Vanderbilt Wellness Program
MODEL AND IMPLEMENTATION GUIDE
Developed for:
Institution X
Developed by:
Matthew Zackoff, B.S., VMSIV
Beth Ann Sastre, MD, Assistant Professor
Scott Rodgers, MD, Dean of Students
Vanderbilt University School of Medicine
Corresponding Author:
Beth Ann Sastre, MD
elizabeth.a.sastre@vanderbilt.edu
(615) 936 - 3216
TABLE OF CONTENTS:
SECTION I: THE NEED FOR WELLNESS ............................................................................................................4
PURPOSE OF THIS GUIDE ................................................................... ERROR! BOOKMARK NOT DEFINED.
BIBLIOGRAPHY: UNMET WELLNESS NEEDS IN UNDERGRADUATE MEDICAL EDUCATION .................6
HISTORY OF THE VANDERBILT WELLNESS PROGRAM ..................................................................................7
DEMONSTRATED SUCCESS ....................................................................................................................................9
SECTION II: THE VANDERBILT WELLNESS PROGRAM ............................................................................ 12
OUR MODEL ............................................................................................................................................................. 13
THE COLLEGES ................................................................................................................................................... 14
THE COLLEGE MENTORS................................................................................................................................ 15
FACULTY AFFILIATE ADVISORS .................................................................................................................... 18
STUDENT AFFILIATE ADVISORS .................................................................................................................... 19
THE STUDENT WELLNESS COMMITTEE........................................................................................................ 21
VMS LIVE: WELLNESS RETREATS .................................................................................................................. 24
FINANCIAL SUPPORT ............................................................................................................................................. 26
INSTITUTIONAL STRUCTURES ............................................................................................................................ 28
STUDENT BUY-IN .................................................................................................................................................... 29
SECTION III: WELLNESS AT YOUR INSTITUTION ....................................................................................... 30
EXISTING STRUCTURE........................................................................................................................................... 31
FACULTY LED MENTORING PROGRAM ........................................................................................................ 31
STUDENT LED PROGRAMMING ....................................................................................................................... 31
CORE PRINCIPLE WELLNESS RETREATS ...................................................................................................... 32
DETERMINING SCALE ............................................................................................................................................ 33
FACULTY LED MENTORING PROGRAM ........................................................................................................ 33
STUDENT LED PROGRAMMING ....................................................................................................................... 35
CORE PRINCIPLE WELLNESS RETREATS ...................................................................................................... 37
INSTITUTIONAL BUY-IN ........................................................................................................................................ 38
FACULTY AND STUDENT BUY-IN ....................................................................................................................... 40
FINANCIAL SUPPORT FLOWSHEETS .................................................................................................................. 41
IMPLEMENTATION TIMELINE .............................................................................................................................. 43
SECTION IV: ESTABLISHMENT OF A WELLNESS COMMUNITY............................................................. 44
COMMUNITY OF MEDICAL COLLEGE WELLNESS ORGANIZATIONS (CMCWO) ...................................... 45
PROGRAM EFFECTIVENESS .................................................................................................................................. 45
VARYING MODELS FOR SUCCESS ...................................................................................................................... 46
LEADERS OF A CHANGING CULTURE ................................................................................................................ 46
FIGURES AND TABLES:
FIGURE 1: VANDERBILT WELLNESS PROGRAM COMPONENTS .....................................................................7
FIGURE 2: VANDERBILT WELLNESS PROGRAM MODEL ........................ ERROR! BOOKMARK NOT DEFINED.3
FIGURE 3: VANDERBILT STUDENT WELLNESS COMMITTEE STRUCTURE .......... ERROR! BOOKMARK NOT
DEFINED.2
FIGURE 4: FACULTY LED MENTORING PROGRAM .......................................................................................... 41
FIGURE 5: STUDENT LED PROGRAMMING ........................................................................................................ 42
FIGURE 6: CORE WELLNESS PRINCIPLE RETREATS ........................................................................................ 42
FIGURE 7: IMPLEMENTATION TIMELINE ........................................................................................................... 43
TABLE 1: BUILDING COMMUNITY ............................................................ ERROR! BOOKMARK NOT DEFINED.15
TABLE 2: SAMPLE COLLEGE MENTOR CALENDAR ......................................................................................... 17
TABLE 3: STUDENT WELLNESS COMMITTEE INITIATIVES ................... ERROR! BOOKMARK NOT DEFINED.3
TABLE 4: ANNUAL YEAR SPECIFIC RETREATS ................................................................................................ 24
TABLE 5: TYPICAL UNIVERSAL SOURCES OF STUDENT DISTRESS .... ERROR! BOOKMARK NOT DEFINED.5
TABLE 6: USEFUL STRATEGIES FOR BRANDING ...................................... ERROR! BOOKMARK NOT DEFINED.6
Section I:
THE NEED FOR WELLNESS
4
PURPOSE OF THIS GUIDE
Since the development and implementation of the Vanderbilt School of Medicine Wellness
Program, institutions across the country have been interested in developing similar programs.
Some have developed their own systems to address medical student wellness while others have
opted to incorporate the time-tested Vanderbilt model into the structure of their institution.
While the development of new structures and programs can lead to better strategies for
addressing medical student wellness, for many institutions starting from scratch is a daunting
task and, frankly, we feel an unnecessary one.
It is our belief that the Vanderbilt model of a school sponsored wellness initiative, the Vanderbilt
School of Medicine Wellness Program, has had a tremendous impact over its five years in
existence. It is a major, if not the leading, factor for many students’ decisions to come to
Vanderbilt. Students openly admit to a 'culture of wellness' at Vanderbilt that makes achieving a
degree in medicine a unique experience. This, we feel, translates to more effective residents and
overall more successful physicians, a worthy investment by any measure.
We hope that you are able to make use of this guide as you initiate or expand medical student
wellness programming at your institution. The contents not only illustrate the Vanderbilt model
for wellness programming, but offer a step-by-step approach for evaluation the needs of your
institution and walking you through the process of implementing the key components of a
wellness initiative tailored to your institution’s needs.
We invite you to explore this guide and hopefully gain the insight and tools necessary to make
medical student wellness a priority at your institution.
Sincerely,
Matthew Zackoff, VMSIV
Beth Ann Sastre, MD
Co-President
Vanderbilt Student Wellness Program 2011-2012
Faculty Advisor
Vanderbilt Student Wellness Program
5
BIBLIOGRAPHY: UNMET WELLNESS
NEEDS IN UNDERGRADUATE MEDICAL
EDUCATION
Drolet, B., & Rodgers, S., (2010). A comprehensive medical student wellness program- design
and implementation at vanderbilt school of medicine. Academic Medicine, 85(1), 103-110.
Dyrbye, L.N., Thomas, M.R., Massie, F.S., Power, D.V., & Eacker, A., Harper, W., Durning, S.,
Moutier, C., Szydio, D.W., Novotny, P.J., Sloan, J.A., Shanafelt, T.D., (2008). Burnout and
suicidal ideation among U.S. medical students. Annals of Internal Medicine, 149, 334-341.
Estabrook, K. (2008). Medical student health promotion: the increasing role of medical students.
Academic Psychiatry, 32(1), 65-68.
Ghodasara SL, Davidson MA, Reich MS, Savoie CV, Rodgers SM (2011). Assessing student
mental health at the Vanderbilt University School of Medicine. Academic Medicine,86(1):116-21
Lee, J., & Graham, A.V. (2001). Students' perception of medical school stress and their
evaluation of a wellness elective. Medical Education, 35, 652-659.
Sastre, EA et all (2010). Improvements in medical school wellness and career counseling: a
comparison of one-on-one advising to and Advisory College Program. Medical
Teacher 2010 32:10, e429-e435
Thomas, M.R., Dyrbye, L.N., Huntington, J.L., Lawson, K.L., & Novotny, P.J., Sloan, J.A.,
Shanafelt, T.D., (2007). How do distress and well-being relate to medical student empathy? A
multicenter study. Society of General Internal Medicine, 22, 177-183.
