Background: Studies on death and dying predominantly emphasise the needs of the dying patient and the process of bereavement. Few studies have focused on the reactions of medical doctors and students when the patients they have cared for die.

Methods: The aim of the study was to explore the thoughts and feelings of doctors and medical students who have lost patients while under their care at the Dr George Mukhari Hospital emergency unit in Ga-Rankuwa, South Africa. The participants included 10 medical doctors and final-year medical students. A qualitative study methodology using a phenomenological approach was used.

Results: Meanings were formulated from transcriptions and themes were identified. The following themes emerged: emotional reactions, which included anger, helplessness, guilt and pain; recurrent thoughts about the incident; blame; perceived incompetence; detachment from emotions; religion; death of a paediatric patient; medical training; psychological services; work environment; coping with the family of the deceased; and facing mortality.

Conclusion: From the study it was concluded that doctors needed enhanced training in communication skills and communicating death to the patients' families. Bereavement counselling and debriefing should be availabel to provide them with an opportunity to share emotional responses and reflect on patients' fatality.