The Medical School battles burnout with a focus on student resilience.
The need to combat medical students’ stress levels could not be more urgent. A recent study in the Journal of the American Medical Association found that 27 percent of medical students contend with depression or depressive symptoms, and a worrisome 11 percent experience suicidal thoughts.
It’s a major concern for medical educators, one that a group from Brown University is taking a new approach to address.
“Training in medicine emphasizes use of diagnostic tools, including observing and interacting with patients, as well as using physical tools, such as stethoscopes or CT scanners,” says Ellen Flynn, MD, clinical assistant professor of psychiatry and human behavior and codirector of the mindfulness-wellness program at the Warren Alpert Medical School.
But, she adds, “Without including the less frequently taught resilience tools, burnout is highly likely.”
Resiliency training, which is being introduced to the school’s curriculum, fosters healthy stress responses. Resilient people are able to achieve difficult goals at minimal psychological and physical cost, and more readily bounce back from challenges.
According to Flynn and Chloe Zimmerman ’15, researcher and manager of the Embodied Neuroscience Lab at Brown, resilience is something that can be cultivated.
They, along with the late Catherine Kerr, PhD, assistant professor of medicine and family medicine and director of mindfulness at the Medical School, developed a longitudinal resilience curriculum to follow the four years of medical training.
The program, currently in a pilot year, introduces mindfulness tools, one of many resilience strategies, through lectures and workshops, as well as the latest scientific data on mindfulness in medicine. This training will help students “metabolize” the stress of medical education and ultimately become more resilient physicians.
On the flip side, research shows that doctors who practice mindfulness are rated as more competent and likeable and also make fewer medical errors. “When doctors experience stress, patients are absorbing it too,” Zimmerman says.
Zimmerman and Flynn are researching the efficacy of mindfulness in reducing burnout and on the neuroscience of resilience. Early results show that medical students who took a six-week mindfulness-based stress reduction course were better able to remember details in a challenging test and also physiologically recovered from the stress of the test more quickly compared to peers who did not take the class.
The nascent program has enthusiastic administrative support from Allan Tunkel, MD, PhD, associate dean for medical education, and Jordan White, MD, assistant dean for student affairs. The all-encompassing nature of medical school can prevent students from engaging in self-care, White says.
Tunkel adds that not all stressors can be removed from the students’ experiences, but resiliency can help students cope.
Resiliency programs for medical students also demonstrate a commitment to developing the whole doctor. “The resiliency skills are great for medical school, but can also be used in your personal life,” Zimmerman says, pointing to the importance of cultivating doctoring skills beyond the textbook or clinic.
Flynn adds: “The program is all about facilitating an environment where medical students can flourish into thriving, healthy, whole physicians.”