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I was surprised to learn in the July 17 issue that between one-fourth and one-third of residents experience a clinical depression during their training. While the article acknowledges that residents "endure an onslaught of stress" in their training, it proceeds to imply that better identification and treatment of those "at-risk" residents is the critical element in reducing resident suicide. This is important and necessary; however, the article doesn't address whether the stressors themselves are overly demanding.
I think we could make significant progress in reducing both resident depression and suicide by taking a preventative approach in identifying, modifying, and sometimes eliminating unnecessary hardships, such as psychological abuse from teaching attendings, to give a common example. It's not good enough to identify and treat 25 percent to 33 percent of depressed residents. Let's reduce the rate.
Mendel J. Feldsher, M.D.
Los Angeles, Calif.