Reimagining Well-Being Initiatives in Medical Education: Shifting from Promoting Wellness to Increasing Satisfaction

Acad Med. 2021 Feb 23. doi: 10.1097/ACM.0000000000004023. Online ahead of print.

Abstract

The well-being movement in medical education has been underway for over a decade. It seems appropriate to examine and evaluate these efforts in order to support the mental health needs of learners, faculty, and staff as medicine and medical education evolve in response to the COVID-19 pandemic and beyond. To date, most interventions intended to promote well-being have focused on individual strategies rather than environmental drivers of distress, and the primary offerings have comprised strategies such as mindfulness, meditation, yoga, nutrition, exercise, and sleep. Responses to this programming from medical learners have primarily ranged from ambivalence to resentment, with many feeling that the programming failed to adequately address their particular needs and the challenges they were experiencing. In this commentary, the author challenges the assumption that well-being per se should be the ideal target or goal. Learners and faculty may be better served by considering other goals-those that do not focus directly on well-being, but that are instead foundational for well-being in that they directly address the challenges that students, residents, and faculty are facing. In other words, goals and associated interventions would focus on the experience of school and work, rather than focusing primarily on encouraging healthy practices outside of school and work. The author proposes using the lens of satisfaction through which to view and assess progress toward well-being, increasing satisfaction within 3 interconnected domains: (1) school and/or work, (2) self, and (3) life. Attention to these domains may be more likely to produce improvements in well-being that have been sought for years, but that remain elusive.