3 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Proactively Developing a Suicide Response Plan Ideally institutions will develop a suicide response plan prior to a suicide occurring. If the institution already has a protocol for death of a trainee, steps should be taken to ensure it specifically addresses suicide. Suicide death should be addressed in a similar manner as other types of death. However, there are some unique aspects of suicide loss that require consideration. Having a plan in place will facilitate a coordinated response by a team of individuals who can support each other. Development and endorsement of such a plan should involve key stakeholders, such as Designated Institutional Official (DIO), Education Committee leaders/Associate Deans, Graduate Medical Education (GME) Dean, House Staff Mental Health Service or Employee Assistance Program personnel, GME office staff, resident/fellow representative, communication office, human resources, and legal. The plan should include details about: • Ensuring the emergency contact list is updated yearly • Reinforcing importance of timely arrival and notification of absences during orientation • Addressing a missing resident • Confirming death of a resident and how to do so • Developing a Crisis Response Team • Communicating with emergency contact/family • Notifying residents and faculty • Determining who needs to know what (program of deceased resident vs. larger medical community) • Creating face-to-face, phone, and written notifications • Planning a memorial service • Managing media inquiries • Managing social media • Supporting wellbeing of residents, faculty, other staff, and Crisis Response Team members Once developed, the plan should be widely disseminated to Program Directors (PDs) and Program Coordinators (PCs), along with GME office personnel. Awareness of the plan should be part of all GME staff orientations. The plan should be easily locatable after-hours and on weekends by key personnel, such as PDs and the DIO.