Are Medical Schools Teaching Self-Care?

[neurophile]

Hi everyone,

 

I am curious to know if medical schools go beyond addressing mental health and self-care in orientation week to hold workshops or seminars through-out the year about practicing self-care? Is this something medical students are interested in learning about? 

 

Thanks!

[goleafsgochris]

Mine taught tons of self care. The problem is the sessions aren't particularly useful. Like everyone knows you shouldn't work 24-7 and do nothing but be a gunner, but a self-care workshop or lecture isn't going to get you to exercise and chill with family more often haha. It's more if the student has the ability to manage time well enough/not be too anxious about stopping work to actually do self care

[Mithril]

They try to.

 

UBC has a course called DPAS which covers a wide range of topics, including self-care and self-reflection. I usually skipped these classes to go work out or do something actually related to self-care.

 

Other schools probably do something similar.

[Snowmen]

We have a class that's dedicated to teaching us how to keep good habits like doing sports, eating well, etc. Ironically, the class is during lunch time between two other classes which means everyone has to eat junk food as quickly as possible during the 5 minute brake between classes.

[#YOLO]

yeah alota these classes are a waste of time, and have stupid mandatory lectures and assignments..taking away from my own personal time. massive  waste of time. 

[JohnGrisham]

yeah alota these classes are a waste of time, and have stupid mandatory lectures and assignments..taking away from my own personal time. massive  waste of time. 

Tend to agree. I dont want a lecture style fluff attempt at you pretending to care about me. 

 

Respect my time with clear objectives and learning goals, and let me use my free time to best manage other aspects of my life.  If medical schools just figured that out, at least for me anyways, there would be big improvements in well-being.

[#YOLO]

accreditation though. its not about the students its about accreditation, thats what being involved with administration has taught me.

[neurophile]

Okay, so it sounds like some of what they are trying to teach is not practical such as not working 24/7, which is largely out of the control of residents and medical students. I'm still in undergrad, and applying next cycle. I have been reading a lot of articles about mental health and suicide within the medical community like the article about Kathryn, and articles on KevinMD which made me wonder if schools are attempting to address self-care at the level of the undergraduate medical education. Based on your responses the Canadian schools are addressing self-care and mental health, but there is still a much higher prevalence of mental illness (particularly anxiety and major depression) in the medical community than in the general population. I wonder why that is. 

 

I can see how a student's ability to handle a large workload will play a large role in the ability to handle stress and cope well. 

[ellorie]

I think there is a real tension with the "self care" rhetoric.  Because when we privilege and push things like self-care and resiliency, it puts all of the onus on individual physicians to do more and more with less and less, and it does in a way frame it as a personal failure when things don't go well - YOU didn't care for yourself, YOU weren't resilient.

 

To answer the question, my residency program doesn't address it much didactically, but it comes up a fair bit informally in supervision and mentorship, which is kind of the best way.  In medical school I think they tried but it's a topic that's SO ill-suited to didactic teaching.

[ralk]

Okay, so it sounds like some of what they are trying to teach is not practical such as not working 24/7, which is largely out of the control of residents and medical students. I'm still in undergrad, and applying next cycle. I have been reading a lot of articles about mental health and suicide within the medical community like the article about Kathryn, and articles on KevinMD which made me wonder if schools are attempting to address self-care at the level of the undergraduate medical education. Based on your responses the Canadian schools are addressing self-care and mental health, but there is still a much higher prevalence of mental illness (particularly anxiety and major depression) in the medical community than in the general population. I wonder why that is. 

 

I can see how a student's ability to handle a large workload will play a large role in the ability to handle stress and cope well. 

 

As the other posters noted, schools are "addressing" the wellness of their students, but in a way that feels like putting a band-aid on a bullet wound. Sure, it's better than nothing, but it's more for show than results and can get in the way of people who are trying to do something more meaningful to help the situation.

 

As to why mental health and poor self-care are a problem in medicine, I don't think it's overly complicated - lack of support, lack of control, and lack of time. The reasons behind why these aspects of life are lacking in medicine is a bit more complex, but the immediate rationale behind the poor state of medical trainee health seems pretty obvious to me.

 

Lastly, ability to handle a large workload has absolutely nothing to do with how well a trainee or practicing physician is coping, dealing with stress, or caring for themselves (mentally or physically). Suicide stories often come from those who are doing well or even above-average when it comes to keeping up in medicine. Oftentimes it's the highest-achieving, most caring students who are suffering the most. Mental health problems in medicine have nothing to do with ability, competency, or mental fortitude.

