Vital Signs S1E4 - Melanie Jessel, Student Wellness

In Episode #4, we speak with Melanie Jessel, The Director of Counseling and Wellness at Western Atlantic University School of Medicine. Student wellness is a priority at WAUSM. Vital Signs is a podcast for anyone who is at any point in their MD Journey, just starting out investigating becoming an MD or already in practice.  We can all learn a thing or two from each other.  Join us as we explore this tough but very rewarding journey together as we speak with students at Western Atlantic University School of Medicine, faculty and those in the industry.

Transcript

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This is vital. Sign a podcast about Western Atlantic University School of Medicine and the MD. Experience. No matter where you are or your empty journey. Just starting out or already in practice, there's something for you to learn. So let's do. Hi, and welcome to Vital Signs. My name is Anthony Lucausi, associate director of recruitment here at Western Atlantic University School of Medicine. And our guest today is Melanie Jessel. She is our director of counseling and wellness for WAUSM. Melanie is a licensed professional counselor and certified Professional counselor Counseling Supervisor. With over a decade of experience providing psychotherapy and nearly 20 years experience in the broader social services field. Melanie began her career as a foster care case manager in the greater Atlanta area. After receiving the Master of Science in Clinical Psychology from Baylor, she spent several years in safety net behavioral health agencies, providing services and later managing and supervising other providers serving the lowest income residents of urban, suburban, and rural Georgia. Thank you so much for joining us today, Melanie. Thank you very much for having me, Anthony. Welcome to my, office slash guest room. We're happy that you're here with us today because we have a great topic, to go over, which is, of course, a big topic to a lot of students, which is student wellness. But before we get to that topic, let me just ask you, just so far your experience with WAUSM, how has it been, helping our students, working with the faculty? Your experience on the island so far? Just kind of give some, some some, some feedback on your your time with WAUSM so far? Absolutely. So I work most closely with Doctor Shannon Evans, who is over student affairs on the pre clerkship side. And, I work with her since December of 2021. Well, we're recruiting a little bit even earlier than that. And so I've been able to be available to watch some students from the very first group of students that started with Map in 2021, remotely. And then I came on board full time in April of 22. And, I gotta tell you, my spouse and I had never even visited the Bahamas before we physically relocated and moved here. And, you know, it's just really, a beautiful place to live. And when we, came to campus for the first time, you know, just coming around that corner and seeing the beautiful building that we've got, obviously, you know, a school is so much more than its building or its facilities or stuff like that, but it really said a lot to me that so much effort had been and been put into, you know, building something, catered to education and to the students. And from the beginning, working with the students has been exciting and energizing. That whole time I was working in the safety net providers, I knew that sooner or later, I wanted to get into, higher ed counseling because being alongside mostly young people. But of course, we have a wonderful range of students. But being alongside people for this part of their lives where there's so much growth and excitement and challenge, it is energizing. And so, I have been able to have so many amazing conversations, both in a fully counseling capacity, but also just as being part of campus. And it's really moving, exciting, inspiring. Hearing all of the inspiration that our students have for, you know, becoming a physician, their why for their why they're doing this. And then, really feeling energized in my part of the, the, my job, my field of being able to see where I can contribute, see where I can, you know, kind of catch where they're coming from sometimes. Sometimes some something comes clear that I didn't understand it first. And we have a realization together sometimes I know a little bit where they're coming from because, you know, human experience in some ways is universal. And so I'm able to say, hey, are you feeling blah, blah, blah, blah, blah, and they're like, oh my gosh, yes, I am. And it gives me this cool opportunity to just be a part of, you know, removing some of the barriers, in some small ways between them and what they are excited to do, what they're moving toward. So it's it's really a fantastic job that I have. Well, the campus number one is lucky to have you because part of being a successful physician, as our students are going through the journey to become doctors, is to be in a very good, both physical state and also mental state. They want to have that that combination of wellness while they're going through, their studies, adjusting to a new, experience as a medical student. So the counseling that you're providing, I'm sure, is, is, is re-energized a lot of students, it's making them feel that they've made the right choice, especially with with WAUSM and how they are, you know, adjusting to the island and, and making student wellness as much as an important piece as their study. So thank you so much for for that. That's that's a great