According to a 2016 systematic review and meta-analysis published in the Journal of the American Medical Association, approximately one in four medical students experience depression and one in 10 have suicidal thoughts. At the time these concerning statistics were published, Michelle Lizotte-Waniewski, Ph.D., also noticed that some of the medical students she was mentoring at the Schmidt College of Medicine at Florida Atlantic University were experiencing stress management issues.
She and fellow administrators channeled their concerns into the creation of an innovative program embedded into the medical school curriculum. Aptly titled HealthFirst: Health and Wellness Initiative, the goal of the program is to encourage wellness in medical students through exercise, nutrition, mindfulness, and stress reduction.
“The premise is to help yourself first,” said Lizotte-Waniewski. She used the analogy of the safety instruction on an airplane – “you are told to put on your own oxygen mask before you can help others with theirs.”
Michelle Lizotte-Waniewski, Ph.D., (center) explains the HealthFirst: Health and Wellness Initiative to a health fair audience.
HealthFirst provides tools for medical students so they will embrace wellness and potentially avoid stress-related mental and physical illnesses now and during their future medical careers. “If we train medical students as part of their curriculum that wellness is important and a clinical tool, they will benefit and share it with their future patients and community,” said Lizotte-Waniewski, now director of the HealthFirst initiative. “We look at wellness as a clinical skill that students can practice on themselves. The overall goal is to enhance the health and well-being of our students, and eventually their patients and communities.”
The HealthFirst coursework begins during the first year of medical school and continues through the second-year curriculum. Embedded in the instruction are experiential learning opportunities that make the subject matter relevant to everyday life. For example, meditation was introduced in the cardiopulmonary class in order for students to learn stress relief techniques while witnessing the effect of relaxed breathing on their heart rate. Creating plant-based meals with salads was incorporated in an endocrinology class in hopes that students would eat healthier themselves and recommend better food choices to their diabetic patients.
Wellness orientations are held for third and fourth year students when they begin clinical rotations. “We emphasize work/life balance and focus on learning skills to maintain wellness,” Lizotte-Waniewski said.
Also included in the initiative is the Wellness in Medicine Signature Lectures series, which is open to students, faculty, staff, and community. Featured lecturers have included best-selling author Barbara Schmidt, who presented “Mindfulness in Medicine,” and Neal Barnard, M.D. who gave a “Nutrition in Medicine” presentation.
Another HealthFirst component is the newly formed Student Wellness Association, which is designed as a support system for the students. “Our purpose is to promote happiness, being healthy, and staying sane during stressful times,” said Dani Steinberg, co-president of the association. During exams, the group leaders try to diffuse stress by distributing healthy snacks and posting motivational messages.
Steinberg and co-president Jordyn Cohen manage a “Be Well Board,” a large bulletin board in the school’s lobby that is the platform for inspirational messages, such as “How are you going to work on your wellness this month?” and “What are you grateful for?” “The response has been very positive,” said Cohen with students and faculty writing comments on the board. “It creates a sense of community – letting people know they are not alone in what they are feeling and that others are going through similar things.” she said. The Association has also participated in community events, such as the 5K Pancreatic Cancer Run and the Out of the Darkness Suicide Prevention Walk.
“This program shows the school really cares for us,” said Cohen, adding that the caring environment was one of the reasons she chose the Schmidt College of Medicine. “We are not just numbers nor are we just students here. We are a family and the school really wants us to do well.”
Destigmatizing mental illness is a central focus of the initiative. Lizotte-Waniewski pointed to the reluctance of medical students and physicians to ask for mental health assistance. In response to this problem, the Palm Beach Medical Society (PBMS) has created a Physician Wellness Task Force, which includes Lizotte-Waniewski. The task force focuses on investigating ways to help doctors avoid depression, anxiety, and burnout. The Society also provides Schmidt College of Medicine students six free and confidential mental health counseling sessions, if needed.
Phillip M. Boiselle, M.D., dean of the Schmidt College of Medicine, said that HealthFirst is a vital component in creating a culture of wellness at the medical school. “One of our strategic initiatives is to foster wellness across our entire organization in recognition that our well-being affects the health and well-being of our patients and communities,” he said. “HealthFirst is an effective initiative that is helping FAU and our community embrace wellness and live healthier lives. I congratulate Dr. Lizotte-Waniewski and the students who have made this so successful.”
Mindfulness expert Barbara Schmidt presents a meditation lecture.
Boiselle noted that the HealthFirst initiative has become so vital to the college’s culture that this year’s first-year class was introduced to mindfulness practice in the White Coat Ceremony. In her keynote address at the ceremony, mindfulness expert Barbara Schmidt said, “If you can be close to your own humanity…you will be able to be fully present with every single one of your patients. You will use your gifts of compassion and expertise to ease the suffering of those in your care.” She then led the students and other attendees in a brief meditation exercise which enhanced the solemnity of the ceremony.
“The HealthFirst initiative is always expanding to meet the needs of the students,” said Lizotte-Waniewski. “We initially focused on physical and mental health, but we are now exploring other elements for wellness – environment, spirituality, financial, among others. We want our students to be cognizant of all these elements and know they have resources to go for help,” she said. At the Schmidt College of Medicine, new students are paired with a community advisor, a physician who monitors all performance over time, and they are also assigned a peer mentor from the second-year class.
Lizotte-Waniewski noted that the support of the initiative is far extending. “All students are encouraging each other’s well-being. Supporting each other has become a pervasive attitude and putting your own health first has become an accepted part of the culture here,” she said.