"Shining a light on an attitude that doesn't acknowledge stress" - Chris Cassel, MD, Planning Dean
"We have to take care of our caregivers to take care of our members" - Marc Klau, MD, MBA
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
We need systemic and cultural change in medicine if we plan to address physician burnout - Kelly Thibert, DO, MPH, American Medical Student Association President, 2016-2017
With thanks from the planning team
Christine Cassel, MD • Marc Klau, MD • Nancy Spiegel, MS • Patrick Burkhardt, MEd • Preethi Kannan, MS • Amy Klawitter, MPH, CPH • Mi Chelle Sorey • Ted Eytan, MD
Credits:
Ted Eytan, MD, MS, MPH, Mohsin Hashmi