Reply to letter to the editor from Dr. Jiayi Chen

We sincerely thank Dr. Chen for the thoughtful and constructive comments on our article examining compensated cases of work-related mental disorders among physicians in Japan.We completely agree with Dr. Chen's assertion that future countermeasures should prioritize three areas: structured mentorship during departmental transitions, formal recognition of academic preparation as protected working time, and proactive mental health screening tailored to clinical residents.Of these, supporting clinical residents in managing the psychological burden of departmental transitions and actively screening for mental health seem particularly essential to us.In Japan, mentorship and supervisory systems exist wuthin certain specialtiessuch as surgery, emergency medicine, and obstetrics and gynecology-as well as within the two-year postgraduate clinical training system for new physicians 1 ) .However, the degree of structure and consistency varies across institutions and specialties.Expanding and strengthening such mentorship systems more broadly across training environments may help reduce psychological stress during transitions and improve support for earlycareer physicians.In addition, we believe that creating a workplace culture in which interns can seek appropriate assistance is also an important part of mental health screening.We will continue to analyze these issues in our future research to identify interventions and solutions that can prevent physician suicide by overwork.Once again, we thank Dr. Chen for the insightful and constructive comments.We hope that this academic exchange contributes to ongoing international dialogue on improving occupational health protections for physicians and strengthening preventive strategies against work-related mental disorders and suicide.