Well-Being Programs: The Hidden Gems of Medical Education

Daryl H. Thorne, EdD, MEd, LCPC, NCC, ACS

The challenging and rigorous learning that typically characterizes medical school can lead to stress, anxiety, and burnout for the learner if deliberate measures are not taken to mediate these potential impacts. This is not new information for the medical community. And because of the ongoing concern for, and research on, mental health and burnout in the medical community (inclusive of students), medical education programs are tasked with establishing wellness/well- being programs and/or wellness-related initiatives, at a minimum.

The broad topic of “mental health” is now widely accepted as being important enough to broach openly. While society continues to struggle with accepting overt signs of mental illness – active psychotic delusions (Le Glaz et al., 2022) and death by suicide (Zivanovic et al., 2018) - there appears to be less stigma around depression and anxiety. In fact, scholarship on anxiety and depression among medical students is burgeoning. From brief literature reviews (Mirza et al., 2021) to empirical research (Manago & Krendl, 2023; Alvi, et al., 2010; Vitaliano, et al. 1984) interest in medical student mental health and well-being have been evident for quite some time; thus, leading the Liaison Committee for Medical Education (LCME) to include element 12.3 in their accreditation Standards. Element 12.3 states, “[a] medical school has in place an effective system of counseling services for its medical students that includes programs to promote their well-being and to facilitate their adjustment to the physical and emotional demands of medical education.” This LCME requirement mandates medical education programs to devote resources to support the well-being of their learners along the continuum of the curriculum. It is important to note that wellness programs vary from university to university, and from program to program. Given the variability and scope of wellness programming, it may not be a stretch to suggest that the breadth and depth of offerings/initiatives within medical education programs reflect their prioritization of student well-being.

Students at nearly every medical school in the United States have access to mental and medical health services, but this may not be enough to help students adjust to medical school or to promote their overall sense of well-being. Wellness programs and offerings may vary depending upon the school’s resources and how they conceptualize ‘well-being’ beyond the LCME’s accreditation directive. Programs that offer a holistic approach to well-being - addressing more than just the mental and physical domains - help students, and physicians of the future, expand the boundaries of what to consider as important to their wellness. This paradigm shift opens the creative space for medical students and physicians in training to attend to their wellness in unexpected ways throughout their careers.

A culture of wellness is the goal. The ideal well-being program becomes part of the culture of the university, not just the medical education program. As mentioned earlier, every program is different. Each should meet the needs of its student-body and reflect the values of the university. I am fortunate to work in the school of medicine at a university that shows its commitment to the well-being of its students and its staff and faculty, as part of its evolving culture. Uniformed Services University of the Health Sciences (USUHS) is a unique institution in that it trains health providers and scientists as its primary mission for the military. Given its uniqueness, USUHS embodies multiple cultures throughout the institution – medical, military, civilian, science, nursing, academic, and etcetera. The culture of the military is shaped by the “mission” and the mission of USUHS is “Learning to Care for Those in Harm’s Way”. The medical students at USUHS are responsible for learning medical and military curricula, which is overwhelming and not typical for most medical education programs. This is precisely why the intention of the well-being program is holistic by design. As the scope of this article is limited, I will note that our Well-Being Program is informed by the Student Wellness Advisory Board (SWAB), which consists of elected student well-being representatives across the university, along with faculty and campus partners to ensure oversight of wellness activities. The inclusive representation contributes to the cultural integration of the well-being program within the University. The annual wellness fair is the event that makes obvious that there is a culture of wellness at USUHS. This year’s fair was held on 22 March.

The purpose of the wellness fair was to bring a host of wellness-related resources, interactive sessions, and activities to campus for the university-stakeholders that included students, staff, faculty, family members, and contracted-workers. There was something there for everyone – relaxation chairs, sleep lab simulations, Reiki, yoga, painting, music, blood pressure checks, counseling information, a burpee station, acupuncture demonstrations, healthy foods, therapy dogs, and additional wellness resources. There were people in attendance who shared that they looked forward to this annual event so that they could get information (or engage in new experiences) that they may not have otherwise considered if left to their own devices. One of the most surprising highlights of the fair was the introduction of Reiki to the campus and seeing students, faculty, and even exhibitors take advantage of a 15-minute session. For those unfamiliar with Reiki, it is an energy-healing modality that can help ease symptoms of anxiety (Lipinski et al., 2020) by promoting relaxation at a deep level without the practitioner touching the client/patient. I am a Reiki practitioner and a licensed counselor, but my role at USUHS is the assistant dean for the well-being program, so it is important for me to have access to a variety of wellness resources to share with my university-community to assist in the amelioration of burnout.