Good morning or afternoon, everyone. My name is Chandrika Sanapala, and I'm a third year medical student at Burrell College of Osteopathic Medicine, and I'd like to introduce my co-presenter, Megan Mapala, who is also a third year medical student at Burrell. It's an honor to speak with you all today regarding an issue that not only affects medical students like ourselves, but the future of healthcare. We often talk about the growing physician shortage, but we don't always address one of the underlying challenges, burnout and mental health struggles that begin early in training. While efforts are being made to expand the physician workforce, we must also ensure that those entering the field have the support needed to thrive, both during medical school and throughout their careers. We have no disclosures to report. So a little bit about us, Chandrika is currently the lead student researcher in our IRB approved study on medical student mental health. In addition to her research, she is a district advocate for the National Multiple Sclerosis Society and is actively involved with the Bureau of Emergent Leaders Communications Workgroup. Chandrika has also held a number of leadership roles, including serving on the SGA Executive Board as Vice President, founding and chairing the Burrell Wellness Task Force, and being the BCOM National Mental Health Liaison. Currently, I serve as the SGA Executive Board OMS3 Class President and previously served as the SGA Student Life Representative. I work alongside Chandrika and a couple of our classmates on our mental health research and I'm also a founding member of the Burrell Wellness Task Force. Our learning objectives include, number one, understanding the current state of medical student burnout, prevalence, causes, and consequences. Number two, methods to tackle issues regarding medical student burnout. Number three, identifying institutional changes that can reduce burnout, such as curriculum adjustments and wellness initiatives. And number four, learning about the importance of peer support, faculty mentorship, and institutional resources in combating burnout. So we often hear about the need for more doctors, from government leaders, healthcare organizations, and policymakers. More medical schools, more residency slots, and more incentives to enter medicine. But while efforts focus on increasing the number of physicians, we must also address a critical issue. Many are leaving the profession just as quickly. The Association of American Medical Colleges projects a shortage of up to 124,000 physicians by the year 2034, driven by an aging population and increased healthcare demand. And a 2022 study found that one in five physicians plan to leave medicine within two years due to burnout. Burnout, depression, and suicide are gutting our profession. And the worst part, it starts early. Long before we become attendings, before we even step into residency, we are trained to believe that exhaustion, emotional distress, and neglecting our own well-being are just part of the job, that it's normal. But what if we took a different approach? What if early warning signs were recognized and addressed? What if stronger support systems were in place from the beginning? These questions matter because physician well-being directly impacts patient care. The numbers are staggering. Today, 63% of physicians experience symptoms of burnout, compared to about 28% in the general workforce. Doctors are twice as likely to suffer from depression as the general population. And physician suicide, it's the highest of any profession, with rates 1.5 to two times higher than the national average. As medical professionals, we are trained to diagnose, treat, and support our patients in prioritizing their health. But when it comes to our own well-being, seeking help is often overlooked or discouraged. This issue is not just a challenge, it's an opportunity for change. And that's why we're here today. Many of you watching this are physicians, but today we are speaking as medical students. We represent the future of this profession, and we recognize the need for solutions that promote longevity and well-being in medicine. Addressing burnout at its roots within medical training will be key to ensuring a healthier, more sustainable workforce. Perhaps we might consider shifting the conversation to implement meaningful support systems and create an environment where future physicians can thrive. Without change, we risk continuing a cycle that serves neither doctors nor the patients who rely on them. Burnout doesn't start in residency. It starts in medical school. From the moment we begin training, we are exposed to intense workloads, long hours, and high-stakes learning environments. Over time, this takes a toll on mental health, and for many, it becomes an accepted part of the profession. We often hear about physician burnout, but studies do show that it does start earlier. A 2021 journal of the American Medical Association, JAMA Study, found that up to 60% of medical students experience burnout symptoms. Compared to their peers in other fields, medical students have higher rates of depression and anxiety. A systematic review in academic medicine reported that 27% of medical students experience depressive symptoms nearly twice the rate of the general population of similar age groups. Suicidal ideation is reported in 11% of medical students, again, significantly higher than their non-medical peers. These numbers aren't just statistics. They represent real students, real future physicians struggling under the pressure of a system that perhaps hasn't evolved to support their well-being. But burnout is a gradual process. It's not a single crisis moment, but the long-term accumulation of stress. Over time, it builds up, and unless it's addressed, it can become overwhelming. And the fact is, many of us don't even recognize it until it's too late. This problem isn't new, but transparency and advocacy are. Past generations of medical students may have suffered in silence, but today we're attempting to change the narrative. We are speaking out, we are pushing for better support, and we are advocating for systemic changes that will help future generations of medical students to avoid the same fate. As osteopathic physicians and future physicians, we