The suicides of a fourth-year student at New York University's (NYU's) Langone Medical Center, in New York City, and a psychiatry resident at NYU Langone Health, which occurred within a week of each other, have sparked a wave of emotions and a renewed search for answers.

The university confirmed the deaths to Medscape Medical News in a statement: "We were saddened to learn of the recent deaths of one of our medical students and one of our psychiatry residents, both by suicide. Counseling and support services are being offered to students, faculty, and staff. On behalf of the institution, we extend our deepest condolences to their families, friends, classmates, and colleagues. Because of the sensitive nature of this issue, we will not be commenting further."

The New York Post, citing police sources, reported that the body of Andrea Liu, 26, was found hanging by a rope inside Vilcek Hall — an NYU-owned dormitory — on the morning of May 1.

According to the New York Post, sources said, "Police believe it was a suicide and say Liu left a note." The newspaper reported she was on track to graduate within weeks.

The university did not release the name of the psychiatry resident or further details. Washington Square News, the independent student newspaper for NYU, reported that the death occurred Sunday.

Community Grieves

Michael Natter, MD, a first-year resident in internal medicine with NYU Langone Health, told Medscape Medical News that students and colleagues are in shock.

"We look for the why. We want to know why," he said. The regular noon-hour discussions at Langone, he said, have become a forum for talking about the deaths, why suicide has become so prevalent in the medical community, and what can possibly prevent such tragedies.

Natter described his own feeling of helplessness — similar to his reactions after hearing the news of another school shooting or terrorist attack.

Natter's path to medicine was untraditional. He studied art as an undergraduate, he said, and the deaths reminded him of his initial fears of switching to medicine. "These were the kinds of things that worried me about going into the world of medicine — its culture and its high rate of suicide," he said.

Physicians at High Risk

Earlier this week, Medscape Medical News reported that US physicians have the highest suicide rate of any profession, with one completed suicide every day.

The article highlighted new research presented at the American Psychiatric Association (APA) 2018 annual meeting, which showed that the number of physician suicides is more than twice that of the general population.

Natter praised NYU's response to the tragedies, which he said has included 24-hour access to mental health services, talks by attending physicians, and offers to cover shifts for those most affected.

"We can't say with certainty what drove these people to that point," Natter said, "and it would be unfair to say it's only because of the work stress or the work hours."

But he said he does think those things can play a role and would like to see them addressed with systemic changes. "We can't put a Band-Aid on this," he said.

He also suggested opt-out therapy sessions, which would allow time for giving attention to students' or providers' mental health and would remove the stigma associated with having to ask for those services.

"That would also allow screening for red flags" while there's still time to get help, he said.

Natter said there is a feeling of vulnerability, because often there is no outward sign that a deeply troubled person is suffering.

In the New York Post article, a fellow fourth-year medical student and friend of Liu's, Jing Ye, said Liu did not show any signs of distress the last time they saw each other, which was a month before, at a fund-raiser for a clinic.

The loss of colleagues has eroded some of the safety of feeling that physicians are the healers and not the victims, Natter said.

"Feeling that you're just as vulnerable is very jarring," he said. "No one is necessarily safe."

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