Suicidal ideation among vascular surgery trainees

Abstract

Background: Suicidal ideation (SI) during surgical training is poorly understood and may be attributed to a variety of personal and environmental risk factors. The purpose of this study was to evaluate the incidence of SI among vascular surgery trainees.

Methods: Data were collected from a confidential, voluntary survey administered after the 2020-2024 Vascular Surgery In-Training Exam as part of the SECOND trial (Surgical Education Culture Optimization through targeted interventions based on National comparative Data Trial). SI was assessed with the following question: "In the past 12 months, have you had thoughts of taking your own life?" Positive screens prompted presentation of the National Suicide Hotline. Descriptive statistics were used to evaluate demographic and learning environmental factors associated with suicidality.

Results: A total of 3272 survey results were collected from 2020 to 2024. Seventy-four respondents (2.3%) reported positive SI. In considering the most recent year of responses (2024), demographic variables were comparable between trainees who did and did not screen positive for SI. However, trainees who screened positive were more likely to report negative learning environment factors, including pressure to under-report hours (31% vs 6%), lack of a sense of belonging among trainees (15% vs 4%), sexual harassment (46% vs 10%), and perception of program unresponsiveness (38% vs 5%), among other factors.

Conclusions: Although low rates of SI limit more detailed statistical analysis, this remains the most comprehensive evaluation among vascular surgery trainees. Although rates remain low, they are associated with burnout. Modifiable learning environmental factors, such as harassment, program responsiveness, and trainee camaraderie, may be potential areas for intervention.

Keywords: Learning environment; Suicidal ideation; Trainee wellness.