are trained to see the body as a whole. We focus on symptoms while looking for the underlying cause, the dysfunction that sets disease in motion. This holistic approach has helped us provide high-quality care for our patients, but when it comes down to our own profession, we often overlook the same principles. Burnout, depression, and exhaustion are not just personal struggles. They can impact the way we care for patients. Research shows that physicians experiencing burnout are twice as likely to make medical errors. They have higher rates of malpractice claims and lower patient satisfaction scores. And in fields like emergency medicine, surgery, and primary care, burnout has been directly linked to worse clinical outcomes. As a profession, we emphasize prevention and early intervention for our patients, but when it comes to physician well-being, these same principles are not always prioritized. Mental health and wellness should be part of the conversation, not as an afterthought, but as an essential component of sustaining a strong and effective healthcare workforce. We are passionate about advocating for improvement, not only as medical students, but also as active members of our school's Wellness Committee and Student Government Association. From our experiences, we've seen the challenges our peers face with mental health, and we are committed to ensuring that the resources available are truly addressing students' needs. Through ongoing research and advocacy, we aim to create a more supportive environment, ensuring that the support systems are practical, accessible, and impactful. We need to apply the same principles of care and balance that we use with our patients to our own profession. Physician well-being is integral to the quality of care we provide. It directly impacts how we serve our patients. To continue offering the best care possible, we must ensure that the system supporting us as providers is both effective and sustainable. So what have we done thus far? As medical students, we recognize that systemic change does take time. But while we advocate for broader reform, we also need to take action to support our current peers. That's why students across the country, including at our own institution, have been working to implement real, student-driven initiatives to address mental health challenges in medical education. At Burrell College of Osteopathic Medicine, we co-founded the Burrell Wellness Task Force, a student-led initiative focused on identifying and addressing mental health concerns among our peers. We recognized that while resources existed, many students weren't utilizing them, whether due to stigma, lack of awareness, or barriers to access. Our goal was to bridge that gap by creating a platform for open conversations, implementing peer-led support initiatives, and working directly with faculty to push for policy changes that prioritize student well-being. Beyond campus, we've worked to bring these conversations to a national level. As the BCom National Liaison for Mental Health last year, I've had the opportunity to connect with student leaders from other medical schools and discuss shared challenges and advocate for broader change in medical education. Mental health isn't just a local issue. It's a profession-wide concern, and we need a unified approach to address it. Through these national conversations, we're learning from each other, sharing best practices, and collectively pushing for reform that extends beyond our own institutions. A key part of mental health advocacy is education, not just about the problem, but about actionable solutions. Through platforms with the help of AACOM and CUSGP, we have hosted advocacy seminars and student leadership workshops, equipping medical students with the tools to advocate for themselves and their peers. Many students want to make a difference, but don't know where exactly to start. These seminars provide tangible steps, how to engage administration, how to implement wellness initiatives, and how to advocate at the state and national level. Another impactful initiative we've implemented is QPR training, which stands for Question, Persuade, and Refer. This is an evidence-based suicide prevention program that teaches individuals how to recognize warning signs, offer support, and connect someone in crisis to professional help. We often think that intervention is the responsibility of mental health professionals, but the reality is that peer support can be life-saving. By making QPR training widely available to students, we are creating a culture where we look out for one another, where no one feels they have to struggle alone. Our institution has also previously implemented resiliency rounds, where students are able to come together in a supportive environment to share their challenges and discuss ways to build resilience, facilitating these sessions in a safe, non-judgmental space where students can vent and offer mutual support, building solidarity. All of these initiatives share a common goal, to normalize discussions around mental health, to equip students with the tools they need, and to build a foundation for lasting change. But we can't stop at just what students can do. Perhaps we consider systemic reform that ensures that the support is not optional, but an integrated part of medical education. And that's where policy comes in. So we've talked about the problem, we've seen the numbers, but what's being done to address it? Right now, there are organizations and research initiatives actively working to create change, using advocacy and data-driven solutions to tackle the physician mental health crisis. One of the leading voices in the movement is the Dr. Lorna Breen Heroes Foundation, named in honor of an ER physician who tragically lost her life to suicide after battling extreme burnout during the COVID-19 pandemic. This foundation has been instrumental in breaking down barriers to physician mental health care, advocating for policy changes, and fighting the stigma that keeps many from seeking help. As medical students, we are conducting an IRB-approved study on medical student mental health at our own institution. Our goal is to assess how students are utilizing mental health resources, identify barriers to access, and evaluate overall well-being using