AbstractObjective:The aim of this scoping review is to map the current landscape of published research and perspectives on physician suicide. Findings could serve as a roadmap for further investigations and potentially inform efforts to prevent physician suicide.Methods:Ovid MEDLINE, PsycINFO, and Scopus were searched for English-language publications from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that were non-English or those that only mentioned physician burnout, mental health, or substance use disorders were excluded. Data extraction was performed by two authors.Results:The search yielded 1,596 articles, of which 347 articles passed to the full-text review round. The oldest article was an editorial from 1903; 210 (60.3%) articles have been published from 2000 to present. Authors originated from 37 countries, and 143 (41.2%) were opinion articles. The most discussed were suicide risk factors and culture of practice issues, while the least discussed themes included public health and postvention.Conclusions:Consistency and reliability of data and information about physician suicides could be improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for physicians have been explored, and several remain poorly understood. Based on this scoping review, a public health approach, including surveillance and early warning systems, investigations of sentinel cases, and postvention may be impactful next steps in preventing physician deaths by suicide.

24Objective: The aim of this scoping review is to map the current landscape of published research and 25 perspectives on physician suicide. Findings could serve as a roadmap for further investigations and 26 potentially inform efforts to prevent physician suicide. 27Methods: Ovid MEDLINE, PsycInfo, and Scopus were searched for English-language publications 28 from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis 29 focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical 30 students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that 31were non-English, or those that only mentioned physician burnout, mental health or substance use 32 disorders were excluded. Data extraction was performed by two authors. 33Results: The search yielded 1,596 articles, of which 347 articles passed to the full-text review round. 34The oldest article was an editorial from 1903; 210 (60.3%) articles were published from 2000 to 35 present. Authors originated from 37 countries and 143 (41.2%) were opinion articles. Most discussed 36were suicide risk factors and culture of practice issues, while least discussed themes included public 37 health and postvention. 38Conclusions: Consistency and reliability of data and information about physician suicides could be 39improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for 40 physicians have been explored, and several remain poorly understood. Based on this scoping review, 41 a public health approach, including surveillance and early warning systems, investigations of sentinel 42 cases, and postvention may be impactful next steps in preventing physician deaths by suicide. 43

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review aims to map the landscape of published research and perspectives on physician suicide. Specifically, the aim is to describe research on physician suicidal behaviors among medical students, postgraduate trainees, including residents and fellows, and physicians. Findings could serve as a roadmap for informing further study, evidence-based policy, and interventions to prevent physician suicide.

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