Medical Student Well-Being
The Burnett School of Medicine has developed a longitudinal, integrated and collaborative system of instruction, learning and support for the School of Medicine students focusing on their wellbeing.
Over the past several years, the School of Medicine has worked closely with TCU mental health counseling and psychiatric services. This has presented many opportunities where our students are supported within their curriculum as well as alongside the curriculum, or in a co-curricular manner.
The School of Medicine utilizes the TCU mental health counseling and psychiatric services provided through the Counseling and Mental Health Center (CMHC). The center is located on the TCU campus and is open from 8:00 a.m. to 8:00 p.m., Monday-Wednesday; and 8:00 a.m.-5:00 p.m., Thursday and Friday. Licensed psychologists, licensed professional counselors, licensed social workers, and graduate level trainees under the supervision of a licensed staff therapist provide counseling services. A board-certified consulting psychiatrist provides psychiatric services. Providers of counseling and mental health services will not have any role in assessment or decisions in promotion of medical students in the medical educational program. The cost of CMHC psychiatric services is covered by student tuition fees at no additional cost to all TCU enrolled students. Students have flexible clinical experience time during the week in Phases 1, 2, and 3 that could be utilized for counseling appointments. Additionally, accessing counseling services meets the criteria for an excused absence per the School of Medicine’s Attendance Policy. The School of Medicine has partnered with the CMHC to provide counseling services to medical students on the School of Medicine campus. These hours are hosted onsite at International Plaza on Wednesdays and Thursdays from 1:00 p.m. to 8:00 p.m. Students also may choose to meet with counseling staff on the main campus.
Crisis Care Counseling is available Monday through Friday, 9:00 a.m. to 4:00 p.m. During this time, students can come to the CMHC and be seen by a drop-in/crisis response counselor. Students, faculty and staff also can call the TCU Counseling and Mental Health Center 24/7 phone counseling helpline at 817-257-7233 to speak with a phone counselor anytime, day or night, including during semester breaks.
If a student is experiencing an urgent mental health crisis outside of the CMHC’s crisis counseling hours, they can call the 24/7 phone counseling helpline to speak with a counselor.
Students are notified of availability of these campus/institutional support services during Introduction to Medicine, as well as through reminders via student affairs communications. As part of THRIVE, the School of Medicine’s medical student wellbeing initiative, students are educated about mental health services during the two-week Introduction to Medicine course. Additional references are provided throughout the academic year to all students via class meetings where information about all physical and mental health resources and access to them is shared by the office for student affairs and the School of Medicine Student Senators. Additionally, handouts are posted throughout the medical school offices with information on the TCU Counseling Center and associated resources, TCU Campus Health Center; Office of Religious and Spiritual Life; Campus Advocacy, Resources & Education (CARE) office; campus police, and School of Medicine student affairs and Professionalism Resource Officer services and personnel.
In addition to the resources captured above, counseling staff members have been physically present, with an on-call status, during curricular elements that might trigger survivor or bystander incidents or events, such as suicide prevention, relationship violence, and child abuse.
Student feedback requested the School of Medicine to find a remote location in International Plaza, where students, faculty and staff do not traverse as frequently. These expectations have been achieved in the building within which the School of Medicine will be housed until summer 2024. Addressing student feedback after our first year, CMHC counselors were relocated to a more private room. Current plans are underway to review all the feedback from students to ensure that the permanent building has both a secure space as well as a sufficiently private location.
The providers available at the CMHC have no affiliation with the medical school. All access and records related to these services are protected and confidential. Specifically, the electronic records utilized by both the TCU Brown Lupton Student Health Center and the CMHC are separate and not accessible to the School of Medicine staff and faculty.
The mission of the wellbeing team is to support the development of healthy and resilient medical students and future residents and physicians. Since the school’s inception, the office for student affairs has been developing and iterating the THRIVE Wellbeing Initiative. The Wellbeing Initiative intends to be a longitudinal, integrated, and collaborative system of instruction, application, learning, and support for medical students focusing on their well-being and personal and professional development. This Wellbeing Initiative, in its second iteration, is being built to be leveraged within the School of Medicine curriculum and co-curriculum and provide knowledge, tools, and practice opportunities that are needed to thrive throughout a productive career despite the challenges inherent to the practice of medicine.