6
HISTORY OF THE VANDERBILT
WELLNESS PROGRAM
The Vanderbilt Wellness Program was first developed in the Fall of 2005. A group of interested
students along with the Dean of Student Affairs, Dr. Scott Rodgers, met to discuss the need to
address medical student wellness at Vanderbilt. From these series of meetings the Student
Wellness Committee (SWC) was born. Over the next several months, this committee developed
the model for the Wellness Program that officially rolled out in the Fall of 2006.
The program sought to help alleviate student stress and subsequent hardship by focusing on three
core principles: mentoring and advising, student leadership, and personal growth. This led to the
three-pronged model of the Vanderbilt Wellness Program: the Colleges to target mentoring and
advising, the Student Wellness Committee to provide for student leadership, and VMS Live
(Wellness Retreats) to address personal growth. Although these three aspects of the Wellness
Program function as independent entities, they have considerable overlap in order to reach the
common goal of promoting and nurturing medical student wellness.
FIGURE 1: VANDERBILT WELLNESS PROGRAM COMPONENTS
Drolet, B., & Rodgers, S., (2010). A comprehensive medical student wellness programdesign and implementation at vanderbilt school of medicine. Academic Medicine, 85(1), 103-110.
7
The above-mentioned components of the Wellness Program were implemented independently
and in several phases over the first few years of the program’s existence. The Colleges were
launched for the arrival of students in 2007, and initially involved only the first- and second-year
classes. After strongly positive feedback, The Colleges were expanded to all four classes and
continue to be a major presence within the medical school today. The Student Wellness
Committee initially consisted of only two students in 2005, expanded in its second year with
increased funding, and by 2009 secured an annual operating budget of $10,000. Lastly, the VMS
Live: Wellness Retreats were piloted in 2007 with the first year class. Secondary to a strong
response by the students, they were expanded yearly to eventually encompass all four years by
2011.
Over its time in existence, there have been subtle changes to various aspects of this system, but
the core structure and purpose remain the same: establishing mentoring communities, nurturing
personal growth, and directing programming with the purpose of addressing medical student
well-being. For additional details on the initial development and implementation of the
Vanderbilt Wellness Program, please see the original paper published in Academic Medicine
(see bibliography on page 6).
8
DEMONSTRATED SUCCESS
Since the implementation of Vanderbilt's Wellness Program, evaluation of the program has been
a vital component of its continued development. The following information is taken from two
major evaluations of the program cited in the bibliography on page 6.
IMPROVEMENTS IN MEDICAL SCHOOL WELLNESS AND CAREER COUNSELING: A
COMPARISON OF ONE-ON-ONE ADVISING TO AN ADVISORY COLLEGE PROGRAM
During the transition from a one-on –one advising system to the newly designed Advisory
College program, a survey was developed to compare the two programs. First year students in
Vanderbilt's new Advisory College Program and second and third year students in a traditional
one-on-one faculty advisor program were asked to complete a survey evaluating their
experiences with their respective programs.
The proportion of students who knew their advisors was significantly higher among the students in the
Advisory College Program: 100% vs. 78%
When comparing the number of contacts between students and their advisors:
Faculty Advisor Program:
56% were never contacted
5% were contacted greater than or equal to 5 times
Advisory College Program:
100% were contacted at least once by their advisors
55% were contacted greater than or equal to 5 times
When comparing meaningful contacts:
Faculty Advisor Program:
53% had no meaningful contacts
25% had greater than 2 meaningful contacts in the past year
Advisory College Program:
87% had greater than 2 meaningful contacts in the past year
94% of students in both programs agreed that wellness and career advising was important to them
- "Are you satisfied with how well your advisor promoted wellness":
Faculty Advisor Program:
Advisory College Program:
27% agreed or strongly agreed
72% agreed or strongly agreed (p<0.001)
- "Are you satisfied with how well your advisor promoted career counseling":
Faculty Advisor Program:
Advisory College Program:
22% agreed or strongly agreed
43% agreed or strongly agreed (p<0.001)
- "I am satisfied with the overall advisory system":
Faculty Advisor Program:
Advisory College Program:
24% agreed or strongly agreed
67% agreed or strongly agreed (p<0.001)
9
MEDICAL STUDENT BURNOUT AND THE IMPACT OF A SCHOOL SPONSORED
WELLNESS INITIATIVE
In 2011, as the Vanderbilt Wellness Program reached five years in existence, leaders of the
program sought to evaluate the Wellness Program’s effectiveness at addressing a common
outcome of medical student distress: burnout. All Vanderbilt medical students were asked to
complete a survey evaluating students’ level of burnout, depression, quality of life, stressors, life
events, and sources of support. Students were then asked questions to gauge both knowledge of
and participation in various aspects of the Vanderbilt Wellness Program. Lastly, students were
asked to rate their perceived level of burnout as well as the impact of each component of the
Wellness Program on their perceived level of burnout.
When attempting to determine whether participation in the Wellness Program led to decreased burnout using
a dose-response model, it was found that there was no significant correlation between participation with any
of the Maslach Burnout Inventory components:
10
However, when assessing the perceived degree of relief of burnout from the various components of the
wellness program, trends suggest that as perception of the usefulness of the Wellness Program increased,
burnout decreased:
The study also supported the regularly held belief that a “culture of wellness” exists at Vanderbilt, which
plays a role in the reason students are able to make wellness a priority:
In addition, the study demonstrates that there is considerable variability in the degree to which students are
meeting their wellness needs; however, a majority of students believe that the Vanderbilt Wellness Program
plays a role in assisting them to meet those wellness needs:
11
Section II:
THE VANDERBILT
WELLNESS PROGRAM
12
OUR MODEL
The Vanderbilt Wellness Program consists of three key components: the Colleges, the Student
Wellness Committee, and VMS Live (further described below). As shown in figure 1, these
three facets of the Wellness Program are housed in the Office of Student Affairs and the Dean of
Student Affairs coordinates the overall program. In this manner, the leaders of each facet of the
Wellness Program function autonomously to develop programming, however there is oversight
from a single administrator to ensure accountability. While each component of the Wellness
Program is independent, their programming is often intertwined due to the common goal of all
three arms of the program: to promote and facilitate medical student wellness.
FIGURE 2: VANDERBILT WELLNESS PROGRAM MODEL
Drolet, B., & Rodgers, S., (2010). A comprehensive medical student wellness programdesign and implementation at vanderbilt school of medicine. Academic Medicine, 85(1), 103-110.
13
THE COLLEGES
Immediately upon the creation of the Wellness Program, it was recognized that development of a
strong advising program was a requirement for success. In the past a large group of faculty
served as faculty advisors to one or two students per class. Understandably, although these
faculty members were dedicated to student mentoring, their level of involvement and support
was variable. The decision was therefore made to seek out a select few faculty members and
support their mentorship of larger groups of students. By providing protected time and financial
support for these faculty, all students could become part of a more uniform and more effective
advising program.
Vanderbilt selected eight faculty members and divided them into four pairs assigned to co-direct
four Advisory Colleges. Each College consists of one-quarter of the students from each medical
school class. With an average class size of 100 students, this means that each College has
approximately 25 first years, 25 second years, etc. This configuration of the Colleges lends itself
to the creation of campus-wide community since each College is composed of students from
every year of training and students remain in their same College for the duration of their medical
school education. The Colleges’ selection of their own unique color, mascot and crest further
adds to the sense of community and identity within each College that contributes significantly to
the effectiveness of its mentoring capabilities.
Medical students within each College are further subdivided into mentoring families. These
families are generated through a process called the first-year-second-year match, which takes
place prior to the arrival of incoming first year students. Every year students from the second
year class are 'matched' with an incoming first year student based on a linking characteristic (i.e.
undergraduate university, major activity of interest, outside experience, etc.). This pairing leads
to a natural mentoring relationship that continues beyond that first year. With each subsequent
year, incoming students are paired with rising second years thus joining existing families thereby
adding more sources of mentoring and support.
