Fostering a resilient medical community
This fall, the Foundations Curriculum included the launch of a new Resilience Curriculum. This curriculum aims to equip first year medical students with an understanding of the characteristics of a resilient physician and the skills needed to assess and build on their own resilience. The goals of the curriculum are to support students experiencing challenges with their transition to medical school, to reduce stigma surrounding seeking help and to build a resilient medical learner community that supports the curriculum.
Shayna Kulman-Lipsey, Manager of Counselling Services at the Office of Health Professions Student Affairs (OHPSA), defines resilience as, “The ability to bounce back from challenges and persevere through adversity. Being able to learn from the experience, so moving forward, you have even more skills to address future challenges”.
The resilience curriculum is a collaborative project of OHPSA, Post-Graduate Medical Education (PGME), and medical students. This committee of students worked closely with OHPSA and PGME to research topics related to resilience, and to create the content of the curriculum.
1T9 student Benjamin Fung was part of the development of the curriculum. He believes that there is a strong need for resilience to be taught in medical schools. “A lot of students, including my peers and I, have feelings of depression, anxiety or burnout,” he says. “It’s so prevalent within this environment. The same way we would want future physicians to know how to give a diagnosis or prescribe medicine, if we want physicians to be resilient, we should be equipped with the tools early on in medical school.”
The curriculum discusses common challenges to resilience including imposter phenomenon, shame and guilt, and the hidden curriculum. “In medical school, there’s a whole curriculum that isn’t formally part of the curriculum. For example, the image of physicians unintentionally promotes the idea that they are invincible – that they’ll work 20-hour days, not take lunch, not even go to the bathroom. The message is that you should be working like that,” said Kulman-Lipsey.
First year students experienced the resilience curriculum over two weeks in October and November 2016. The curriculum provided students with practical skills to combat these challenges by highlighting concepts such as cognitive reframing, self-compassion, mindfulness, and identifying downward and upwards spirals.
Yezarni Wynn, 2T0 student felt reassured by the curriculum. “Medicine is hard, we're not heroes and there will come a time when even the strongest people need help and support,” he says. “These underlying themes in the curriculum give me a sense of comfort in times of stress by reminding me that I am not the only one struggling. In turn, this has also made me more comfortable with, and transparent about, seeking help from my peers.”
A video testimonial series called Monologues in Medicine is interspersed throughout three modules that correspond to specific topics within the resilience curriculum. The monologues share the experiences of 15 medical students and residents who volunteered to share their personal stories of challenges experienced in medical school and how they overcame these challenges. Kulman-Lipsey states, “The participants were very open about their challenges and of their experiences of reaching out for help. We made these videos because we want to destigmatize the idea of students struggling or having mental health issues. The sharing of these stories is extremely powerful.”
Fung was actively involved in the development of the monologues due to his experience with video editing and storytelling. He says, “It’s brave for them to share their experiences, but it’s also rare. It shouldn’t be rare. If we want an environment that’s safe and supportive, these things should be done by all students. All students should be able to feel like, if they want to, that they should be able to share their stories.”
1T8 student Noam Berlin helped transition the curriculum content online, and also shared his own struggle with resilience through a video testimonial. Berlin states that this was his most meaningful takeaway from working on the curriculum, “It was incredible to share my story alongside my peers,” he says. “By doing so, we are fighting the stigma that forces medical students to suffer in silence and to think there must be something wrong with them if they aren't able to just ‘push through’ these challenges. Seeing others share their stories has helped me feel like I still belong.”
Students are able to access resources any time through Portal. The curriculum is currently composed of three online modules and two workshops. A resilience curriculum for second year students is currently in development with the goal of having available resources for all four years.
Kulman-Lipsey hopes that the resilience curriculum will help to foster a resilient medical culture, “I’d like to think that this group of students can be agents of change within the medical culture. That it’s okay to say that you’re struggling, it’s okay to reach out for help. We’re also looking beyond the students; we’re looking at building a resilient medical learner community. It’s not just the curriculum in isolation; we also need the support of the medical learner community.”