Your response to this is honestly baffling, particularly since you're normally a hell of a lot more insightful than this on these boards.
You're a chief resident, no? So let's do a little Tarrytowning.
What would YOU propose if your program had an incident? If your program isn't dirt crap, you should have the program's ear and actual administrative responsibility and running something like this would absolutely be within your job description. Are you seriously saying that the logistics aren't important? C'mon bro. Is your "M&M" a resident-only process group/bitch session. You bringing the whole department in? Just the PD. As others have said, M&M has a very specific connotation related to patient care, and the employee who completed suicide isn't your patient, so whatever normal rules absolutely do not apply. How do you avoid baseless speculation about what lead to the suicide or proposals that will have unintended consequences (Wible was a big 16 hour rule proponent after all, for example). If you're truly making this about the workplace culture, how will you manage specific negative incidents that are to be discussed related to specific individuals? Do you interview the involved parties first? Do you leave the floor open to bringing up these incidents. How do you manage the exchange of information related to the MH history of the employee, of which there will be an asymmetric amount of knowledge and involved parties will not have a legal right to that information. As I mentioned upthread, this employee is not your patient and that affects what can or can't be shared legally within your M&M. How DOES your M&M differ from a process group? You mentioned outside doctors: Who would you bring in and how would you involve them and their role? How do you ensure that your M&M doesn't result in further trauma to involved parties? Perhaps this stuff is obvious, but none of us besides you have ever run an M&M before, apparently.
You're a chief, so it's part of your day to day responsibility now is to be monitoring the culture of the program and how your residents are interacting within it and relaying concerns up the appropriate chains. How is what you're proposing any different than what you're already doing? What ARE you doing now?
Again, you don't have to call it an M&M. The M&Ms at my institution are department run, NOT resident run and they involve doctors, nurses, social workers, etc. We discuss a case (and it's not always a resident case) and analyze what went wrong, what could have been done better, etc. In the case of a resident who committed suicide, call it a root cause analysis or whatever else you want. The point I'm making is that in a lot of these cases, there is a link to work environment and we know that things like public humiliation, role instability, guilt related to potentially disastrous mistakes are all risks for suicide in someone who is depressed. Being a trainee lends itself to all of those factors. So yes, I think when a trainee takes his/her own life, we should examine what was going on AT WORK that could have contributed to it. This is not necessarily punitive (none of the M&Ms in my department are punitive, in fact), it is not to punish an attending for yelling at an intern, it is not to reprimand fellow residents for not asking the resident to have a drink with them at happy hour. It IS, however, to highlight things that shouldn't ever happen -- intimidation, bullying, forcing residents to lie on time sheets. We all know these things happen. It's about time they were given attention, especially if they contributed to one of these deaths.
This is about introspection and accountability when it comes to how we treat trainees, people who many times feel they don't have a voice and can't stand up to the injustices we all know take place in the hospital, because if they did, another injustice would likely follow and their professional lives would be harmed because of it. The hope is that when these things come to light, enough good people will put an end to it, especially in today's climate where there is a legitimate push for treating trainees better.
Perhaps it's my Pollyanna viewpoint, but I'm sick of brushing this stuff under the rug. When anyone commits suicide, I wonder how rough their life must have been that death was the better option. When a med student or resident commits suicide, I remember how rough training can be and I wonder if they would have done it had someone stood up for them or the person who came before them to, at the very least, bring attention to what was happening.
BTW...head on over to Zabar's deli...best one in NYC!!!