It is the goal of the Colleges to support mentorship and to provide a home within a home for
medical students at Vanderbilt. To achieve those ends, the Colleges utilize three key groups of
personnel with very specific roles and expectations: College Mentors, Faculty Affiliate Advisors,
and Student Affiliate Advisors (see Figure 1). It is through these key faculty and student
positions described below working along with the family structure described above to facilitate
mentoring and generate a strong sense of community that the Colleges have been so successful
and well received.
14
THE COLLEGE MENTORS
Initially the role of these College Mentors was to support and mentor students from the
standpoint of helping them to combat the stressors of medical school. They served as the go-to
faculty members for advice, thus giving students access to someone who had been there before
and made it out to the other-side. These mentoring relationships were just what students had
been looking for: a faculty member dedicated to supporting them through four of the most
stressful years of their lives. Of course, the close mentoring relationship that exists between the
College Mentors and students does not develop overnight. Below are some examples of how the
College Mentors work to encourage the community atmosphere within their colleges, thus
facilitating greater communication and development of the mentoring relationship:
TABLE 1: BUILDING COMMUNITY
- College Welcoming Parties - at local parks, homes of College Mentors
- Regular study breaks before exams - class specific, always with food
- Annual college wide social gatherings - local restaurants, parks
- College family dinners - homes of College Mentors
- Regular weekly office hours - open and casual and private opportunities
- Cheerleaders-in-chief for College Cup
With regards to the how mentoring occurs, College Mentors makes themselves available to
students in a variety of venues. They readily engage students in individual meetings as well as
offer regular office hours allowing small groups to discuss a range of topics. Often College
Mentors are sought out for study skills advice or to serve as research mentors, as well as for
general personal growth advice in regards to various transitions in medical school training and
the medical profession as a whole. College Mentors are regular advocates for students, helping
to provide a broader context at promotions committee meetings and supporting them in life
challenges that may arise.
While these College Mentors chief roles are to provide support, direction and encouragement to
the medical students within their college, they are also responsible for having tough
conversations with students who are faltering on an academic or a personal level. For example,
when students are noted to have alcohol problems, difficulties with interpersonal social skills,
deficits in empathy or who just seem to be withdrawing from the social milieu around them, it is
the College Mentors who reach out to these students to set goals and create action plans.
Vanderbilt Medical School has come to rely heavily on the strength of the relationship formed
between College Mentors and their students as a tool to effectively reach those students in need
of additional assistance. The roles and expectations of the College Mentors are summarized
below:
15
Student Wellness
 Assist with major transitions such as starting medical school, beginning third-year ward
rotations, and preparing for graduation and residency.
 Participate as small-group leaders in all Wellness Retreats
 Meet individually with each student within the College on a regular basis throughout medical
school in order to facilitate students’ self-assessment of their own state of wellness and
develop goals and plans for maintenance of personal wellness.
 Participate in College events focused on maintaining personal wellness
 Serve as proponents of the ideals of Wellness - balance, fitness, support, mental health - in
their interactions with students in all environments
Career Exposure and Counseling
 Meet individually with each student within the College on a regular basis throughout their
medical school career to offer guidance, advice and direction in the area of career selection.
 Facilitate the establishment of mentoring relationships between students and other clinical and
research faculty within their areas of interests.
 Offer shadowing experiences for pre-clinical interested students
 Serve as mock interviewers for senior students preparing for residency interviews
Scholarship and Academic Advising
 Meet individually with each student within the College on a regular basis throughout their
medical school career to develop Personalized Learning Plans to encourage academic growth.
 Advise students regarding healthy study habits and academic goal-setting as well as provide
structures of support for students struggling academically.
Peer Mentoring and Community-Building
 Arrange College-wide meetings on a regular basis to promote community –building within the
College and between students of different academic years
 Support the established peer-mentoring program by selecting senior leaders to serve as SAAs,
and providing peer-mentoring avenues to benefit both preclinical and clinical students.
Service-Learning
 Participate and encourage student participation in college-wide service-projects and activities
to address needs in the local community
 Encourage each student to actively engage in their own personal service-learning projects
based on individual interests, exposures, and career-goals.
While the Colleges were designed to allow for some standardization in the mentoring received
by Vanderbilt medical students, there is some variation in how College Mentors have sought to
create that mentoring community. While some events are college-wide in order to facilitate
16
peer-peer mentoring, others are class-specific in order to target more specific needs. In addition,
individual meetings between Mentors and students (more scheduled in the first two years and
more ad hoc in the latter two years) provide the foundation for mentorship and guidance
provided by the Colleges to all medical students. Below is an example of how one set of College
Mentors have allocated time and resources over the course of a year in pursuit of encouraging
medical student well-being:
TABLE 2: SAMPLE COLLEGE MENTOR CALENDAR
MONTH
EVENTS
August:
Welcoming Party (College-wide)
Bowling Night (Third Year students)
Review of Personal Statements & CVs (Fourth Year students)
September:
Study Break (First Year students)
College Cup (Inter-collegiate competition and event)
Individual meetings with all First Year students
Pizza Night (Second Year Students)
October:
Study Break (First Year Students)
Pumpkin-Carving event (College-wide, families included)
Individual meetings with all Second Year students
Pizza Night (Third Year students)
November:
Small-Group Dinners at Mentors’ homes (College-wide)
Study Break (Second Year students)
Mock Interviews (Fourth Year students)
December:
Study Break (First Year students)
Holiday Party (College-wide)
January:
Billiards event (Third Year students)
Career Day (First and Second Year students)
February:
“Winter Blues” Night-out (College-wide)
March:
Study Break (First Year students)
The Match (Fourth Year students)
Individual meetings with all First Year students
April:
Pizza Night (Third Year students)
5K Fundraiser (Intercollegiate service-project)
May:
Graduation Events (Fourth Year students)
End-of-Year Party (College-wide)
June:
Step I Boards Study Breaks (Rising Third year students)
Residency Preparations sessions (Rising Fourth year students)
July:
Intro to the Wards (Rising Third year students)
17
Mid-summer Pool Party (Rising Second year students)
The role of these faculty mentors recently has been upgraded to involve a larger academic
component. These select faculty will now be more directly involved as small group leaders in
discussions of the humanistic and professional aspects of medicine during preclinical courses.
This offers even greater opportunity to demonstrate the need to be well as a physician in order to
be successful in this profession. Additionally, utilizing the College Mentors as teachers in these
official medical school courses emphasizes to preclinical students the importance and legitimacy
of this wellness program at Vanderbilt. Involvement in the official curriculum will also provide
the College Mentors with increased access to students’ grades and evaluations which will enable
them to help address academic concerns and better address the unique needs of individual
students. These added responsibilities have been accompanied by increased administrative and
financial support for the position, to be discussed further in the Section II: Financial Support.
FACULTY AFFILIATE ADVISORS
As the College Mentors were being sought, the search team discovered that many more faculty
members wanted to be involved in the program than could serve as official College Mentors.
Subsequently they created faculty affiliate advisor (FAA) positions which provided these select
faculty members with the opportunity for extensive participation in mentorship of students. The
role of the FAA was designed to focus on two central themes: wellness and career counseling.
Today, FAAs are a key component of the Colleges and they play an amazing supportive role for
the College Mentors and serve students in a variety of ways. Although the FAAs do not receive
salary support for their work, they have more flexibility and autonomy to be as involved as they
wish within the College system. The roles and expectations of encouraging and supporting
wellness and providing career exposure and counseling as described in the official Vanderbilt
Faculty Affiliate Advisor Program Roles and Expectations are seen below:
Encouraging and Supporting Wellness
 Resource for College Mentors to be called on for assistance with College event conception,
planning, and implementation
 Serve as faculty family heads within the Colleges
 Proponents of the ideals of Wellness - balance, fitness, support, mental health - in their
interactions with students in all environments (especially on the wards)
Career Exposure and Counseling
 Offer shadowing experiences for pre-clinical interested students
 Serve as mock interviewers for senior students preparing for residency interviews
18
STUDENT AFFILIATE ADVISORS
In addition to the faculty/student mentoring relationship, a major source of support in medical
school comes from fellow students. Specifically, senior students who have very recently dealt
with the same struggles and stressors can be an effective resource. Much of this mentoring
relationship is naturally supported by the family structure of the Colleges. However, prior to the
creation of the College system, much like what was seen with the prior faculty advising system,
there was remarkable variability in terms of the quantity as well as the quality of peer-support
that students were receiving.
