Students

• Face competition and academic pressure
• Have an idealized image of medicine
• Are separated from humanity throughout medical education
• Feel isolation when studying alone in cubicles or at home
• Are not emotionally prepared for the realities of caring for patients or changing identity
• Start questioning why they are going into the medical profession

Culture

• Schools don’t prepare students for the transition and the concept of failing
• Technology could lead to more social isolation in the current generation
• Social media and technology could support less personal connections and increased isolation
• Lack of commitment from leadership and faculty on personal well-being

Medical Schools

• Understand that it's difficult to study
• Create facilitated small groups as a protected space
• Promote a positive tone at the leadership level
• Promote faculty support on a culture of well-being
• Create protected flex time throughout all 4 years
• Understand that behavior is a function of the person and the environment
• Promote the necessity of physician and faculty role-modeling
• Create curricula on functioning as team-members

Evidence Base

• Limited evidence with the need of a variety of interventions
• Re-think what we think of as acceptable evidence
• Significant amount of evidence on the impact of unconscious bias on culturally humble patient care
• National Academy of Medicine currently doing a literature review on this topic

What we believe

• Students coming from different groups want acknowledgement that their needs are different - equity vs. equality
• Imposter syndrome may be more pronounced - if a student is the "first" in their family, there can be a sense of isolation
• Connectivity, relationships, and feeling "known" create a culture of inclusion
• Even the best organizations struggle with unconscious bias

What's needed

• Informal mentors with concordant demographics, to share in an open and honest way
• Mentors with specific skills and ongoing evaluations of these skills
• Faculty who clearly show that they are allies and have the ability to support diverse student groups
• Resources to support students to deal with microaggressions
• Involvement of community

People

• Deans must believe in the issues and back them up
• Mentors need to recognize individual needs of students
• Faculty should represent the diversity of the student body

Process

• Every student and core faculty should participate in counseling
• Professional passage thread - connected multiple times throughout training
• Coaches that teach lifestyle, behaviors, skills
• Student champions to help with well-being initiatives that could be tied to projects or research
• Student participation in creating surveys and implementing solutions
• Co-creation and co-evaluation of activities - measure and share
• Maintain connection and develop support for students going to outside environments - give them the ability to lead
• Those most affected by a decision should be engaged in the discussion and decision