Although the ultimate goal is to save lives (i.e., reduce the rate of suicide among medical trainees and faculty), the low base rate of suicide in a population makes it difficult to evaluate whether the implementation of the ISP at OHSU will lead to a drop in suicide rates at this institution. Even using patient suicidal ideation and attempts as outcomes is problematic as this information can be difficult to gather unless the patient is actively involved in treatment at the time. Rather in the present study the effectiveness of this suicide prevention program will be measured by examining related variables to suicide risk—increases in protective factors and decreases in risk factors. Specifically, these researchers seek to decrease known risk factors (e.g., identify and intervene with untreated depression, substance abuse, high level of stress) and increase protective factors (e.g., promote self-awareness, receipt of support and resources and delivery of mental health services if needed).