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Peer Support Advocacy Program – Supporting Med Students Personally and Professionally

Peer Support Advocacy Program – Supporting Med Students Personally and Professionally

As I look back over the last few years, I find myself overwhelmed with how much has changed. In February 2018, the last time I wrote a Dose of Reality blog, I was just returning to school after having been on a yearlong personal leave. I had started a peer support program the year prior out of a selfish need to be surrounded by classmates who would unconditionally support me through my struggles. After opening up about my depression and anxiety, I got overwhelming support from the medical school community, but felt that a more structured setup should be available for other students to seek out help before a crisis hits.

In 2018, with more stable footing, and a better handle on my mental health disabilities, I was able to complete the first-year curriculum and move into the second year Clinical Trunk. Three months into the Clinical Trunk I found myself in another crisis, having just failed my first shelf exam. I was spun into another unfortunate predicament, which led me to have to reevaluate my status at the medical school. Under policies that have now changed, I had to step out of school once again, and prove to not one, but two, committees that I should stay in the school. During this time I found that the peer support advocates were such an important support for me. Instead of having to overcome yet another barrier to finding support, it was easily available with a single email. I could reach out to fellow advocates without shame or guilt, and I knew that I would be able to get through the hardship because I wasn’t alone.

Now as 2020 begins, I have finished my core clinical trunk courses, and find myself returning to the passion that drew me to found the Peer Support Advocacy Program.

The program officially had its first training in July 2018, and has since trained over 30 medical students. The training curriculum was compiled with input from various members of the medical school and central campus communities. The training focuses on the importance of emotional intelligence and the ability to be a referral agent to students who contact the advocates. Our role as advocates is to first and foremost be a good listener, identify when we can make suggestions, and help determine when our peers need resources outside of our own capabilities.

Through suggestions of the initial group of advocates, a paging number was established so that medical students could reach out 24/7, and receive support within six hours of outreach. A listserv email was also created for students to reach out with generalized questions when they didn’t know where to go. The listserv and pager are meant to cater to medical students, who work at all hours of the day and night, and may need support outside of the Monday through Friday 8-5 window in which most faculty and staff who run the medical school work.

Over the course of 2018 and 2019, programming efforts were made to help place a focus on student well-being. This mainly occurred through drop-in meetings focused on de-stigmatizing mental health in medical students and other health care professionals, and through advocate outreach in the Taubman Health Sciences Library (THSL); mainly going around to check-in during intense study periods. Marketing efforts are still in the works, with printed fliers up around THSL, counselors and other staff referring to the group, and an online presence. A page was created on the OMSE website about the program, and how to get in contact with various trained advocates. I encourage anyone reading this to follow the link to look up some of the amazing, candid, biographies of some of our advocates.

Because of the public nature of this website, I received inquiries from different medical students around the US. I emailed and called with them to help them set up similar programs at their medical school. As I started learning more about the deficiency of this type of program nationwide, myself and two staff co-leads of the program created a poster presentation, and attended the central and southern GSA/OSR joint regional meeting in April 2019. At that conference, we met more students, staff and faculty who were interested in promoting the well-being of medical students at each of their campuses. We exchanged ideas with others around the nation, and look forward to partnering more intentionally with many of those we met to create a more robust national standard for peer-led wellness programming.

On our own campus, M-HOME has worked to have peer programs, including Winding Roads, M-PACT, Near-Peer Mentoring, eMpower and Peer Support Advocacy work together to create a more cohesive road map for students navigating the different peer support resources offered. These talks continue, as each of the groups finds its place within M-HOME and the larger medical school community.

Over the next year, I hope to see the Peer Support Advocacy Program continue to grow, especially in its marketing and visibility efforts. I have just recently connected with the new Michigan Medicine Office of Wellness, and hope that the growing collaboration with strengthen our efforts. I feel so grateful to my fellow advocates, who are dedicated to change the culture of medicine, to become a more inclusive and understanding environment for health care professionals with mental health concerns, conditions, and disabilities.

Have questions? Or need to talk? Email peer.advocacy@umich.edu and one of our peer advocates will reach out to you. Check out our page on the OMSE website!

Changing Medical Student Wellbeing – A Peer Support Initiative

While taking a year off of medical school for depression and anxiety, I decided to start a peer support group, something I had wished was available to me during my struggles. I had been supported by faculty and staff immensely during my first semester of medical school but felt so isolated from other students. I thought I was the only one struggling so much to make it through the pre-clinical curriculum. I attributed so many of my feelings to “medical school is just hard.” Later, I learned that although medical school is challenging, it becomes nearly impossible when you’re struggling with mental health issues.

Through the support of my counselor, M-Home director, and others in the Office of Medical Student Education, I started putting together peer support meetings. At the onset, my only goal was to open up the discussion about the emotional hardships and growth that occurs during medical school. We learn so many important things in medical school, but rarely do we have time in our busy schedules to sit back and personally reflect.

I was greeted by overwhelming support from my classmates after I disclosed my mental health struggles. Everyone I talked to about my depression and anxiety was candid in their responses. I started having open, honest conversations with my peers about mental health struggles they or someone they knew had experienced. Being transparent with my peers allowed them to open up as well. I was unveiling this thin disguise that many medical students wear: portraying themselves, intentionally or not, as being perfectly fine.

After doing many literature searches, talking to staff and faculty in the medical school, and others in the community, I have become determined to change the culture in medical schools around mental health struggles. You would think that of all places, medical schools would be the one place that mental health issues are readily talked about. I participated in a project spearheaded by my classmate and friend Rahael that shows this is not the case, and much more needs to be done to remove the stigma of speaking out. Unfortunately Michigan is not alone, and not the worst offender, in medical student mental health interventions.

As the peer support group and advocacy program grows, I challenge the faculty, staff, resident, fellows and attending physicians in our school and hospital to demand better mental and physical wellbeing initiatives for medical care providers. If we can get those at the top of the health care pyramid to require wellness initiatives for all medical care providers, I believe that we can change the culture around mental health struggles, and start to tackle the high rates of physician, and student physician (medical student) burnout, depression, anxiety and suicide.

As a quote from one of my favorite movies goes,

You see a lot, Doctor. But are you strong enough to point that high-powered perception at yourself? What about it? Why don’t you – why don’t you look at yourself and write down what you see? Or maybe you’re afraid to.” – Clarice Starling, Silence of the Lambs