Book on Medical Student Wellbeing released

Dr Andrew Molodynski, our secretary general, has worked with Dr Sarah Farrell and Professor Dinesh Bhugra on medical student wellbeing over recent years and they have recently released the book below to support students and institutions in raising standards.

The final part of the book contains a charter for medical schools/ colleges of things they can do to help maximise the wellbeing of their students.
Please do contact Andrew on andrew.molodynski@oxfordhealth.nhs.uk if you have any questions or would like further information.

Oxford, UK May 2025

Medical Student Wellbeing Charter

Introduction

It is widely recognized that medical students are a vulnerable group of people with high levels of stress, burnout, mental health problems, and substance misuse (Drybe 2016). Medical students in general are at a vulnerable stage in life and also have higher than base population levels of burnout and symptoms of mental ill-health

There is thus a major responsibility on health professionals to ensure the wellbeing of the next generation of doctors  both for their own sake but also because they will come to make up a crucial part of both the healthcare workforce and of their society.

There has traditionally been a focus on resilience and individual factors alongside treating those whose difficulties become manifest, but it is important to recognize that most stressors are system based. They are therefore amenable to intervention at institutional level and institutions have a clear responsibility to look after their students. The evidence base for interventions is still evolving and any guidance will necessarily evolve also. However, we endeavour here to provide a charter of basic steps that all institutions should take to safeguard their students and to reassure funders and students alike (indeed the two overlap enormously!) that they provide a safe and supportive environment for learning. Although there is clearly variation of approach internationally, levels of distress are high, and the charter is broad enough to be applicable regardless of geography.

This charter stands unashamedly on the shoulders of giants (British Medical Association 2022; Kemp et al 2019; General Medical Council 2015)

1. All medical schools should explicitly include student wellbeing in their core documentation
2. Induction programmes should include sessions around stress, wellbeing, and in person introductions to those who provide support services (not just information giving).
3. The early part of medical training should have a strong focus on self-care and the physical and psychological effects of stress.
4. Peer mentoring arrangements should be routine and attract protected time.
5. Curricula should be designed to minimise ‘pinch points’ of high stress while maintaining rigour. A pass/ fail approach will be appropriate in most (if not all) exams.
6. Curricula should allow students protected time to take part in wellbeing activities individually and in groups
7. Placements that rotate geographically need to be managed to reduce disruption and allow for access to supports for students. Ideally, they should also allow for flexibility taking into account student preference and need.
8. Clear arrangements and support for subsequent job finding must be made available to final year students, preferably as part of a coordinated matching scheme by the institution.
9. All medical schools should have a wellbeing department for students that is adequately resourced, well signposted, and supported at the very highest level by a wellbeing responsible officer ensuring confidentiality and privacy.
10. Funding for student support and wellbeing must be clearly identified and spent transparently. There should be student representation on committees that make decisions regarding amount of funding and how it is spent.
11. The responsible officer for wellbeing is a legally accountable board member of the medical school council or appropriate body for the purposes of reporting, quality control and health and safety investigations.

References

Dyrbye, L. and Shanafelt, T., 2016. A narrative review on burnout experienced by medical students and residents. Medical education, 50(1), pp.132-149.

General medical Council 2015. Supporting medical students with mental health conditions.        Supporting medical students with mental health conditions (gmc-uk.org)

Kemp, S., Hu, W., Bishop, J., Forrest, K., Hudson, J.N., Wilson, I., Teodorczuk, A., Rogers, G.D., Roberts, C. and Wearn, A., 2019. Medical student wellbeing–a consensus statement from Australia and New Zealand. BMC Medical Education, 19(1), pp.1-8.

Medical student wellbeing checklist, British Medical Association 2022. med-students-wellbeing-checklist.pdf (bma.org.uk)