Psychological Effect of a Mass Casualty Event on General Surgery Residents

J Surg Educ. 2017 Nov-Dec;74(6):e74-e80. doi: 10.1016/j.jsurg.2017.07.021. Epub 2017 Aug 7.


Objective: To evaluate the psychological effect of a mass casualty shooting event on general surgery residents.

Design: Three and 7 months following the Pulse nightclub mass casualty shooting, the mental well-being of general surgery residents employed at the receiving institution was evaluated. A voluntary and anonymous screening questionnaire for posttraumatic stress disorder (PTSD) and major depression (MD) was administered. Responses were stratified into 2 groups; residents who worked (ON-CALL) and residents who did not work (OFF-CALL) the night of the event. Data were analyzed using Mann-Whitney U and Fisher's exact tests and are reported as median with interquartile range (IQR) or percentage.

Setting: Level I trauma center.

Participants: Thirty-one general surgery residents.

Results: Twenty-four residents (77%) returned the 3-month questionnaire: 10 ON-CALL and 14 OFF-CALL. There was no difference in PTSD and MD between the 2 groups (30% vs. 14%; p = 0.61) and (30% vs. 7%; p = 0.27), respectively. Twenty-three of the 24 residents responded to the 7-month questionnaire. Over time, the incidence of PTSD did not resolve in the ON-CALL group, but did resolve in the OFF-CALL group (30% vs. 0%; p = 0.07). There was no significant change in the incidence of MD in either group (30% vs. 8%; p = 0.28). At 7 months postevent, more residents in both groups stated that they had sought counseling (30% vs. 44%; p = 0.65) and (0% vs. 15%; p = 0.22).

Conclusions: The emotional toll associated with this mass casualty event had a substantial effect upon the general surgery residents involved. With the incidence of PTSD and MD identified, we believe that all residents should be provided with counseling following such events.

Keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Systems-Based Practice; major depression; mass casualty; posttraumatic stress disorder; psychological effect; surgical residents.

MeSH terms

  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / etiology
  • Depression / physiopathology
  • Female
  • Follow-Up Studies
  • General Surgery / education*
  • Humans
  • Internship and Residency / methods
  • Male
  • Mass Casualty Incidents / psychology*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress, Psychological
  • Surgeons / psychology*
  • Surveys and Questionnaires*
  • Time Factors
  • Trauma Centers
  • United States