[Edict]

Hi everyone,

 

I am curious to know if medical schools go beyond addressing mental health and self-care in orientation week to hold workshops or seminars through-out the year about practicing self-care? Is this something medical students are interested in learning about? 

 

Thanks!

 

The issue is that they talk the talk in class but reality (medical professions) tells us to do something else. 

[NLengr]

yeah alota these classes are a waste of time, and have stupid mandatory lectures and assignments..taking away from my own personal time. massive  waste of time. 

It's like how I once got in a huge argument with the PGME office as a resident after they tried to haul me over the coals for missing a professionalism session. I missed it because I was busy resuscitating a septic patient in the ER so they could get to the OR for life saving surgery. I was the only physician available at the time. PGME kept trying to tell me that I should have left the patient in order to attend the session. When I pointed out multiple times it wouldn't have been very professional to abandon a critically ill patient in order to attend a random academic session on professionalism, they just couldn't wrap their heads around it.

 

Universities can be pretty weak in the common sense department.

[NLengr]

Tend to agree. I dont want a lecture style fluff attempt at you pretending to care about me. 

 

Respect my time with clear objectives and learning goals, and let me use my free time to best manage other aspects of my life.  If medical schools just figured that out, at least for me anyways, there would be big improvements in well-being.

Medical schools love to treat medical students, residents and fellows like they are petulant little children incapable of independent thought, action or decision making. I found it incredibly annoying.

[JohnGrisham]

Medical schools love to treat medical students, residents and fellows like they are petulant little children incapable of independent thought, action or decision making. I found it incredibly annoying.

Yep.

 

"Oh look, we don't want to tell you if lectures are recorded in advanced, because then students maybe wouldnt come and hurt lecturers feelings. P.S. not all lectures are recorded like we said in orientation to make our school look like #1. And btw, we're not going to have PPTs up on time, and likely have many changes...but thats okay, you got your new fangled Ipad-whats-it, you should be able to fix that on your own time"

[Arztin]

Medical schools love to treat medical students, residents and fellows like they are petulant little children incapable of independent thought, action or decision making. I found it incredibly annoying.

Yup. This part seems to be a problem throughout the country and it's extreeeeemely irritating.

[Arztin]

Hi everyone,

 

I am curious to know if medical schools go beyond addressing mental health and self-care in orientation week to hold workshops or seminars through-out the year about practicing self-care? Is this something medical students are interested in learning about?

 

Thanks!

They do but then, when you are forced to attend this the day before an exam, would you rather study or have a mandatory relaxation session before your exam? This happened to us.

 

Once, in the middle of the day, during lunch hour, they scheduled a wellness lunch hour session for us. I was forced to go away in the middle of the day, to find out they didn't even have lunch for us. Then we had to go back to our clinical duties in another hospital. That wellness session was more stressful and annoying more than anything (missed the opportunity to see 3 consults).

 

In other terms, most students think of these self care sessions as BS.

[Arztin]

At McGill, we were one of the only schools that doesn't give the students any time off right before the board exams.

So a lot of the students would not book patients during that week to give themselves extra time to study. Especially those students who were close to finished their clinical requirements and could afford some days away from clinic.

Well, our clinical director took this as an insult to the supervisors who came in for the clinical sessions. He would take attendance for those specific clinical sessions and then come down hard on the students who were absent. Previous to that, missing a clinical session here and there was no big deal.

It was more important that the once a week visiting dentists who supervise clinic feel like their 3-4 hours of time were valued that week than for the students to be given the freedom to choose how best to use their time the week before the boards.

Meanwhile, it just meant that those of us who were there got more one on one time with the supervisors. It's not like their time was wasted, and a lot of them enjoyed the less hectic clinic time.

Point being, the students well being was at the very bottom of the priority list for the administration.

Even worse, they know it happens every year and it was almost like they looked forward to a known and expected opportunity to shit on us.

To me, a sane reaction to knowing your students are up against the single most important test they've ever done would be to offer support, not catching them off guard with shaming and discipline for taking precious time to study.

Yup. Entirely agree. Schools just want to look good. When a student commits suicide, all of a sudden, they send out emails about wellness and make it a sudden wellness day.

Then, right after, back to the usual unrealistic expectations the day after...

I have talked to a few students in different med schools and we all had the impression that wellbeing isn't a priority for med schools in general.

[neurophile]

This opens the door to the complexity of the system. Self-care is a tiny portion of it. I guess I won't know what it's really like until I'm in it myself.

 

Thanks for all the replies everyone.