To address this concern the Student Affiliate Advisor (SAA) Program was developed. Very
similar to the College Mentor structure but on a smaller scale, a select number of senior students
from each College are selected to serve as SAAs for a year. Their role is to encourage and
support students’ personal wellness efforts as well as to provide key participation and support in
all College and Wellness Program events. Their roles and expectations are further described in
the official Vanderbilt Student Affiliate Advisor Program Roles and Expectations seen below:
ROLES AND EXPECTATIONS:
 Go-to senior students for the College Mentors
 Student head of a College family made up of students from all four years
- This consists of coordinating the annual family dinner in addition to responsibilities described
in the Peer Mentoring Program below.
 Assist with College and Wellness events:
- College Welcome Parties and other events
- College Cup
 Peer Mentoring Program
The Peer Mentoring Program, only recently developed and implemented, was designed to foster
relationships between senior and pre-clinical students who traditionally did not have much
interaction with each other. Through this program, senior students can serve as a valuable source
of support and perspective. The official Vanderbilt Peer Mentoring Program Structure and
Guidelines is seen below:
PEER MENTORING PROGRAM:
The purpose of this program is to foster relationships between preclinical and senior students, as
fourth year students are a valuable resource for support and perspective. The fourth year student
(who will receive the title of Student Affiliated Advisor - SAA) will arrange individualized
meetings with first and second year students lasting 15-30 minutes. The meetings will be centered
on the pillars of wellness and will follow the theme of the yearly retreats. These meetings will
also give students the opportunity to set wellness goals for the year.
19
MEETINGS WILL SERVE THE FOLLOWING FUNCTIONS:
 A screening tool for academic concerns
- In the case of a student with academic concerns, a meeting with an academic tutor will be set up to
discuss study skills on a separate occasion.
 A time for reflection on a theme (students will have encountered this theme at their annual retreat)
- First year: thriving v. surviving
- Second year: motivated abilities
 Establish/Discuss Wellness Goals
- SAA will discuss the feasibility of such goals
- Develop strategies to accomplish said goals
- If previous goals are not being achieved, consider possible reasons why
 Discuss sources of support
 Discuss sources available for mental health concerns
 Discuss Student Safety Net Program for concerning behavior
- SAA is available for contact if student has concerns about their own or a peer’s behavior.
- This can provide an outlet to intervene on dangerous or inappropriate behavior (ex: excessive drinking)
without involving faculty directly.
Serving as an SAA is an opportunity for students to demonstrate a commitment to mentorship
and to foster beneficial relationships with underclassmen. They are a vital component of the
Colleges, serving as a source of manpower and support that increases the effectiveness of a vast
array of programming.
20
THE STUDENT WELLNESS COMMITTEE
The Student Wellness Committee was the initial driving force behind the creation of the
Vanderbilt Wellness Program - a group of students who believed strongly in the importance of
encouraging wellness during medical school and considered ways to achieve this goal. That
same focus exists today with the current mission statement of the Student Wellness Committee
below:
“To promote and facilitate the lifelong pursuit of balance, healthy lifestyle, community, and
mental well-being while supporting the current and future needs of Vanderbilt Medical
Students.”
This goal mirrors that of the Colleges but approaches it from a completely different direction
through the efforts of students working through the various subcommittees to be described
further below.
The leadership of the Student Wellness Committee, currently held by two fourth year medical
student co-presidents, is charged with two main purposes: first, to provide organizational
oversight of the subcommittee chairs encompassing the Student Wellness Committee (i.e.
overseeing student led programming) and, secondly, to coordinate the efforts of the other two
components of the Wellness Program (the Colleges and VMS Live). It is for this reason that two
senior students are selected to lead this crucial component of the Wellness Program - ensuring
the successful integration of all three components. In addition, several other senior students are
tapped by the Wellness Presidents to play key roles coordinating other initiatives developed by
the Student Wellness Committee such as providing support for students during USMLE Step I
and formalizing the mentorship provided to preclinical students by senior students. This group
of select senior students constitutes the Wellness Advisory Council.
Serving with the Wellness Presidents and the Wellness Advisory Council are subcommittee
chairs filled currently by second year medical students. These chairs have complete autonomy
over their subcommittee (however, with funding controlled by the Presidents) allowing for an
unprecedented amount of programming autonomy for students. While there are several key
events, described below, which remain consistent from year to year, this autonomy has led to a
wide variety of programming that attempts to find new and improved ways to reach out and
support students on a variety of fronts.
There are five subcommittees, each with a different focus but with inevitably much overlap.
They consist of physical wellness (a.k.a. Body), intellectual wellness (a.k.a. Mentoring),
interpersonal wellness (a.k.a. Social), emotional and spiritual wellness (a.k.a. Mind), and
environmental wellness (a.k.a. Community) subcommittees. Together, as shown in figure 2,
these five subcommittees cover the key of aspects that require balance to allow a person to be
well.
21
INTELLECTUAL
WELLNESS
ENVIRONMENTAL
WELLNESS
MENTORING
COMMUNITY
EMOTIONAL &
SPIRITUAL
WELLNESS
Vanderbilt
Medical Student
Wellness
Model
PHYSICAL
WELLNESS
BODY
MIND
INTERPERSONAL
WELLNESS
SOCIAL
FIGURE 3: VANDERBILT STUDENT WELLNESS COMMITTEE STRUCTURE
Drolet, B., & Rodgers, S., (2010). A comprehensive medical student wellness programdesign and implementation at vanderbilt school of medicine. Academic Medicine, 85(1), 103-110.
Each of these subcommittees strive to live up to the Student Wellness Committee's mission to
'promote and facilitate the lifelong pursuit' of wellness and to 'support the needs' of Vanderbilt
Medical Students. There are four key components of that goal, the first being to promote.
Students selected to serve as subcommittee chairs need to be more than effective event planners;
these students need to exude wellness so that people will 'buy' what they're 'selling'. That is to
say that they must convince extremely busy and stressed medical students that wellness is not
only important but is actually achievable based on their own example.
Secondly, the programming aspect of the Student Wellness Committee is focused on providing
exposure and opportunity to partake in activities that students can then incorporate into their own
routine for maintaining wellness. This is a key point that cannot be stressed enough. The
purpose is not to fill medical school with event after activity after seminar that by pure
attendance leads to a well individual; rather the goal is to create targeted programming to provide
exposure and the opportunity to experience different activities that can contribute towards the
goal of being well if a student subsequently incorporates that activity into his or her life.
Another key aspect of the mission of the SWC is the idea of lifelong wellness. While medical
school is a rigorous environment with numerous stressors and constant time constraints; intern
year, residency, and future practice as an attending all come with their own stressors and time
commitments. While work and training will certainly continue to become more enjoyable as
students and residents move closer to their desired career goal, there will continue to be massive
22
time constraints requiring effective time management. If a student cannot make time for
activities and endeavors that are vital to staying well, it is very unlikely that as a resident or
attending physician they will be able to achieve balance in their lives. For that reason it is vital
that students take the time in medical school to determine what it is they need in their lives to
stay balanced and move towards wellness so that they can carry that forward as they progress in
their careers. It is our belief that a physician cannot effectively take care of others if they are not
taking care of themselves, and the Student Wellness Committee serves on the front lines of
addressing that issue.