the PHQ-4, a validated screening tool for anxiety and depression. We are gathering real, quantifiable data on the struggles faced by medical students because burnout can start before residency. Why does this research matter? Because meaningful change starts with understanding the problem, by identifying where gaps exist, such as barriers to seeking help, the effectiveness of current resources, and the impact of early intervention. We hope to provide insights to guide improvements in mental health support for medical students, starting with our own home institution. With this study, we hope to advocate for a learning environment where students feel supported and equipped to manage the challenges of medical training and beyond. So now to further explore the importance of physician mental health and the ongoing efforts to create change, we are honored to share insights from Dr. Stephanie Simmons. Dr. Stephanie Simmons is a nationally recognized leader in physician well-being and serves as the Chief Medical Officer of the Dr. Lorna Breen Heroes Foundation. A board-certified emergency medicine physician, she has dedicated her career to advocating for systemic changes that protect the mental health of healthcare workers addressing both stigma and institutional barriers that prevent physicians from seeking help. Previously, Dr. Simmons served as the Vice President of Patient and Clinician Experience for Envision Physician Services for over seven years, supporting 26,000 physicians and advanced practice providers. In this role, she focused on professional well-being, leading translational research and developing programs to implement well-being best practices in clinical environments. She also served as the lead clinical faculty for the Clinician Experience Project Well-Being Program. Dr. Simmons was the primary advisor to the National Institute for Occupational Safety and Health for the Impact Well-Being Guide for Healthcare Leaders and currently leads multi-state programs aimed at improving the operational environment of care and removing barriers to mental health care. She is widely recognized as a national thought leader in healthcare worker well-being. Dr. Simmons, thank you for joining us today. Thank you, Chandrika. I'm happy to be here. Megan, thank you for having me. So to start off our interview, we wanted to ask, what drew you to the field of physician well-being? I have always been very interested in how we speak to each other in medicine, how we learn our patients' histories, how we lead in teams and work in teams together, how we teach, and also how we talk to ourselves, the conversations that happen sort of between the ears, right? I was doing research in patient-physician communication while in residency and started to shift that research to patient and team communication. So there was always this interest in the interpersonal and communication side of medicine. As I started my career and started to work within my organization to improve communication skills and work with my colleagues, it became very clear to me that the number one difficulty that people have in communicating with patients is really the time they have, right, and the energy and ability to sort of tap into the desire to really have that compassionate care experience. So I actually came into the work of clinician well-being through patient experience, working on how we could do a better job communicating and caring for our patients and realizing that one of the biggest barriers to doing that was our own clinician well-being. It's really interesting how you kind of had that transition from patient to physician with this being an overarching story. Was there a moment in your career that made this issue personal for you? Several. And I would say this really started in residency for me. One of my co-residents, his wife, on our first day of orientation, developed HELP syndrome and had emergency C-section. So on his first day of internship, he has a wife in the ICU and a 34-week preemie daughter. And I was currently, at that time, I was pregnant with my first child, and to help him out sort of incubated his newborn on my growing belly during our internship lectures just to try to help him out a little bit as he was visiting his wife or managing everything. And it really brought home how medical training and residency training and, in a lot of ways, the entire career of a physician can really tax you to a high degree. And then any additional stressor on top of that, right, can just tip you over the edge. And so it was an early learning of that. And I watched another colleague develop a seizure disorder after contracting encephalitis during her pediatrics rotation and having to manage an acute and chronic illness on top of her medical training, sort of deepened my understanding of the barriers that people can face. And then in my own training, near the end of residency, I had peripartum depression. And again, this was a wake-up call to me on how difficult mental health conditions can make the practice of medicine and the interplay between our performance, our mental health, and the culture of medicine, which makes it very difficult to ask for help or to be open about the fact that you need help. I think as third-year medical students and being on rotations now, we've finally been being exposed to these types of experiences and dealing with our own physical health or mental health and also seeing our doctors go through it as well and seeing how that can affect the patient's experience. So as the chief medical officer for the Dr. Lorna Breen Heroes Foundation, what do you see as the most urgent priorities in physician mental health today? Thanks for the question, Megan. There has been a shift in the understanding of professional wellbeing from being mostly a individual factor, so the need for the individual to attend to their mental health treatment, the ability of the individual to be resilient to stress and trauma, right, to a systems view of professional wellbeing. So what is the work environment? What is the learning environment? What are the technology requirements that can take us away from those communication components of the work? And how do we look at the system to reduce the burden of administrative tasks that are not value added, right? So to me, as