How students at the Mayo Clinic are learning from senior trainees and faculty members about challenges they faced and overcame during medical school.
At Mayo Clinic, a culture of excellence and commitment to providing the best in patient care has always been the top priority. For medical students matriculating through the challenging and rigorous curriculum of medicine, it can be daunting to sustain resiliency and navigate tough times. Alexandra Wolanskyj-Spinner, MD, Senior Associate Dean for Student Affairs, knows how important well-being is for medical students, both for their future success as well as the health of their future patients. She recognized the obstacles students encountered when trying to seek help, ranging from finding the time to access health services to the potential stigma of being seen as someone struggling or having problems. While it was commonplace for the medical profession to encourage help-seeking behavior in patients, it was often not considered acceptable for physicians and physicians-in-training to seek help.
Developing the Intervention
To change the dialogue and culture for medical students, Dr Wolanskyj-Spinner felt that, “The best way to normalize the behavior is to model it: see it in your peers, residents, faculty, leadership, and people you respect.” This mindset led the Mayo Clinic Alix School of Medicine (MCASOM) to develop robust programming at all 3 campuses focused on normalizing help-seeking behavior, fostering open and honest dialogue about the unique challenges of medicine, and supporting peers to create a culture of well-being. A key initiative of the MCASOM THRIVE program is the MyStory Series.
The MyStory Series initially started because a student shared struggles she faced throughout her clerkship in internal medicine with Dr Wolanskyj-Spinner. During medical school, this student received a late diagnosis of a learning disability, which impacted her significantly. At the end of her clerkship she felt compelled to share her own experiences and what she learned with others. From this idea came the MyStory Series, which aims to help other colleagues and peers share their own personal journeys from feeling challenged and overwhelmed to thriving.
The MyStory Series offers students at any stage in their training located on 2 of the 3 campuses (Minnesota and Arizona) a firsthand opportunity to listen to the personal experiences of a trainee or physician who has encountered and overcome challenges during his or her career. Each series features a single upper classman, trainee, or physician speaker who has struggled or experienced a self-perceived failure, allowing them to share how they handled the situation. This series helps to demonstrate and encourage a culture of normalization in help-seeking behavior.
It was important to MCASOM that no one who manages or has leadership over the students attend the speaker sessions, and therefore only students are invited to the presentations. Topics are selected in advance by the student leads of the Student Life and Wellness Committee, and speakers choose to attend if they are interested in presenting. The students then work with an educational coordinator to organize the MyStory Session. Only the topic, type of session (eg, a group session or single presenter), and the speaker's career stage (eg, medical student, resident, faculty) are announced in advance, giving the speaker a degree of anonymity to present their story in a safe space. Similarly, the goal is for students to feel they can freely express themselves without impact or judgment. As Dr Wolanskyj- Spinner states, “It's important that students feel they can be transparent and share their struggles openly.” The sessions are not recorded to protect privacy. The series takes place approximately 10 times per year, usually over lunch with refreshments.
Student buy-in was essential to the success of the program. Word of mouth spread quickly among students after the first session, which boosted attendance at future sessions. Positive feedback continued and attendance solidified throughout the years and across topics and speakers.
The program has now been in place for 4 years and has featured approximately 50 presentations since launch. Attendance at a MyStory session ranges from 25 to 50 students. Thus far, the topics have included:
| Struggles in medical careers Remediation Imposter syndrome Switching residency programs Personal medical diagnoses during medical school and during medical careers Family and marriage Work–life integration and balance
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There is still room for growth in topics and the types of presenters. Currently, it seems that more third- year and fourth-year medical students than residents and faculty are sharing their stories, so effort is being put towards introducing more variety in speaker experience. Other ideas for topics include:
Faith in medicine
Burnout
Academic and social challenges related to USMLE Step examinations
Being a minority in medicine
Difficult patient encounters at all stages of training and work
In addition, the MyStory Series is exploring new session formats. During a session on relationships, the group heard audio recordings of couples being interviewed and talking about their long-distance relationship; this exercise was paired with a panel of couples to answer questions. Also, Imposter syndrome sessions in recent years have included a personal reflective component in which anonymous submissions of Imposter syndrome experiences were read out loud by students during the session, in addition to a student speaker presentation.
In the future there is potential for MyStory to not only include sharing difficult experiences and struggles, but rather be a platform to share all life stories, including those that simply help students get to know their community members better. For example, attendees may share their stories regarding why they chose medicine and what they find fulfilling in their training or work.
In a student's own words: “I have really enjoyed both attending and helping to organize the MyStory sessions. It is something that I heard about while interviewing at Mayo and something that honestly played a role in ranking Mayo as my first choice because I thought it really spoke to Mayo's focus on creating a supportive community. I thought MyStory was a very unique way of endorsing wellness through authenticity and vulnerability and I knew then that I wanted to be a part of it. Through the speaker recruiting process I have connected with students outside of my class in meaningful ways that would not have occurred otherwise. I also hope to connect/network with representatives from different resident and physician wellness groups at Mayo. The stories my classmates and others have shared during these sessions have served as a source of patience with myself and others, inspiration, a sense of belonging and support, empathy, and gratitude.”
Ariela Marshall, MD, Director of Student Wellness for the Minnesota campus at MCASOM, notes that, “MyStory has been incredibly successful in normalizing the concept of struggle. We hope that MyStory continues to provide our students with a supportive, encouraging, and safe space to share and learn about resources that have been helpful to others facing challenging times in their lives.”
The Mayo Clinic College of Medicine and Science is composed of 1 college and 5 schools. There are 4000 active students and trainees in 400+ programs. Mayo Clinic locations around the globe see more than 1.3 million patients each year.