Lastly, the SWC is also committed to supporting students as they deal with medical school
specific stressors such as Gross Anatomy, preparing for the USMLE exams, and transitioning to
the wards. As such, the SWC organizes and delivers a multitude of resources to directly assist
with these stressors and plays a vital role in ushering medical students through the twists, turns,
and trials of a medical education. A representative list of the programming offered by the
Student Wellness Committee from the official Vanderbilt Student Wellness Committee Charter
is seen below; however it is important to remember that this list includes only those key
cornerstone initiatives that occur every year, and is not exhaustive of the multitude of other
events and initiatives that arise as student concerns and needs vary from year to year:
TABLE 3: STUDENT WELLNESS COMMITTEE INITIATIVES
COMMITTEE
EXAMPLE INITIATIVES
Wellness Advisory
Council
SAA Peer Mentoring Program, SAA Student Safety Net,
Targeted Support Initiatives
Body
College Cup, Commodore Challenge, Personalized Fitness Goals
VMS Cookbook, Running Club, Swim Club
Mentoring
VMS Buddy Match, Study Tips/Course/Boards Panels,
Practice Anatomy and Histology Practicals
Mind
Ask a Psychiatrist Forum, Art Therapy Sessions,
Yoga Workshops
Social
Boards Study Breaks, Light Hall Lock-In, Night at the Gallery,
School Mixers, Game Watches
Community
Wellness Bulletin Board, Safety Alerts, Student Space Renovations,
Community Service Initiatives
23
VMS LIVE: WELLNESS RETREATS
The VMS Live program is a longitudinal curriculum adjunct designed to support personal
growth and reflection through a series of workshops over the four years of medical school. The
curriculum of these sessions has three specific goals:
1. To provide a forum through which faculty model self-care as the ultimate goal for being able
to supply compassionate patient care.
2. To construct a context for each student to contemplate his or her life as a person. This serves
as the engine for his or her life as a physician.
3. To foster open dialogue and discussion of issues related to cultivating life-giving
relationships, which are central to all compassionate healthcare.
The purpose of the program is to guide students through a process of self-discovery through
which they will identify their abilities, convictions, and values. This process gives students the
skills and knowledge to incorporate personal needs and life goals into their future practice of
medicine.
These workshops take place over annual half-day long retreats at locations distant from the
Vanderbilt campus. Each retreat consists of large group sessions led by the VMS Live organizer
as well as small group sessions led by the College Mentors. Student attendance is required at
these events, and the retreats are universally well received. Below are the themes for each
respective year's retreat:
TABLE 4: ANNUAL YEAR SPECIFIC RETREATS
YEAR
THEME
1
Surviving vs. Thriving: Understanding the difference
-Students will receive an overview of the VMS Live Program and learn the difference
between growing/becoming vs. achieving/performing and its long-term impact on their
personal well-being.
- Students will learn the importance of maintaining space for their personal identity and
culture, i.e. avoiding the dangers of completely immersing themselves into the medical
culture
Key learning objective: embracing your humanity
2
Motivated abilities: Connecting with one's natural talents
- Students will discover more about their unique motivated abilities and how to begin to
think about specialty selection in light of their natural abilities
Key learning objective: embracing your design
24
3
Professionalism and Professional Health and Wellness
- Students will determine their own personality traits and explore how those traits relate
to their role in their families as well as to their chosen medical specialty to understand
their own innate strengths and weaknesses
- Students will delve into the topic of professional health and wellness by exploring the
concept of flooding and the strategies to deal with flooding in their own lives as well as
in their colleagues by taking advantage of their underlying personality traits.
Key learning objective: cultivating authentic, life-giving relationships
4
Integration and choices: Putting into practice lessons from years 1-3
- Students will engage in self-reflection on the lessons of the past three years and how
they have impacted where they are today
- Students will identify areas of difficulty over the past three years and areas where
continued work is needed to successfully embrace their humanity, design, and ability to
cultivate authentic life-giving relationships and consult with their peers to develop
strategies for success in these areas
Key learning objective: wellness is a life-long process with no correct route
While the topic of each retreat varies, the general template of faculty moderated discussions
remains consistent. The College Mentors play a key role in the success of these sessions by
discussing their own struggles and being open about their own strengths and weaknesses that
led them to where they are today. In addition Student Affiliate Advisors also attend the first
and second year retreats to offer their perspectives.
25
FINANCIAL SUPPORT
The provision of substantial financial support has certainly contributed to the breadth of
programming, the variety of experiential learning, and the organization and “running” of the dayto-day activities of the Student Wellness Committee, the Colleges, and the annual Retreats
within Vanderbilt’s Wellness Program. However, the Program did not start with the budget and
resources we currently enjoy today. Vanderbilt’s Wellness initiatives began with a core group
of passionate students and faculty members armed with little in the way of funding but a great
deal in the way of commitment. As time progressed and the efforts of this core group
demonstrated success in terms of student satisfaction, student wellness, and burnout prevention,
the funding (in terms of programming dollars and salary support) followed. Even if your
resources are limited, we believe that you can gain a foothold for wellness within your institution
in the hopes that your successful outcomes will result in increased funding opportunities.
At the time of the creation of the Student Wellness Committee, this volunteer group of students
was granted funding on an event by event basis, with spending tightly controlled. Otherwise, the
organization and administration of the Committee was completely run by student volunteers.
Similarly, when the initial task force met to interview and select the first faculty mentors for the
new Colleges system, these busy faculty were asked to donate their time freely to student
mentorship. Surprisingly, perhaps, in spite of busy clinical and research endeavors, the core
group of eight College Mentors were willing to donate what amounted to about 3-5 hours weekly
(averaged annually) to group activities and individual advising within the College system.
College Mentors were provided with $3000 per College to spend on activities to promote
College identity and foster faculty/student relationships. Additionally, approximately 20 other
faculty members agreed to serve as Faculty Affiliate Advisors to pinch-hit and participate as they
were able.
Following the success of the Colleges during their first year of implementation, the School of
Medicine committed to providing 10% salary support (to a maximum of $20,000 per College
Mentor in order to provide them more protected time for College events and individual
mentoring. While actual student activities and advising often took up more than 10% of a typical
work-week, these faculty were dedicated to their students, to the Colleges, and to the mission of
establishing a culture of Wellness at Vanderbilt. The budget for programming for each college
was also raised to $5000 annually. Additional funding was then garnered from the School of
Medicine in order to fund two Wellness Retreats: one for the First Year students and one for the
Second Year students. Surveys and focus groups following these two events documented
success in terms of attitudes toward wellness and knowledge about how to maintain wellness in
medical school thus solidifying the role of this retreat as a core component of the Wellness
Program.
26
Over the last few years, significant changes have been made in the financial contributions to
Wellness at Vanderbilt Medical School. A separate donation fund has been established that has
successfully funded the annual College Cup (~$6,000 annually), an intercollegiate competition
held every Fall that helps to establish the identities of the College, foster friendly competition,
and encourage students to continue to include physical wellness as a priority in their medical
school lives. The Student Wellness Committee has continued to expand in terms of student
volunteers and leaders and now has a stable annual budget of $10,000, over which they have
complete autonomy, enabling it to provide a host of programs, events, and outings. The
Wellness Retreats, now offered four times each year to each individual class of students, requires
$2,000 for off-campus meeting space, food, transportation, and entertainment options. Within
the Colleges, the eight core College Mentors now earn 30% salary support which allows them to
host office hours, attend group events, and teach in the pre-clinical years. Each College’s
programming budget has expanded to $7,500 annually in order to provide Mentors, FAAs, and
SAAs with the necessary funds to allow frequent and variable large-group events and smallgroup get-togethers.
Much of the funding for the Vanderbilt School of Medicine Wellness Program is derived from
the school’s annual White Coat Fund. This fund allows alumni and friends of Vanderbilt the
opportunity to contribute to the well-being and success of current students through individual
sponsorship, generating approximately $50,000 annually. This fund was developed in
conjunction with Vanderbilt’s development office, which set up the account, but much of the
fundraising is a joint effort between the alumni office, school administration, and current
students.
While Vanderbilt is fortunate to have high-level administrators and faculty who value the
promotion of wellness and are willing to back it up with funding, we saw significant success
even with smaller budgets at the onset of the development of our program. No matter where
your institution lies in the financial spectrum, we believe a Wellness Program can be
successfully established with the hopes that continued positive reinforcement from students and
faculty alike may result in continued increases in the annual budget.
