledge of medical student suicide rates, risk factors, and targets for intervention. Significant barriers have impeded information collection. Yet, more comprehensive data collection is needed to understand suicide risk in this population and to implement and improve effective intervention strategies.

C.J. Blacker is fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-3510-0696.

C.P. Lewis is research fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0001-8791-657X.

C.C. Swintak is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

J.M. Bostwick is professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

S.J. Rackley is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Previous presentations: A preliminary version of these findings was presented in poster format at the Aeschi 9: Suicide Across the Lifespan: Relational Models of Treatment conference, June 8–10, 2017, Vail, Colorado.

Correspondence should be addressed to Caren J. Blacker, Department of Psychiatry and Psychology, 200 First St. S.W., Rochester, MN 55905; telephone: (507) 284-5849; e-mail: blacker.caren@mayo.edu.

© 2019 by the Association of American Medical Colleges