A Hotline for Med Students Facing Burnout

Medical Students Changing Medicine

Varsha Radhakrishnan, MD; Ragha Suresh, MD

Disclosures

May 03, 2019

Creating a Hotline

Rutgers NJMS Peer Wellness is an online, Google voice-based service that connects fourth-year peer coaches with first-, second- and third-year medical students in need. The goal is to minimize the time it takes to reach out for help, as well as provide access to resources after work or on weekends and offer help in real time. For example, if a student is stressed about finishing a research project while also studying for an anatomy exam on a Sunday night, that student can contact the designated on-call peer coach.

Students can call the number when they feel down or are struggling with academic stressors, sleep hygiene, time management, work-life balance, or any other concern. Trained fourth-year peer coaches are available 7 days a week throughout the academic year on an on-call system. Coaches are available 2-3 hours per evening and are responsible for responding to students who have contacted the services within the 24 hours leading up to their shift.

The goal of the hotline is to capitalize on basic technology to connect with students at times that are convenient for them. It also offers the opportunity to build connections and network with senior students, increase access to multiple mentors, and provides highly individualized support. Around 60 fourth-year medical students were interested in becoming peer coaches. Approximately 40 coaches were selected after a training session that discussed logistics, using positive psychology techniques during phone calls, crisis protocols for students at elevated risk for self-harm, and how to generally best help peers. The interviews were in the format of a simulated phone call from a third-year medical student.

How the Hotline Works

Peer coaching services are not entirely unique. The idea was initially inspired by a peer coaching service for Yale undergraduates, as well as from the book Peer Counseling: Skills, Ethics, and Perspectives by Vincent D'Andrea and Peter Salovey. The training sessions were built on the following tenets:

  • Respecting confidentiality;

  • Refraining from unsolicited or specific advice;

  • Focusing on a "growth mindset";

  • Building resilience; and

  • Encouraging a student to discover their own solutions, rather than providing them with answers.

In addition to communicating with students over the phone, peer coaches are responsible for sending a follow-up email that includes coach contact information; a survey; and a wellness packet, which contains mindfulness exercises, YouTube links, and other resources. The peer coach also fills out a call log and, most important, contacts the student within 1 week after the initial phone call to help build a long-term connection. If the student appears to need professional intervention, the peer coach first offers to contact student wellness for the caller and then provides the contact number for the student. Coaches follow up in 1-2 days. If the at-risk student has not done so, the coach reaches out to appropriately designated faculty to help set up an appointment with counseling services, all while working to maintain confidentiality.

Looking forward, we hope to maintain sustainability of this program through continuing leadership and integrating a research component via quality assurance and quality improvement projects to establish measurable outcomes and use of the program. Since our graduation, the program at Rutgers NJMS has also expanded to include in-person group sessions to discuss feelings of burnout and healthy coping mechanisms. Our ultimate goal is expansion of this program to form a network for peer coaches to help medical professionals at every step of training, from students to residents and attendings on a national and even international level.

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