“I Cannot Take This Any More!”: Preparing Interns to Identify and Help a Struggling Colleague

  • Sondra ZabarEmail author
  • Kathleen Hanley
  • Margaret Horlick
  • Patrick Cocks
  • Lisa Altshuler
  • Amanda Watsula-Morley
  • Russell Berman
  • Mark Hochberg
  • Donna Phillips
  • Adina Kalet
  • Colleen Gillespie
Innovation and Improvement: Innovations in Medical Education



Few programs train residents in recognizing and responding to distressed colleagues at risk for suicide.


To assess interns’ ability to identify a struggling colleague, describe resources, and recognize that physicians can and should help colleagues in trouble.


Residency programs at an academic medical center.


One hundred forty-five interns.

Program Design

An OSCE case was designed to give interns practice and feedback on their skills in recognizing a colleague in distress and recommending the appropriate course of action. Embedded in a patient “sign-out” case, standardized health professionals (SHP) portrayed a resident with depressed mood and an underlying drinking problem. The SHP assessed intern skills in assessing symptoms and directing the resident to seek help.

Program Evaluation

Interns appreciated the opportunity to practice addressing this situation. Debriefing the case led to productive conversations between faculty and residents on available resources. Interns’ skills require further development: while 60% of interns asked about their colleague’s emotional state, only one-third screened for depression and just under half explored suicidal ideation. Only 32% directed the colleague to specific resources for his depression (higher among those that checked his emotional state, 54%, or screened for depression, 80%).


This OSCE case identified varying intern skill levels for identifying and assessing a struggling colleague while also providing experiential learning and supporting a culture of addressing peer wellness.


OSCE depression struggling colleague substance use burnout 



The authors would like to recognize the valuable contributions of the inter-professional members of the Research on Medical Education Outcomes (ROMEO) group, our dedicated faculty, standardized patients, and learners, all who participated in creating a supportive learning environment. We acknowledge that The New York Simulation Center for the Health Sciences (NYSIM), a Partnership of The City University of New York and NYU Langone Health, provided material support of staff, space and equipment for the research conducted in this publication.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Sondra Zabar
    • 1
    Email author
  • Kathleen Hanley
    • 1
  • Margaret Horlick
    • 1
  • Patrick Cocks
    • 1
  • Lisa Altshuler
    • 1
  • Amanda Watsula-Morley
    • 1
  • Russell Berman
    • 2
  • Mark Hochberg
    • 2
  • Donna Phillips
    • 3
  • Adina Kalet
    • 1
  • Colleen Gillespie
    • 4
  1. 1.Department of Medicine, Division of General Internal Medicine and Clinical InnovationNYU School of MedicineNew YorkUSA
  2. 2.Department of SurgeryNYU School of MedicineNew YorkUSA
  3. 3.Department of Orthopedic SurgeryNYU School of MedicineNew YorkUSA
  4. 4.Institute for Innovation in Medical Education, Division of Quality and Evaluation and Department of Medicine, Division of General Internal Medicine and Clinical InnovationNYU School of MedicineNew YorkUSA

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