‘Suicide is not a clinical case topic!’: On taboos, particularities, and gaps in pediatric medical education

Abstract

The epidemiological transition in Brazil has prompted adaptations in the care of children and adolescents. This New Pediatrics faces violence, chronic and complex conditions, and mental health as central issues, with particular emphasis on suicidal behavior due to its clinical and epidemiological impact. Pediatric Medical Residency Programs, which play a critical role in medical training, represent privileged spaces for understanding how this specialty has been organizing itself and responding clinically. Based on the hypothesis of theoretical and clinical inadequacy among pediatric residents regarding this issue, the study aimed to explore their perceptions and knowledge about suicidal behavior in childhood and adolescence. A qualitative approach was employed, using the Focus Group technique, in which 44 pediatric residents from five Medical Residency Programs in Rio de Janeiro participated. Through thematic content analysis, three core thematic units emerged from the discussions held in the five focus groups: The taboo of suicide; Specificities of pediatric care: idealizations and conflicts; and Training gaps in pediatric Medical Residency Programs. An integral and appropriate approach to suicidal behavior by pediatricians requires a reorganization of these programs, enabling the deconstruction of taboos and fostering critical reflections on the inherent conflicts within the specialty.