we develop new tools in medicine that can streamline those administrative tasks, we need to make sure that we are not just making the hamster wheel spin faster for healthcare workers, right? And we don't just, as we increase efficiency, we don't just add in more work, but we allow that work to deepen in our relationships with our patients and with our teams. My next follow-up question would be what role do you think policy plays in addressing these challenges, and what do you think are the next steps? So policy at the organizational level, at the state level, and at the federal level is deeply tied to healthcare worker wellbeing. And that includes the policy that is required reporting, right, that can actually add to some of those administrative burdens. There needs to be a real thoughtfulness about how we ensure safe, effective patient care while not adding administrative burden to healthcare workers, right? We also need to think about policy that removes administrative burden associated with prior authorization, right, or payer requirements. We need to think about how policy can protect healthcare workers from violence, how policy can improve access of healthcare workers to mental healthcare by removing invasive or stigmatizing language from licensing questions, how institutional policy can remove that language from credentialing applications, and how state policy can improve the state environment for healthcare workers to provide care. So there's policy, whether it is formal legislative policy at the federal, the state level, whether that is rulemaking, right, at the state level or at the organizational level that impacts every day how you experience the practice of medicine and how you experience your career. It's interesting to hear from your perspective how nuanced it is. I think from an outsider's perspective, again, like Megan alluded to earlier as a medical student, you're exposed to some of these layers, you're only able to see the breadth of it once you're in that role and facing each of those different responsibilities and the kind of burden you then have to assume based on that. So transitioning from that into kind of more of what the problem or what part of the problem may be, why do you think that so many physicians hesitate to seek mental health support? So in a word, stigma, and stigma takes three forms. So there's internal stigma. What do I think it says about me if I need to ask for help, right? There's external stigma. What are other people going to think about me if I need help? And then there's institutional stigma. So what are those rules and those policies that stigmatize getting help? And I don't need to tell anyone listening here today that the medical school application process is rigorous. It selects for people who are achievement oriented, who are hard workers, who you may say are perfectionist tendencies, right? Do you wanna get a good grade, a good score? And having to say, I need help. There's something going on in my life that I can't handle by myself as well as I can handle with someone's help is deeply difficult for people who have been selected for and then trained up in that culture. So the internal stigma is very strong. In terms of external, so how do we combat that? Well, that's an inside job. So we all need to be thinking that through ourselves. If you don't start with your own thoughts and reactions on that, then it will be very difficult for you to support a colleague in a way that's helpful to them. So I encourage everyone to be thoughtful about their own relationship to help seeking. In terms of external stigma, we need to share our stories. We need to thoughtfully reach out to colleagues. And we also need to be very careful about the words we use when we are referring to mental health conditions, when we are referring to substance use disorder, not only among our colleagues, but in our patients as well. Because our colleagues will hear us using those words and say, I never want somebody to talk about me like that, right? And so we need to be thoughtful in the language we use. And in terms of institutional stigma, we can address the licensing questions at the state level. In fact, there are 34 state medical licensing boards that have changed their questions to eliminate any stigmatizing or invasive language. Over 10% of the hospitals in the country have already been verified of having removed those questions from their credentialing application. And that's something where everyone here who's listening today can act. Because we have had medical students who have gone to their institution and gotten those credentialing applications changed through their advocacy. And so by addressing stigma in sort of all three of those areas, we can increase physicians' willingness and ability to seek care. Yeah, I think you hit it on the nail. Stigma is like the biggest barrier to all of this, especially in medical school. It starts early. We all think we're so resilient and invincible and I can't have anxiety and I can't have this and I don't want people knowing. And it's important that we all talk about it now. And so I wanted to ask you about physician suicide and how devastating of an issue it is. Can you speak to the importance of suicide prevention resources, including hotlines designed specifically for healthcare professionals? Absolutely, Megan. And I appreciate the question. As many of you know, the Dr. Lorna Breen Heroes Foundation was started after the death by suicide of an emergency physician and emergency department medical director, Dr. Lorna Breen. Unfortunately, we know that physicians lose their life by suicide at a higher rate for female physicians than their peers. And also that there is a high rate of suicide for male physicians as well as a higher rate of suicide in both male and female nurses than the background population. So this, despite the fact that they should have more knowledge and access to care, right? We also know that physicians are more likely than any other group to have had a work-related or legal stressor prior to death by suicide. And so there's opportunities to educate and to have outreach in professional settings to help prevent suicide. The stressors for healthcare workers are unique in both type and degree. And the stigma around receiving care is very strong