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A Conceptual Model of Medical Student Well-Being: Promoting Resilience and Preventing Burnout

Received August 15, 2006; revised January 7, February 8, and March 23, 2007; accepted May 2, 2007. Dr. Dunn is affiliated with the Department of Psychiatry and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco. Dr. Iglewicz is affiliated with the Department of Psychiatry, University of California, San Diego. Dr. Moutier is affiliated with the Department of Psychiatry and the School of Medicine Office of Student Affairs at the University of California, San Diego. Address correspondence to Christine Moutier, M.D., UCSD School of Medicine, Medical Teaching Facility Room 180, 9500 Gilman Drive, 0606, La Jolla, CA 92093-0606; cmoutier{at}ucsd.edu (e-mail).

OBJECTIVE: This article proposes and illustrates a conceptual model of medical student well-being. METHOD: The authors reviewed the literature on medical student stress, coping, and well-being and developed a model of medical student coping termed the "coping reservoir." RESULTS: The reservoir can be replenished or drained by various aspects of medical students’ experiences. The reservoir itself has an internal structure, conceptualized as consisting of the individual’s personal traits, temperament, and coping style. The coping reservoir metaphor is used to highlight the dynamic nature of students’ experiences, with potential outcomes including enhanced resilience and mental health versus distress and burnout. CONCLUSION: Medical student well-being is affected by multiple stressors as well as positive aspects of medical training. Attention to individual students’ coping reservoirs can help promote well-being and minimize burnout; formal and informal offerings within medical schools can help fill the reservoir. Helping students cultivate the skills to sustain their well-being throughout their careers has important payoffs for the overall medical education enterprise, for promotion of physician resilience and personal fulfillment, and for enhancement of professionalism and patient care. This and other models of coping should be empirically validated.

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