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Medical Student Mental Health 3.0: Improving Student Wellness Through Curricular Changes

Slavin, Stuart J. MD, MEd; Schindler, Debra L. PhD; Chibnall, John T. PhD

doi: 10.1097/ACM.0000000000000166

Medical education can have significant negative effects on the well-being of medical students. To date, efforts to improve student mental health have focused largely on improving access to mental health providers, reducing the stigma and other barriers to mental health treatment, and implementing ancillary wellness programs. Still, new and innovative models that build on these efforts by directly addressing the root causes of stress that lie within the curriculum itself are needed to properly promote student wellness. In this article, the authors present a new paradigm for improving medical student mental health, by describing an integrated, multifaceted, preclinical curricular change program implemented through the Office of Curricular Affairs at the Saint Louis University School of Medicine starting in the 2009–2010 academic year. The authors found that significant but efficient changes to course content, contact hours, scheduling, grading, electives, learning communities, and required resilience/mindfulness experiences were associated with significantly lower levels of depression symptoms, anxiety symptoms, and stress, and significantly higher levels of community cohesion, in medical students who participated in the expanded wellness program compared with those who preceded its implementation. The authors discuss the utility and relevance of such curricular changes as an overlooked component of change models for improving medical student mental health.

Dr. Slavin is associate dean for curriculum, Office of Curricular Affairs, and professor, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri.

Dr. Schindler is senior education specialist, Office of Curricular Affairs, Saint Louis University School of Medicine, St. Louis, Missouri.

Dr. Chibnall is professor, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri.

Funding/Support: The authors acknowledge Dr. Frank O’Donnell, whose gift to the medical school supported the implementation of this program.

Other disclosures: None reported.

Ethical approval: The Saint Louis University institutional review board approved the research component of this article.

Correspondence should be addressed to Dr. Slavin, Saint Louis University School of Medicine, Office of Curricular Affairs (LRC 101), 1402 S. Grand Blvd., St. Louis, MO 63104; telephone: (314) 977-8077; e-mail:

© 2014 by the Association of American Medical Colleges