in healthcare. And so there are healthcare resources, including the physician helpline and emotional PPE and care sites that provide mental health resources specifically for physicians and are anonymous and free. And so there are really great resources out there. I would also say, it is my privilege to know several survivors of suicide. So healthcare workers who did not die from suicide. And I've had the opportunity to speak with them after they've had a chance to recover. And there is this phenomenon of immediate change of heart. So for anyone who feels like it is hopeless, that it is easier or better for others for them to die than for them to stay. I please, I always encourage people, let someone know. It just takes one person that you need to share that with and to get some help. And I would much rather have you as a colleague than as an unfortunate loss of a colleague. I'm glad that you brought that up. I feel like that's a small but very meaningful, impactful step that can be made and perhaps be the difference in a person's life. So thank you for bringing that up. So speaking more on a bigger scale, what do you think are some of the largest systemic barriers preventing change in physician wellbeing? Physician wellbeing is tied to workload and is tied to the systems of care delivery. And that is not a simple system to change. It is not simple to change in terms of its payment structure, in terms of the multiple large types of organizations, including payers, including governmental agencies, including hospitals and health systems that are involved in that system. And there are a lot of moving parts. Having said that, it is not a system that cannot change. And we have seen change and we are seeing more change. So this week I'm in Washington, DC for the Health, Culture and Transformation Summit hosted jointly between Johns Hopkins University and the Dr. Lorna Breen Heroes Foundation, the National Academies of Medicine, Healthcare Workforce Wellbeing Day, and the launch of the All In for Mental Health Movement. And so there are changes underway. The analogy is often of a big ship, like one of those ocean ships that you see with all of the crates, right? Storage crates and shipping crates on them. You have to turn those ships a little bit at the time. If you crank the steering wheel all the way to the side on one of those ships, it goes, whoop, like it makes a little change. And right away you might not see a lot of that change, but a few miles down the road, you'll see a deviation in the path. And so large systems change slowly unless there's a disruptive technology. And we are starting to see some evidence of a disruptive technology with the way AI is being implemented in healthcare settings. And it is still a large complex system. So change will be slow for the most part. I'm glad to hear though that you're saying that there is slowly but surely change happening. And I think as medical students who are looking to go into the field and pre-medical students even looking to go into this field, it's really exciting to see that things are moving in a positive way. So based on your experience, what strategies would you say have been effective in breaking down some of these barriers to physician wellbeing? So advocacy, advocacy, advocacy. And I talked about federal, state and local advocacy. Advocacy does not need to mean big A advocacy by introducing a bill at the federal level. Although there is a federal bill currently up for reauthorization at the federal level called the Dr. Lorna Breen Healthcare Provider Protection Act. So I encourage you to go to our website and to advocate for reauthorization. So you'll see the link for that. At the state level, understand what the state issues are, where you are a student, where you will be practicing. Get involved in the state professional organizations and understand what they're advocating for. Last week, a Colorado medical student advocated for a state bill to remove invasive and stigmatizing language in the state licensing application. And her testimony was some of the most compelling testimony that we've heard at a state level. So you can get involved, you can make a difference. At the organizational level, advocate for changes in the hospitals and health systems that you work, in the medical schools where you study and learn what those changes are and advocate for them. Last year, after this healthcare transformations event, there was a medical student from upstate New York who went back to his organization and got their credentialing applications changed along with his faculty mentors. So there are advocacy opportunities available at the institutional, state and federal level for medical students. Yeah, I think it's so important for us and everybody listening today to know that there is opportunity for change and whether that be small or big change. And I wanted to ask you a little bit more about current solutions. And I know that you helped develop the impact well-being guide. And if you could talk a little bit more about what that is and what are the key takeaways for healthcare leaders? Thanks for that question, Megan. The impact well-being guide was part of a awareness campaign that was jointly created by NIOSH, the National Institute of Occupational Safety and Health as part of the CDC and the Dr. Lerner Brain Heroes Foundation. And this guide is aimed at healthcare leaders, we know that this is a complex moving system, you want to improve the professional well-being of your healthcare workforce, that can feel like an elephant is sitting in front of you and you're being told to eat it. It's like a huge overwhelming task. So the impact well-being guide says, okay, if you're gonna eat this elephant, here are the first six bites, right? And here's who you need to join you in this quest. So to give you an example, the six steps are to understand what's already happening at your organization. This is the last thing you wanna do is to stop something good that's happening, right? Then you need to form a multidisciplinary representative committee within your organization so that the people who are being impacted by this work have a voice in the work being done. And that includes learners. Next, you need to change your credentialing applications. It is an early win and it sends a message