27
INSTITUTIONAL STRUCTURES
Before the creation of the Vanderbilt Wellness Program, there were several key support
structures already in place for students. One major resource is the Vanderbilt Student Health
Center, which provides primary medical care for all Vanderbilt Students. In addition to the
standard primary care office resources, the Vanderbilt Student Health Center also supplies a
multitude of information on all aspects of health and even some discussion of wellness which has
allowed the Vanderbilt Wellness Program to avoid recreating the wheel in terms of producing
information on medical health. The Vanderbilt Student Health Center serves as an excellent
resource for student referrals when issues surrounding medical health arise. More information
about the Vanderbilt Student Health Center can be found at
http://www.vanderbilt.edu/student_health/.
The second remarkable support structure provided for Vanderbilt Students is the Vanderbilt
Psychological and Counseling Center. This is an excellent resource which offers students up to
one session of counseling services free of charge per week. These services range from one-onone counseling to group therapy on topics spanning anxiety to substance abuse to obsessivecompulsive disorder. All of these resources are confidential, and the center works seamlessly
with psychiatric providers associated with the Student Health Center. More information about
the Vanderbilt Psychological and Counseling Center can be found at
http://www.vanderbilt.edu/pcc/.
These comprehensive healthcare resources for medical students provide an additional level of
support that the Vanderbilt Wellness Program can partner with in order to provide enhanced
medical and mental health support to Vanderbilt medical students.
28
STUDENT BUY-IN
The speed with which Vanderbilt medical students have embraced the Wellness Program is truly
remarkable. The results of the published evaluations of various aspects of the program speak for
themselves (see bibliography on page 6).
While much of the success of this program is due to the organization and effectiveness of the
mentoring structure and programming, some of the success is due, at least in part, to students’
knowledge that this program receives a substantial amount of funding. With the slowing of the
economy, cuts in spending have occurred on all fronts at medical institutions across the country.
Changes in the landscape of healthcare have forced institutions to re-evaluate where they spend
their money and to trim spending where possible. Vanderbilt has not been immune to these
changes; however, throughout this process of development the Vanderbilt Wellness Program has
seen a steady increase in its funding and support from the school's administration, and has
continued to expand its reach and subsequent impact.
Students are not oblivious to this fact. They recognize that medical student wellness is
something that the school feels is a worthy investment and, therefore, is something to be taken
seriously. This, coupled with the fact that Vanderbilt has dedicated personnel involved with the
program who consistently exude wellness and inspire involvement without which the program
would not be what it is today, results in a unique medical education experience that students
appreciate and therefore support.
Additionally, the speed at which initiatives were rolled out and subsequently adopted by the
medical student body can be attributed to the several key charismatic student leaders who have
stood at the forefront of each stage of the program’s growth. The Wellness Program has drawn
the interest of strong student leaders on an annual basis. These students, through their energy,
excitement, and effective communication have successfully conveyed the importance of this
Program and generated the strong support it enjoys. A key reason for their success, beyond their
inherent charisma, is a ‘practice what you preach’ mentality universal to all past and current
student leaders. These students work on a daily basis to stay well while still continuing to enjoy
academic success, a feat not overlooked by the rest of the medical student body. Thus, not only
through their efforts but also by example have these student leaders been pivotal in the
successful student buy-in of the Vanderbilt Wellness Program.
29
Section III:
WELLNESS AT YOUR
INSTITUTION
30
EXISTING STRUCTURE
Firstly, it is important to be clear that even before the official creation of the Wellness Program
at Vanderbilt, there was what many describe as an existing 'culture of wellness' which made
incorporation of the Wellness Program into the structure of the medical school a much smoother
process.
The very fact that you sought out this information would suggest that a similar interest in
supporting and encouraging medical student wellness exists at your institution. Along the same
lines, it is vital to consider what programs and structures already exist at your institution and to
integrate a Wellness Program into this system rather than establish a competing endeavor or
discard an existing program that is effective but doesn't match the Vanderbilt model. Some
questions to consider before getting started may help in avoiding redundancy or unnecessary
restructuring:
FACULTY LED MENTORING PROGRAM
Does an advising system already exist at your institution?
Does it involve faculty dedicated to the mentoring role or is it a minor responsibility?
Are there faculty at your institution who would want an increased role in mentoring?
Are there faculty at your institution who would be willing to play a supportive role?
Does a system for student-to-student mentoring already exist?
Are there senior students at your institution willing to take on additional mentoring
responsibilities during their final year?
STUDENT LED PROGRAMMING
Are student groups active at your institution?
Are students at your institution receptive to student led programming?
Are student groups already in existence that develop programming in the categories
described in Section II: Our Model?
31
CORE PRINCIPLE WELLNESS RETREATS
Does a retreat system already exist?
Would the administration be receptive to removing students from class or clinical
responsibilities one day a year for a retreat?
Are there faculty that would be willing to moderate these retreats?
Are there senior students who would be willing and able to moderate these retreats?
Are there locations off campus where retreats could be held?
These might seem like fairly obvious questions, but they are important to consider prior to
making the substantial logistical and financial investments in a school sponsored wellness
initiative.
32
DETERMINING SCALE
While we believe that the ideal model for encouraging and supporting wellness is to utilize all
three components of our model of a wellness program, we are well aware that there are often
limitations in what different institutions are willing and able to implement at any one time. The
following sections attempt to frame the major aspects of each program that can be utilized
independently as well as offer some guidance for scaling based on the size of your institution.
FACULTY LED MENTORING PROGRAM
The Colleges at Vanderbilt are arguably the most impact-full and well-received component of
the Wellness Program. Therefore, we highly recommend that any attempt at creating a wellness
program at your institution involve the creation of a faculty led mentoring program. Below are
the key components that have led to its success:
 Developing a structure to house mentoring groups to allow for the development closer
communities within your greater medical school community
- Vanderbilt has chosen the title of “The Colleges” for these communities, but any
unifying structure to give a home to the mentoring relationship is crucial in establishing
an identity for the program as well as providing an effective structure within which to
build other wellness programming
- Not to mention, it makes it much more fun and entertaining
- For your institution, we would recommend the creation of # students per class/25 mentoring
communities to keep them to a manageable and effective size
 Limiting the number of faculty serving as mandatory mentors for students
- we feel that 25 students per class per faculty pair is a manageable number to allow
sufficient personal connection with a mentor while at the same time limiting the number
of faculty in this role.
- based on your institutions incoming class size of
need for (# students per class/25) x 2 faculty mentors
students, this would translate to a
 Pairing faculty to give students access to two potential mentors working
collaboratively
- Having faculty mentor pairs benefits the faculty as well as the students
33
- It allows for more effective distribution of labor as well as support with
programming for the faculty members
- For the students it allows for the opportunity to interact and hopefully connect
with two potential mentors who have unique backgrounds and experiences
ultimately leading to the increased likelihood of stronger connections and more
effective mentoring
 Incorporating other faculty to provide additional sources of mentoring for various needs
- Recruiting additional faculty to have a relationship with the faculty mentoring program
helps extend the message of wellness beyond events directly associated with the
communities, and can help tie wellness activities into clinical encounters further assisting
students in the exploration of specialty options.
- This is crucial for establishing a 'culture of wellness' beyond the classroom and out into
an entire medical center
- Based on the size of your institution, we would recommend 5-10 associated faculty for
each mentoring community, ensuring equal number of faculty per community, for a total
of (5 x # of communities) - (10 x # of communities) associated faculty

Incorporating senior students to serve as mentors
- Senior students also play a unique role in mentoring younger students due to their
approachability and the knowledge that they just recently experienced the same stressors
- For senior students, involvement in mentorship solidifies the importance of serving as a
mentor thus encouraging them to seek out and create similar relationships throughout all
levels of training. This further extends the wellness components of seeking support and
establishing community beyond medical school into residency training and beyond.
