To the Editor:
A wellness revolution is sweeping across our nation’s medical school campuses. In response to concerns regarding trainee burnout, both the number and comprehensiveness of wellness initiatives have grown, with all-inclusive programs such as Vanderbilt’s emerging as a national model.1 For students like me with access to these programs, we have benefited from their variety and flexibility. At my institution, I can create my own unofficial “wellness curriculum” tailored to my interests—participating in activities such as advisory dean meetings, yoga, or student-led socials. But is this model the best approach to wellness?
The majority of wellness programming offered is optional, and not all students elect to participate. Among those of us who do, questions invariably arise: Mindfulness may calm the soul, but does it address the self-imposed or institutional expectations surrounding academic performance? A meeting with an advisory dean may contextualize a clinical conflict, but does it alleviate the stress-inducing demands of a rigorous clinical environment?
Simply put—are wellness programs truly targeting the causes of trainee distress?
In many ways, they are not. The current wellness model focuses on reducing the manifestations of student stress rather than addressing its underlying sources, which are often environmental, interpersonal, or cultural in nature. I am thankful to Slavin and colleagues2 for breaking away from this mind-set, choosing instead to “attack the source of the distress” by implementing fundamental changes to their institution’s preclinical curriculum. Reexamining medical team dynamics on the wards may be another area where trainee distress could be prevented.3
Just as medicine has transformed its outlook on patient care by appreciating the value of a holistic approach to health, a paradigm shift is needed in the current wellness movement. By recognizing wellness as a philosophy, not an activity, a culture instead of a program, we can begin to generate lasting solutions that will truly promote and sustain the well-being of our nation’s next generation of physicians.
Christopher E. Gaw
Fourth-year medical student, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; [email protected]; ORCID: http://orcid.org/0000-0002-2847-6372.
1. Drolet BC, Rodgers S. A comprehensive medical student wellness program–design and implementation at Vanderbilt School of Medicine. Acad Med. 2010;85:103110.
2. Slavin SJ, Schindler DL, Chibnall JT. Medical student mental health 3.0: improving student wellness through curricular changes. Acad Med. 2014;89:573577.
3. Gaw CE. Becoming a member of the team. Med Teach. 2017;39:105106.