that you're thinking about this from a systems approach and you've made substantial change. Next, you need to identify a quality improvement project happening within your organization that could be looked at through a slightly different lens to incorporate an outcome that is professional well-being based, right? So transforming this from a triple aim quality improvement project, meaning patient experience, efficiency of care and outcomes to a quadruple aim, which is those three plus the impact on the healthcare workforce. Next, you need to communicate and have a communication strategy, not only about what you've done so far and the changes you've made, but as a bi-directional communication to listen to the workforce and find out what else needs to be worked on and then develop a 12 month plan in the areas of peer support, in quality improvement projects that are quadruple aim and in measurement. And so that's the impact well-being guide and it's a sort of an incubator, a Kickstarter for organizations to accelerate the pace of change in professional well-being. Thank you for sharing your insights on that. You've worked on multi-state programs to improve the clinical environment. Can you share an example of a program or a program that's upcoming that has made or may make a real difference? I'm happy to Chandrika, and thank you for the question. I'm going to highlight two programs. One is our All In Caring for Caregivers program, and the second is All In for Mental Health. So All In Caring for Caregivers is a state-based program. We're currently operating in Virginia, North Carolina, and New Jersey, and we will be starting in Wisconsin this year as well. So we work with the state organizations, the Medical Society, Nursing Association, and Hospital Association, partner with them, and change the state licensing applications to remove stigmatizing language, challenge the hospitals to remove their stigmatizing language from their credentialing applications, educate hospital leaders in the clinical and operational C-suite about the drivers of burnout and how to address them, and then put the hospitals in the state into a learning collaborative together to work on an operational environment project. So in Virginia, they are working on EHR optimization, for instance. How do we implement tools that reduce the burden of the electronic health record? So that All In Caring for Caregivers program is accelerating the pace of change across states in both access to mental health care by changing licensing and credentialing applications, but also in the environment of care. Just this week, we have launched All In for Mental Health, which can be found at allinformentalhealth.org, and that is a program that is designed to raise awareness on the calls to action in order to improve access to mental health for health care workers. That is that health care workers need accessible and affordable mental health care, confidential professional health program support, equal privacy in mental health care, confidential peer support, education and training on mental health, and a supportive pathway for reentry after impairment. And so we are working with professional organizations to advocate for those changes and also to educate stakeholders on why these changes are important and how they can act to bring them about. Those are really exciting initiatives. I'm very excited to kind of see those roll out and even, you know, use these resources and advocate for them and share them with our home institutions as well. I think it was also a great thing that you brought up about the pathway for reentrance. You know, we talk a lot about the approach to mental health, and the other part that is just as important to think about is for individuals who are in such circumstances, how do we help bring them back to wherever their baseline or new baseline may be? So I appreciate you bringing that up. It's absolutely critical. Not everyone who has a mental health condition is impaired, but some people are. And, you know, that doesn't mean that you are perpetually impaired. And if you need to take a break from education or from practice, to take care of yourself to heal, there should be a path back. Because we've invested so many years and dollars into becoming physicians that we deserve the opportunity to practice the profession that we've trained for. And frankly, our patients deserve to have us there as well. Yeah, I think this conversation gives me a lot of hope and hopefully everybody listening as well. And I wanted to just ask you, what gives you hope for the future physician wellbeing? I, you know, people often ask me what I like best about my job, and I say the people I get to work alongside. So I'm going to give you two answers, two for the price of one here. The first thing that gives me hope is the number of people, really intelligent, really dedicated, passionate people who are making this their life's work to work on and improve this issue. And the second thing that gives me hope is the focus that people like you in training in medical school and nursing school and pharmacy are thinking about the issue of health worker wellbeing already during their training and addressing those sources of stigma, one, getting their individual thinking about themselves, you know, in line with what's going to be supportive and healthy for them, but also bringing this to their colleagues, thinking about mental health globally, and then also working to advocate at the federal state and institutional level to make change. So I guess if I had to change that long answer to a short answer, what gives me hope? You. Thank you. We appreciate you saying that. And it's really encouraging to hear from leaders in this field like yourself who, who show us that there is a path forward and people like ourselves can make change even in small ways. And so moving forward and looking ahead, how do you think that both medical students and physicians can support the mission of the Dr. Lorna Brain Heroes Foundation? Well, thank you. So we do have a medical student coalition, and I encourage any medical students who may be interested in joining the mission of the foundation to either start a chapter or join a chapter, depending on whether you're at a medical student medical school that has a chapter already