- Based on the size of your institution we would recommend 5 senior students to serve as
senior student mentors for each mentoring community' for a total of (5 x # of communities)
senior student mentors
34
STUDENT LED PROGRAMMING
A strong group of students is key to the effectiveness of the overall Wellness Program. As
discussed above, the senior leaders of the Student Wellness Committee play a vital role in the
organization and implementation of all three components. Below are the key components that
lead to a successful student led programming component:
 Strong senior leadership
- Students are vital to the success of each component of Vanderbilt's Wellness Program,
and regardless of which components you are incorporating into your program, strong
student involvement is a must.
 All or none approach to subcommittee chairs
- While your program may not be able to develop the multitude of initiatives that
encompass all five of the wellness subcommittees, we feel that representation of all five of
the realms of wellness is necessary to portray the message that there is a place for
everyone within the programming of the student led programming committee.
 Address the most pressing needs first with 'programming for a purpose'
- While a massive intercollegiate competition event would be exciting to create and might
develop a sense of community among the college; that might not be the most pressing
need for your student body.
- Take time to evaluate the needs of your students and support them through their
greatest challenges first. This will establish both the effectiveness of and need for a
wellness program at your institution and will garner the necessary student interest to
expand programming to other venues.
TABLE 5: TYPICAL UNIVERSAL SOURCES OF STUDENT DISTRESS
- Gross Anatomy practical exams
- USMLE Step I
- School year transitions - new expectations, classroom to the wards, etc.
- Applying to residency
- Of course many other stressors exist for medical students, but these are some of the
universal ones where implementation of effective supportive programming may allow the
student led wellness programming committee to be viewed as an advocate and trusted
source of support for students.
35
- Eventually, programming can expand into other venues, however if options for
expansion remain limited due to lack of financial support or faculty support, the very
effort of disseminating information about the other aspects of wellness and establishing
the committee as a source of support in any area will greatly expand the potential for
developing future initiatives.
 Well-rounded programming schedule
- Once your student- led wellness programming committee is established it is important
to have a well-rounded programming schedule. While some committees lend themselves
more easily to events such as Vanderbilt's Mentoring, Body, and Social committees, it
important to continuously seek out ways to keep the Mind and Community aspects of
wellness in the forefront as well. This may require limiting the programming of some
committees to avoid over saturating the student body with events.
 Consistency and dependability
- For a wellness program to effectively take root in your institution it is extremely
important to maintain an image of consistency and dependability, which will help
separate the student led wellness group from the typical student organization. Providing
standard events and support structures year after year regardless of the students involved
establishes a wellness program as a component of the school, not the transient work of
interested students.
 Branding, Branding, Branding...
- Depending on your institution, the multitude of available student programming can
become overwhelming. Having a consistent professional way in which information is
delivered by the student led wellness program will separate it from other standard
student group initiatives and adds that additional subtle authority that causes students to
pay attention and take heed.
TABLE 6: USEFUL STRATEGIES FOR BRANDING
- Use of a logo representing your wellness program - to be placed on everything the committee
does
- Consistent email format for all student led wellness committee announcements
- Visible support by the faculty member associated with your wellness program - follow up
supportive emails, attendance at events, etc.
36
CORE PRINCIPLE WELLNESS RETREATS
The core principle wellness retreats are an easy way to add to the legitimacy of a school
sponsored wellness initiative. Medical students quickly learn that there are very few programs or
events for which medical school administrators will pardon absence from class or grant time off
from clerkship rotations. These generally consist of presenting research at national meetings or
residency interviews. That being said, excusing students from their class and clerkship
obligations to attend a retreat focused on wellness greatly legitimizes wellness as a fundamental
component of a medical education. Below are some key components to creating a successful
core wellness retreat program:
 Retreats must be mandatory
- By making the retreats mandatory it sends the message that the content of the retreat is
deemed vital to a medical student's education by the administration.
- Additionally, it removes the 'what is everyone else doing?' stress, allowing students to
refrain from being spiteful towards the time commitment of the retreat.
 Structured programming should only encompass half of the day, with students being
given the remainder of the day off from class or clerkship obligations
- Many students comment that, for them, wellness entails having a free day off. By giving
students the afternoon off and specifically forbidding the scheduling of class or clerkship
activities that afternoon; students are provided with guilt-free time off.
 Retreats should take place off campus
- By having retreats off-campus at a peaceful location (local park, campgrounds, meeting
site, etc.) students are removed from reminders of their stressors and distractions in their
environment. This allows for more open discussion and reflection by students and
creates space within which they may truly be able to hear what is being said by small
group leaders and their fellow students.
 Retreats must remain flexible to the needs of the students
- Often small group conversation will stray from the workshop template to what is at the
forefront of many students’ minds: classroom and clerkship stressors. It is not the role of
the small group leaders to keep to the structured content via an iron fist. What truly
makes an outstanding small group moderator is the ability to link current student
concerns to the topic of the retreat and allow the discussion to naturally involve the goals
of the retreat while still addressing student concerns.
37
INSTITUTIONAL BUY-IN
Hopefully it has been apparent that a consistent requirement for the development of each aspect
of an all-encompassing school sponsored wellness initiative is institutional buy-in. Without
support from the institution any attempt at the development of a wellness initiative is doomed to
failure.
Upon reflection on the evolution of the Vanderbilt Wellness Program is becomes readily
apparent that much of the program’s success was dependent on the consistent efforts of the Dean
of Students who, in having the ear of the Dean of Medicine and the ability to gain access to the
key decision makers at Vanderbilt, was able to make the vision of the Wellness Program a
reality. Having a point person for implementation within the Dean’s Office is vital to the success
of a program such as this. While the Dean of Students at Vanderbilt took up that charge, there
may be others at your institution that can serve as the administrative point person for this effort
and provide the key support needed within the Dean’s Office.
Institutional buy-in as a whole exists in several forms with the most obvious, but not necessarily
the most crucial, being financial support. It goes without saying that the substantial financial
support that the Vanderbilt Wellness Program receives annually has had a great impact on the
current state of the program. It has allowed for the provision of 30% protected salary time for
faculty serving as College Mentors, which enables these faculty members to contribute
significant portions of their time to their role as College Mentors without detracting from
departmental benchmarks. The Student Wellness Committee's annual $10,000 budget allows for
extensive annual programming as well as the flexibility to attempt new programming and
initiatives each year. Lastly, funding of the annual Wellness Retreats for each class, including
transportation, food, meeting space and free-day entertainment options, is an expense that goes a
long way toward legitimizing the importance of wellness.
However, we would argue that this is not the most crucial aspect of institutional buy-in. An
institution must truly believe that maintaining wellness is a crucial aspect of medical education
which will ultimately have a substantial impact on a student's future success as a physician. This
type of buy-in is manifested by school administrators’ presence at key wellness events, their
comments on wellness when discussing institutional goals, and their willingness to illustrate
wellness in their own lives. This must be the first step in the creation of any wellness initiative.
It is not necessary for everyone to instantly start professing the virtues of wellness, but rather that
key leaders demonstrate an openness to the idea that the goals of a school-sponsored wellness
initiative benefit students and, thereby, the institution as a whole. Following this first step,
financial investments in wellness appear much more plausible as institutional leaders are able to
38
see that wellness initiatives result in more successful students which develop into thriving
physicians.
The length of time required for this type of institutional buy-in to be accomplished is extremely
variable. However, we feel that the information we have learned about the success and impact of
our Wellness Program, as discussed previously, should help legitimize the importance of a
school-sponsored wellness initiative and should help encourage administrators to make the
cultural, if not financial, investment in a similar program at your institution.
39
FACULTY AND STUDENT BUY-IN
As with institutional buy-in, garnering support from faculty is crucial to the success of any
program. You may have all the financial resources you need, but if do not have faculty who are
interested in devoting a considerable portion of time to mentoring and supporting students then
no wellness program can be successful. However, it is likely that certain faculty members within
your institution already stand out because of their ability to actively engage with students in the
processes we have described above. Undoubtedly upon searching through your institution for
such individuals you would quickly find a multitude of excited faculty members who would
revel in being involved in such a program. Also, by demonstrating support from the
administration, faculty members can utilize involvement in these activities for career
advancement, thus further supporting the time and energy a faculty member would be investing
into such a program.
