Medical professional burnout has been a topic of research and concern for decades. After COVID-19 hit, large numbers of desperately ill patients overwhelmed health care facilities, resulting in stories of demoralization.
The pandemic took a huge toll on mental health but opened the door for greater discussion and honest reflection, with some surveys reporting more than half of practicing doctors feeling burnout. As a result, wellness and how to achieve it is now a critical topic in medicine, not only for patients but for physicians and trainees.
Prospective medical school students today are keenly aware of stress and burnout that can result not only from med school, but also from the practice of medicine itself. They are highly interested in ways to prevent or minimize the consequences, which unfortunately include alcohol or other substance abuse and even suicide. What can be done to promote resilience?
During interview day, as well as during a medical school second visit, applicants often ask if the med school offers programs to help them cope. In recent years, more applicants are asking about stress-management programs because they are interested in a medical career that focuses on wellness for their patients.
These students want to be part of the solution, working in areas of lifestyle, wellness and disease prevention. These forward-thinking students see the roles that nutrition, sleep, physical activity and mental health play in life expectancy. They also understand that disease can be slowed or reversed in some cases, and overall satisfaction with life improves if a person takes care of their body and mind.
[READ: Everything You Need to Know About Medical School Interviews.]
Climate change has also been increasingly associated with physical and emotional sequela. Environmental health is an exploding area of interest for wellness, and the medical school you select should be at the forefront.
How is the school you are visiting addressing these issues? Are they educating their students adequately to teach the patients they will encounter?
This is another area of health care disparities, as you think of urban areas with high rates of air pollution, water contamination and, more recently, heat domes. Wellness can be an uphill battle, but we have no choice other than to put our sincere effort into improving our environment.
Medical schools have been behind in educating students in areas of wellness, but are trying to catch up at lightning speed as millennials and Generation Z progress through their education and careers. Earlier generations driven by a post-World War II work ethic and career demands are falling to the side as millennials begin pushing the envelope for life balance.
For example, in decades past, nutrition was barely taught in medical schools. Now it is surfacing in almost all, and some even allow students to get an additional master’s degree in nutrition.
[READ: How to Discuss Mental Health Issues in Medical School Applications.]
The Liaison Committee on Medical Education, the accrediting body for medical schools that award M.D. degrees, list standards and guidelines to approve med school education in wellness and well-being. One focus has been the offering of mental health services to students. There is concern that students have ease of access to personal counseling delivered in a confidential manner that students find satisfactory.
The purpose is to help students adjust to the physical and emotional stresses of medical school. Schools must provide evidence that they tell the students how and from whom they can get help easily and confidentially.
Schools also report that they let students know how to get excused from class or clinic for this help. During a school’s LCME review, class surveys and direct discussion with some students dig into how it’s working.
There is a follow-up item in which schools describe other programs available to improve well-being. I know many schools take this very seriously, but I am uncertain how well this works at others. You may find it a fertile area to explore during an interview.
When I was working full time, we introduced students to the topic of sleep within the first month of medical school. Poor sleep can lead to depression and depression can lead to poor sleep. Students needed to learn from an expert why getting enough restorative sleep can renew their mood and daytime energy. They needed to learn about increased physical pain associated with poor sleep, and how to teach patients. They learned to appreciate the risks of inadequate sleep, how it could increase anxiety and how to improve their overall wellness.
In past decades, physical activity did not play much of a role in the medical school curriculum. It was assumed that everyone understood it was important. Now there is increasing literature supporting its role in lengthening life span, improving cognition and helping those with chronic illness to reduce pain and lessen depression through regular exercise and monitoring.
Many schools have started programs where patients run with their doctors, and medical students are invited to join in these activities. Other schools have their own running clubs, groups that work out in the gym together or student organizations that promote physical exercise in various fun ways.
[The Importance of Emotional Intelligence in Medical School Admissions]
Physical exercise is extremely helpful in maintaining mental health, and adequate sleep, nutrition, mindfulness practices and a positive attitude can work powerfully to prevent or minimize dysphoric symptoms. Although an individual can’t change their genetics of mental illness that may lean in an untoward direction, there is much they can do to influence environmental stressors and other precipitants.
These topics, which influence resilience and how you rebound after adversity, should have a powerful presence in the curriculum through all years. Whether you’re interested in wellness from a personal or career standpoint, here are some questions to consider asking during your medical school interviews.
Nutrition
— What do you teach about nutrition and where can I find that in the curriculum?
— Do your students feel adequately prepared to counsel patients about nutrition?
— What kind of scientific research around nutrition is the school or medical center involved in?
— How is nutritional information delivered to patients in the community?
Physical Activity
— How is this taught in the school?
— Does the school have students who lead physical activity initiatives?
— Is physical activity for patients embedded in the curriculum?
— How is physical activity information delivered to patients in the community?
Sleep Health
— When are students taught about sleep?
— Are there sessions to discuss how poor sleep leads to other illnesses?
— What about the role of poor sleep in physical pain?
— Do students learn nonpharmacological methods to benefit sleep?
Mental Health
— Are strategies such as mindfulness, meditation, yoga, relaxation exercises and imagery included in the curriculum?
— Are electives like cognitive behavioral therapy for mental health and sleep included in the curriculum?
— How can I connect with students and faculty who are interested in mental health, particularly those in preclinical and clinical research?
— How does the school support students’ education, clinical interests and research regarding mental health?
These questions require respondents to have adequate depth in their answers. If they don’t know what their school teaches in these areas, the curriculum may not meet the students’ or the patients’ needs.
For example, solid evidence-based nutrition taught by a specialist should be demonstrable in the curriculum outline. It’s also important to know how clinical preceptors reinforce this teaching with patients. Some outpatient clinics even have kitchens to help demonstrate cooking techniques to patients.
You may also consider asking admissions committees to connect you with graduates who are interested in nutrition, physical activity or mental health, and who are heading toward residencies in areas that will lead them to a career in wellness.
Although medical advances have helped millions of people live well into their golden years, these advances haven’t necessarily helped them live better. You can do yourself and your future patients a favor by considering how wellness and medicine intersect and how you can integrate wellness into patient practice and your own life.
Remember that, in the end, it is all about resilience to adversity.
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How to Discuss Wellness Curriculum in Medical School Interviews originally appeared on usnews.com