or not. Our medical student coalition members work together on projects that they believe will benefit medical student mental health and also work with the foundation. You can download our licensing and credentialing toolkit and bring it to your institution, the hospital or the health system where you are training and ask them to change their credentialing application and join one of the over 600 hospitals that have already received the Dr. Lorna Brain and all in licensing and credentialing champions challenge badge. You can advocate for the reauthorization of the Dr. Lorna Brain Healthcare Provider Protection Act in advocacy, and we have a direct advocacy tool on our website as well. And if you are so minded, you can host a fundraiser to help support the Dr. Lorna Brain Foundation. We are philanthropically supported, and we will continue to work on behalf of all healthcare workers. So we appreciate all and any support that medical students and physicians can provide. So thank you so much for that question. Yeah, I just wanted to thank you so much for speaking with us today. And hopefully we can start change even before medical school. I know that there's pre-med students who might be on this conference as well, listening in, and they can start chapters at colleges as well. I think that wraps up our questions. I just wanted to ask if you had any concluding thoughts that you wanted to share that maybe we haven't touched on already. Thank you for that opportunity. You know, you asked a question earlier about change and what are some of the barriers to change. When I think back to when I was a medical student, okay, this was not a conversation that was happening. Where there were licensing and credentialing applications that were not stigmatizing, nobody knew about them, and they just assumed they were bad anyway, right? So we didn't know the rules. We assumed they were bad. The conversations about mental health, substance use disorder, professional well-being were all quiet. They were all hidden. And that has changed. We increasingly know what the rules are. We are increasingly having public conversations about the need for professional well-being for health care workers, for health care learners. We are sharing our stories, and we are recognizing that this is a human profession, and we are human beings. And we are human beings, caring for human beings, and we're allowed to be and do that. And as everyone listening to this knows, it's not that we don't work hard. It's not that we don't study hard, right? It's that we also can be human beings while we do that. And so the one thing I'd just love to share is things have changed immensely already in the course of my career, and I know you will see that change as well. So I encourage you to be part of it. Thank you so much for sharing your insights today. We really appreciate having you. It's my pleasure. Thank you. Knowing what we know, what can we do? Many medical schools acknowledge the importance of student well-being, but the reality is that wellness programs are often underfunded or lack the resources needed to sustain them in the long run. So what can we do? One solution to this challenge is the implementation of student wellness budgets, funding that is specifically allocated for mental health initiatives and student well-being programs. A dedicated wellness budget ensures that these initiatives are not just one-time events, but ongoing and adaptable resources that meet the evolving need of students. One solution to this challenge is the implementation of student wellness budgets, and adaptable resources that meet the evolving need of students. This approach allows students to take an active role in shaping the resources available to them. When students are empowered to guide wellness initiatives, we see programs that truly resonate with their needs, creating a sense of ownership and engagement. Schools that have prioritized wellness funding have seen significant benefits. For instance, a 2018 survey by the American Medical Association found that institutions that allocated dedicated resources to wellness programs reported reductions in depression and anxiety rates among students. During the preclinical years, medical students typically have more flexibility to engage in self-care. However, during clinical rotations, the schedule changes significantly. The unpredictable schedules and patient responsibilities often make it difficult for students to care for their own mental health. The general expectation becomes to keep moving forward. One way to address this challenge is by introducing wellness and mental health days during the clinical years. These days wouldn't be just for rest. They would be for structured, protected time for students to focus on their well-being. For example, students could use these days to attend therapy or counseling sessions without worrying about falling behind in their clinical duties. They could participate in wellness workshops that offer practical tools for managing stress and reflect on their clinical experiences and address the emotional aspects of their training. A study published in Academic Medicine found that medical trainees with access to structured wellness programs had lower rates of burnout and higher job satisfaction. By ensuring that students have time to focus on their own mental health, we help them maintain their well-being, which in turn supports their ability to provide quality patient care. While telehealth services have expanded access to mental health care, in-person support remains critical, especially for medical students facing abundant stress. Many students report that wait times for therapy appointments are too long. A 2019 study published in JAMA Network Open found that over half of medical students reported wait times of two weeks or more for counseling appointments. Increased funding for on-campus, in-person mental health services would ensure that students have access to therapists trained in working with medical students, immediate crisis intervention services, and confidential counseling that doesn't require students to go off-site or deal with long wait times. These solutions offer a way to prioritize mental health services in the same way that we prioritize academic success. By ensuring that students have access