Student buy-in exists on two fronts: seeking students willing to lead and organize the efforts of a
wellness initiative as well as convincing the student body of the importance of seeking and
maintaining wellness. Much of the second point has been described above including
programming that responds to student needs, seeking out engaged faculty, and garnering
administration support. The first point however is a more subtle but profoundly important one.
Wellness at your institution will be entirely dependent on how your student leaders portray it.
For example, if your student wellness leader only discusses training for triathlons and the need to
go to the gym every day of week, then that is exactly what the student body will perceive
wellness to be. Subsequently, if a student is incapable of that or disagrees with that, they will
likely come to the conclusion that 'wellness isn't for me'. Seeking out students who actually
embody the true sense of wellness as well as who are able to convey that message to others is of
the utmost importance, and is something that must be done before attempting to move forward.
40
FINANCIAL SUPPORT FLOWSHEETS
As has been discussed previously, financial support has a great impact on what can be achieved
by a wellness initiative, as well as how quickly. The amount of financial support an institution
can initially provide to a wellness initiative is understandably variable. The following
flowsheets, figures 3 through 5, attempt to assist you in determining how best to allocate
resources based on varying degrees of institutional support.
NONE
SUPPLEMENTAL FUNDING
FOR COMMUNITY
BUILDING
COMMUNITY BUILDING
EVENTS
IDENTIFY FACULTY FOR
PROGRAM
RECRUITMENT OF
ADDITIONAL FACULTY TO
SUPPORT MENTORING
10% PROTECTED SALARY
TIME FOR MAIN FACULTY
MENTORS
30% PROTECTED SALARY
TIME FOR MAIN FACULTY
MENTORS
SUPPLEMENTAL FUNDING
FOR COMMUNITY
BUILDING
SUPPLEMENTAL FUNDING
FOR COMMUNITY
BUILDING
COMMUNITY BUILDING
EVENTS
COMMUNITY BUILDING
EVENTS
SEMESTERLY INDIVIDUAL
MENTORING MEETINGS
SEMESTERLY INDIVIDUAL
MENTORING MEETINGS
DEVELOPMENT OF
MENTORING PROGRAM
INVOLVEMENT AS SMALL
GROUP INSTRUCTORS
WITHIN CURRICULUM
ANNUAL INDIVIDUAL
MENTORING MEETINGS
ENHANCED AVAILABILTY
WITH OFFICE HOURS
ENHANCED AVAILABILITY
WITH OFFICE HOURS
FIGURE 4: FACULTY LED MENTORING PROGRAM
41
NONE
NONE OR
MINIMAL
FUNDING
MODERATE
FUNDING
EXTENSIVE
FUNDING
COURSE SPECIFIC
SUPPORTIVE
PROGRAMMING
COURSE SPECIFIC
SUPPORTIVE
PROGRAMMING
EXPANDED WELLNESS
PROGRAMMING
MINIMAL COURSE
SPECIFIC SUPPORTIVE
PROGRAMMING
IDENTIFY STUDENT
LEADERS
EXPANSION TO
INCLUDE
SUBCOMMITTEE
CHAIRS
EXPANDED WELLNESS
PROGRAMMING
DEVELOPMENT OF
ANNUAL EVENTS
ENHANCEMENT OF
EVENTS
CREATION OF A
PROFESSIONAL IMAGE
FIGURE 5: STUDENT LED PROGRAMMING
NONE
MINIMAL
FUNDING
MODERATE
FUNDING
SUFFICIENT
FUNDING
RETREATS FOR 1ST AND 2ND
YEAR STUDENTS
- OFF CAMPUS RETREATS FOR 1ST AND 2ND
YEAR STUDENTS
- ON CAMPUS RETREATS FOR 3RD AND 4TH
YEAR STUDENTS
IDENTIFY FACULTY ORGANIZER
- ON CAMPUS -
DEVELOPMENT OF RETREAT
PROGRAM CONTENT
SMALL GROUPS LED BY
AVAILABLE FACULTY
RETREATS FOR ALL STUDENTS
- OFF CAMPUS -
SMALL GROUPS LED BY
FACUTLY MENTORING
PROGRAM LEADERS
FIGURE 6: CORE WELLNESS PRINCIPLE RETREATS
42
IMPLEMENTATION TIMELINE
With the creation of a school sponsored wellness initiative you are also attempting to create a
culture of wellness at your institution. This is, undoubtedly, an endeavor that takes a
considerable amount of time and patience and is not something that can be thrust on a medical
school all at once. While the time it will take to achieve this goal is remarkably variable (and
greatly depends on everything that has been discussed thus far) there are some general steps that
should be taken in sequence for the best chance of success, as shown in figure 6.
FIGURE 7: IMPLEMENTATION TIMELINE
43
Section IV:
ESTABLISHMENT OF A
WELLNESS COMMUNITY
44
WELLNESS ORGANIZATIONS WITHIN
MEDICAL COLLEGES (WOWMC)
With the acquisition of this guidebook and your expressed interest in the creation of a school
sponsored wellness initiative at your institution, you are expressing your support of the
importance of wellness in medical education and your commitment to spreading that message at
your institution.
It is the goal of Vanderbilt to more formally recognize that commitment with the creation of a
medical society encompassing medical institutions that support medical student wellness: the
Wellness Organizations Within Medical Colleges (WOWMC). With the creation of this society,
we hope to send the message that wellness is not simply an extracurricular activity at a handful
of institutions, but rather an integral component of the medical profession that institutions have
made a commitment to pursue.
This society in only just now in its infancy, but it is our vision that as wellness initiatives are
adopted at medical institutions across the country and around the world, this society will lead the
way in the development and advancement of wellness principles and will allow for the sharing
and disseminating of information quickly for the benefit of medical students world-wide.
PROGRAM EFFECTIVENESS
We strongly encourage you to constantly evaluate your program’s effectiveness. It is our belief
that only through regular evaluation and scrutiny will a program continue to remain effective and
relevant. Through the regular use of surveys as well as tracking student participation, your
program will better be able to meet the needs of your individual students, and thus remain
relevant at your institution.
Vanderbilt has developed several assessment tools to evaluate our wellness programming and
would happily share these resources with other institutions. As your program gets underway,
please remain in contact with us so that we may continue to assist you in the development of
self-assessment tools that target the needs of your specific program.
Ideally, with the creation and expansion of WOWMC, this type of information will be easily
disseminated amongst institutions and will allow all involved programs to continue to improve
their own self-evaluation.
45
VARYING MODELS FOR SUCCESS
While we are understandably confident in our model for a school sponsored wellness initiative
we do recognize that there are alternative approaches that may be as, or even more, successful
than our approach at encouraging and supporting our students’ wellness.
Just as we are happy to share our approaches, we would love to learn what is successful at your
institution so that we also can continue to improve the ways in which we support our medical
student population. Open exchange of information is vital to the successful adoption of wellness
as an integral part of medical education.
Ideally, this will become a major component of the work done through WOWMC as it is
developed, and will help all involved institutions to continually improve the reach and impact of
their wellness initiatives.
LEADERS OF A CHANGING CULTURE
As has been stated numerous times throughout this guide, we feel that student wellness is a
crucial component of medical education. While this view is beginning to spread to other
institutions, it has yet to be commonly adopted into the culture of medical education.
By seeking out this information, you are acknowledging your commitment to encouraging and
supporting medical student wellness, and invite you to participate in the charge to change the
culture of medical education. We are thrilled that you have joined us in this endeavor and are
excited to see what new ideas and energy you will bring to the table as we continue to work to
change the culture of medical education to one that supports the needs of its students and
acknowledges that a physician cannot effectively care for his or her patients if he or she cannot
effectively care for him or herself.
46