The objectives of the Wellbeing curriculum are:
1. To identify and implement individualized practices and tools that lead to greater self-awareness and awareness of others, self-care, resilience, and foster lifelong personal growth and development of students, starting in the medical education journey and evolving throughout their career.
2. To promote a sense of belonging and personal and community wellbeing for all students within the School of Medicine community.
3. To support the expression of the varied and diverse student identities and interests within the School of Medicine community.
4. To empower students to discover purpose, passion, and meaning within their medical school experience.
The Wellbeing Initiative is streamlined into three areas of focus for medical student wellbeing:
• individual – health and wellness as it pertains to self,
• relational – health and wellness as it pertains to community, and
• environmental – health and wellness as it pertains to interaction with systems and processes inherent to training and practice.
Content, programs, and activities focusing on these three areas have been identified and developed within the curriculum and co-curriculum in a collaborative fashion within the Burnett School of Medicine. This content has been mapped to the four objectives of the Wellbeing initiative with expected outcomes and measures. Some of the specific content for the Wellbeing Initiative is listed below.
The office for student affairs has provided co-curricular wellness programming for all medical students, with particular emphasis on the physical and emotional demands of medical school and the prevention of burnout. Participation is strongly encouraged but not mandatory. The focus of all wellness programming is to develop awareness of self, others, and environment; understanding of the importance and practical application of self-care and personal health and wellbeing; developing skills to manage life, family, and school/professional balance; and understanding and preventing burnout. To date, programs have been organized according to holistic health and whole-person wellbeing using the wellness wheel as a practical guide. The graph below articulates the categories of wellbeing that the School of Medicine initiates and facilitates student programming.
To assess and evaluate the students and better identify their most relevant needs and wants, the Wellbeing Initiative has implemented use of the Mayo Well-Being Index (WBI). The WBI is an anonymous web-based tool, available for all students, used to evaluate multiple dimensions of medical student distress. The WBI is a validated measure that scores and reports individual distress; provides mental health and well-being resources within the School of Medicine, TCU campus, and local community; and allows users to compare their scores to national averages, as well as track progress over time to promote self-awareness. Additionally, the WBI allows for open-ended process improvement questions (PQI) which center around medical student well-being. Historically, students have been assessed, on average, two times per year. After each WBI administration, the data collected is analyzed and used to focus co-curricular (and, going forward, curricular) wellbeing programming accordingly.
Growth and Development of the Well-Being Initiative
Current initiatives include:
• Class Leader Focus Groups with Senate leaders and each class’s Senate, learning more about the experience, needs and wants of students
• Wellbeing Focus Groups with students from any class interested in promotion of well-being, learning more about the experience, needs and wants of students, especially from those that may not be represented through class leader conversations or to identify factors not recognized in the WBI
• WBI and Student Wellbeing Assessment: Working with the coordinator and assistant dean for student affairs, along with a WBI specialist, developing a more systematized approach to utilizing the WBI assessments and tools. Additionally, working with the Office of Assessment and Quality Improvement, investigate and implement measures more specifically targeting Burnett School of Medicine students and classes and their experiences, needs, and wants
• Wellbeing Committee: Identify and engage students, faculty, and staff interested in promotion of medical student and school wellbeing and the formation and ongoing participation in an active group staying current with student needs and wants and to help guide the development and implementation of a four-year integrated wellbeing curriculum
• Class Well Checks: Meetings with each class to gauge and assess how things are, get a better understanding of what is going on with individual students and in their school and clinical experiences, learn how the wellbeing team and our school can help and support, and plan and take action to positively impact medical student and school wellbeing
• Mindful Moments: Brief activities - for example, before exams – to support understanding and learning to work with test and professional practice anxiety
• Curriculum Development and Integration: In collaboration with the associate dean for curriculum and faculty, create and implement, in a stepwise fashion, a wellbeing curriculum that will be integrated in the school curriculum and reinforced in clinical experiences. This curriculum will cover topics such as physical health, mental health, and relational/social health; individualized self-care: self-awareness, self-compassion, and self-development; professionalism and professional identity development, and health and resiliency transitioning into and in residency.