Cultural Change for Students’ Health and Humanity

By Scott Rodgers, MD

Whenever I attend a AAMC meeting these days, the topic of medical student well-being is often discussed. Many schools have launched wellness programs to address some of the common, and potentially avoidable, problems facing tomorrow’s doctors. We have become familiar with studies showing higher rates of burnout and depression among medical students compared to their non-medical peer group. Medical school administrators, faculty, and students around the country are searching for solutions. There are many challenges in addressing a problem as complex and poorly understood as the mental health of professional students, but it’s clear that the motivation now exists to effect a type of cultural change that can help our students maintain their health and humanity as they work to become practitioners in the art of healing.

Vanderbilt University Medical School has been trying very hard to address this problem with our Student Wellness Program. When I began in my role as the medical school’s dean for students around seven years ago, I was curious to know more about the issues facing medical students, and I also wanted to find out which schools were out front and leading. What were these schools doing and how could we learn from them and do something positive for our own students in Nashville? After making a few phone calls to schools around the country, I decided to bring together a group of interested students and faculty members to brainstorm what to do at Vanderbilt.

Leaning heavily on the students themselves for idea generation and leadership, we launched our program a little over five years ago with a tiny operating budget and an ambitious mission to improve the well-being of our students. The talent, creativity, and motivation of these student leaders have allowed us to grow beyond anything that I would have imagined in those early days of brainstorming. While we have made some mistakes along the way, I am excited to report that the Student Wellness Program is now flourishing on our campus, and our own internal surveys indicate that it is making a difference. Some of its elements include:

Wellness Retreats
Commodore Challenge – incentivizing self-care
College Cup – a medical school Olympics

In what was a huge surprise to me, the program was featured in a New York Times article in December.

The attention that the article received was interesting. While most people were excited to read about the program and generally supportive of what we were trying to do, there were more than a few critics — mostly physicians who suggested, in so many words, that wellness programming such as ours was foolish and a waste of time. I receive these criticisms with appreciation, as I feel that training future doctors is a very serious business. Those who have lived the life of a medical student and then experienced residency training and beyond were clearly entitled, based on wisdom gained from experience, to comment either favorably or unfavorably on our efforts. Though I could be wrong, I believe that their concern is based primarily on a fear or misunderstanding that wellness promotion involves a softening of educational and work-related expectations.

The Vanderbilt approach to medical student wellness is not based on a lessening of expectations in academics, research, and clinical responsibility. On the contrary, our students appear to be doing more than ever before in each of these areas. They are a motivated, hardworking, and industrious group of young adults who have an impact on patient care, both at Vanderbilt and in the Nashville community. I am inspired by their example on a daily basis. If anything, students are sometimes their own worst enemies as they seem conditioned to drive themselves extremely hard in everything they do.

The goal-oriented, achievement-focused mentality of today’s medical students is awesome to behold, but it is fraught with danger in terms of deteriorating personal health. Though they may not act on it, I believe the students often know exactly what they need in terms of work–life balance. Our program’s popularity is based in part on the fact that it gives them permission to exercise, sleep, stay connected with friends and family, and have fun every now and then.

We have much to learn about how we can improve medical student mental health, and I look forward to more discussions with students and colleagues from around the country. Empowering medical students to take better care of themselves is a laudable medical school priority, and I’m glad it’s getting the attention it deserves.

—Scott Rodgers, MD, is associate dean of medical student affairs at the Vanderbilt University School of Medicine. He can be reached at scott.rodgers@vanderbilt.edu.