to timely, specialized care, we can help create a more balanced and supportive environment for future physicians. Another potential solution is providing every medical student with a standardized toolkit for preventing burnout. It's worth noting that there are already existing resources, like the mental health toolkit developed by members of CUSGP, as well as resources from the Dr. Lorna Brain Heroes Foundation. A way forward would be to build on these resources, collaborating with a team of physicians, psychologists, and educators to create a comprehensive toolkit. While medical training focuses primarily on clinical skills, mental health support is often left to the students themselves. A standardized toolkit could include practical strategies for managing stress and emotional fatigue, guidelines for recognizing the early signs of burnout, tips for maintaining work-life balance even during demanding training periods, and a list of mental health resources, including crisis hotlines, therapy options, and peer support groups. Integrating this toolkit into the medical curriculum would ensure that students are introduced to mental health tools early in their training. Additionally, providing an online version would allow for students to access the resources whenever they need them, offering flexibility and support. By providing students with a toolkit to manage their mental health, we can help prevent burnout before it becomes a larger issue, ensuring that students are better equipped to handle stress throughout their career. The earlier we tackle these challenges, the more beneficial it will be for the individual and institution. So what could a policy-level solution look like? To truly support medical students' mental health, we must advocate for structural solutions that integrate peer support into medical education, ensure sustainable funding, and remove barriers that discourage students from seeking help. Our first proposed idea is a peer support network. Pairing students with mentors who have navigated similar challenges can be incredibly impactful. Peer mentors can provide guidance on managing workloads, handling clinical stress, and maintaining balance between academics and personal life. This one-on-one relationship fosters a sense of community and reduces feelings of isolation. At our own institution, we've seen success with peer mentorship programs through SGA, available to OMS2 through OMS4, as well as a more detailed and individualized Big Little Program for OMS1s. Our proposed solution is to expand this model on a larger scale, creating a program where students can connect with mentors outside their own institution. Having access to a mentor completely removed from their academic environment would provide a safe, anonymous space to discuss not just academic challenges, but also mental health concerns. As it stands, no program like this currently exists. Another critical component of these networks would be equipping peer mentors with basic training in crisis intervention. By incorporating programs like Mental Health First Aid and QPR, mentors could be prepared to provide initial support and direct students to professional resources when needed. This added layer of training ensures that peers are not only there to listen, but are also equipped to respond effectively in sensitive situations. By implementing structured, well-supported peer networks, we can reshape the way medical students experience support, creating a system where seeking help is not just accepted, but encouraged. For these networks to be effective, they must be supported at the institutional level with dedicated resources, funding, and a genuine commitment to integrating mental health into medical education. Advocacy and policy changes, such as securing federal funding for wellness programs, could play a crucial role in making this a reality. By prioritizing institutional and federal investment, peer support networks would no longer be an afterthought, but an essential component of every medical school's infrastructure. This long-term commitment would ensure these programs have the resources needed to not only exist, but thrive, creating lasting change in the way medical students receive support. Second, it's crucial that we address the stigma surrounding mental health by removing mental health disclosure questions from licensing applications. Currently, some licensing boards ask applicants about their mental health history, which can create a significant barrier to seeking help as early on as medical students. Removing these questions would reduce stigma and encourage medical professionals to seek the support they need without fear of professional repercussions. This small change could have a profound impact on fostering a culture where mental well-being is seen as just as important as physical health. We've talked about the challenges medical students face and the role peer support can play in improving mental health. Now, it's about taking the next step. Expand the conversation. Help make mental health a regular part of discussions in medical education. Advocate for structured peer support programs and work towards reducing stigma. Second, be a resource. Support your peers by checking in, sharing resources, and considering mentorship or crisis intervention training. Small actions can make a real difference. And our final thoughts, the well-being of medical students is central to the future of medicine. By creating a culture where seeking support is the norm, we can make meaningful progress starting today. We'd like to thank various individuals and people who have helped us throughout this process, including our guest speaker, Dr. Stephanie Simmons, members and our PIs of our ongoing research study on medical student mental health, our fellow COSGP and SGA student representatives from Burrell, our Burrell Wellness Task Force co-founders, as well as our administration, staff, and students. Thank you all so much for listening today. Here are our references. And if you'd like to contact us, feel free to email us and we hope you have a great day. Have a great rest of your day. Thank you.

medical student burnout

mental health

physician shortage

student well-being

systemic changes

wellness budgets

peer support networks

advocacy

healthcare reform