Notify the DIO who will identify Crisis Response Team Leader, based on the communities affected.  It is OK to lean heavily on this person as well as others within your program, since you will have plenty to manage in the first few days.

Identify if someone in your program will be the liaison with the deceased trainee’s family or if you would like someone on the Crisis Response Team to do this.  

If you were the first to learn of the death, inform the trainee’s emergency contact person.  Determine their wishes regarding communication of the news of the death.

If the you receive news of the tragedy during regular business hours, it is appropriate to close  a clinic so that you can inform fellow trainees, faculty, program staff, and clinic partners.  

Call an emergency meeting(s) to share the news with your trainees, faculty, and program staff.  Invite members of the Crisis Response Team to attend to offer support.  

Consider other constituencies who you want to notify (hospital, clinic staff, etc.).   Don't be surprised that they offer support and coverage for your trainees in this tragic circumstance.   Take advantage of support others offer.

Conduct meetings with trainees, providing connections to mental health resources for immediate support.

Consider inviting trainees to a meal.  Focus on good stories and memories of the deceased.  A smaller group of trainees may want to hang out together.

Assign a program representative to funnel communication to the Crisis Response team lead on needs for program trainees and faculty.

Assure that check-ins occur with any at risk trainees

Work with the Crisis Response Lead to plan an opportunity for trainees to meet with mental health professionals, either in a group setting or as individuals.

Check-in with Chief Residents to see how they are doing.  They will be aware of how many of the trainees are coping. This can be a particularly difficult time for Chiefs.  

Consider cancelling didactics and/or conferences and letting trainees just gather.

Consider asking attending(s) to cover for trainees for a period of time during the initial grief process.

If you are the family liaison, check in with the deceased trainee’s family to see how they are doing.  Ask when they expect decisions to be made regarding funeral arrangements and next steps.

 Hold either a group meeting with mental health professionals or an opportunity for trainees and faculty to meet individually with a counselor where they are not expected to be on service.  Take away the stigma of seeking help.

Schedule an appointment for yourself with a mental health professional.  Don’t use busyness as a coping method for the long term.

For trainees not on call for the weekend, encourage informal gatherings.

Let trainees and faculty know about funeral arrangements and an address for condolence cards.

Talk with trainees and faculty about how they would like to memorialize the deceased trainee.

Check with your trainees to see if another session with a mental health counselor would be beneficial.  Some will find this helpful even at the 3 month mark.  

Continue to monitor schedules and work flow of impacted trainees

Consider monthly process groups with mental health professionals.

Adjust any program trainee wellbeing efforts, based on current needs

Continue to check periodically with each trainee and faculty member on how they are doing.

Make a statement that this is still early in the grieving process, reinforce continued availability of mental health services, caring for each other, faculty who are available to speak to, etc. 

Ask faculty advisors to check in with advisees, plan group dinners, etc. 

Participate in any memorial services that are planned, depending on the family’s wishes

NOTE:  Balancing how different people grieve can be challenging.  Some may want multiple opportunities to talk about their grief and the deceased.  Others may want to focus on their work.  Try to provide space for sharing, while respecting those who need to grieve on their own.  

After the first week, consider a way to memorialize the deceased without providing a constant reminder to those who would be triggered by things like displaying pictures of the deceased.  Some will welcome a "return to normal", and others will feel that it is "too soon".  For example, you might encourage the group to put together a memorial scrapbook for the family, plant a tree at a clinic site in their honor, or volunteer as a group to support a cause that was meaningful to the deceased.