way to start off our discussion. So the, the, the main thing that we will focus on which of course, you know better than anybody is student wellness. Student wellness is a broad term that, we in, higher education use to mean lots and lots of different things, whether it be academics, whether it be, extracurriculars, adjusting to a new school, new environment. So being your this is your area of expertise. What is student wellness mean to you? This is a conversation I have with every incoming cohort, wellness, well-being. Kind of interchangeable terms. I ask them to imagine in small groups that you are starting your own medical school. You are the founders. What does student wellbeing or wellness mean to you? How do you define it? How do you measure it, and how do you try to foster it? And one of the things I, I, have ready to, to discuss is the acknowledgment that there is not a definition of wellness or wellbeing, that we can just hang our hat on from every single direction. It is, you know, you can take someone's temperature and that's comparatively objective. You can measure someone's height, but there is something, about wellness and well-being where we have to accept the lack of concreteness. So, in sort of like an interesting contrast to something you alluded to before. While we want to create an environment where our students have the opportunity to be at their most physically healthy and at their most emotionally and psychologically healthy, well-being is not something or wellness is not something that is only available to fully abled bodied people. Well-being and wellness is not something that is only available to people without mental illness. So we're looking at, wellness and well-being, being a multifaceted experience. And, a collection of qualities of your life that you can look out for that as an agency, as a, as an organization, we can try to use as a lens in our decision making so that we can try and foster it so that some of the very basics, like eating enough and sleeping enough and having people in your lives and, that sort of thing. What are we doing to make sure that is as achievable as possible and as valued as possible? Knowing how strenuous medical school is. So, a lot of our leadership has attempted to come from that sort of wellness lens. These students are whole people, not just, information processing robots. Right, right. That's that's a that's a key piece because a lot of times students and and we do it in our personal lives, we're focused so much on the task that we forget of all the other things that we have to deal with as humans, as people that, come at us. And one of the things that I would say to try to broaden this discussion and kind of drill down a little bit is what makes unique, for medical students, what what is unique for medical students, for student wellness, in the sense that, you know, there's obviously student wellness on a broader scale with students that are in high school undergrad. But then why do we focus so much on the uniqueness of a medical student, and what are some of the those qualities that you see that, that these medical students will face, when they, you know, begin their journey as a, as a to become a doctor. If you ask people that have had multiple kinds of educational experiences, they have done undergrad, they've done masters, maybe they've even done a PhD and they've done medical school. You will absolutely hear that medical school is its own beast. Amount of information that students are expected to be able to take and gain some level of mastery over, and, the fact that medical school is also a professional identity formation process where we are expecting them not just to know this, but to be this as well. It's just, I don't know quite what else asks this of you. You know, I would compare it to the military. Training piece of what people may go through with military. And so, we also have a very we have the weight of history when it comes to medical school. There is certainly evidence that the best way to find out mastery is not through multiple choice questions. And the current state of the profession is that's what we have. That is what has been used for all this time. And we have to deal with that reality, even if it's something that we would want to change in the future. So, what we are, trying to equip our medical students to do is to see how hard this is, know how hard this is, even make sacrifices in some places in order to be able to make it through this very difficult process and be able to see outside of it and beyond it, and at times, make decisions about where that time and effort is going to be limited. Because there's a there is a fundamental internal logic to the idea that the more minutes I study, the better I will do from the inside. That is unassailable logic, just profoundly simple and clear. So when you ask a student to say, well, let's look at it in a fuller context, what would happen if you studied 24 hours a day? Right. What would happen now then? Is it possible that studying 18 hours a day might also be a concern? What would happen if you studied for six hours straight with no breaks compared to if you studied? Maybe it's still six hours, you know, in a row, at least on some days. But it's with breaks. It's with. So we're we're asking our students to try and find some degree of balance while knowing that this is a relatively unbalanced, system and part of life. Right. Big ask. Yes. And I would imagine that the students and I love to point that you made earlier about identity because it's one thing to learn the material, but then you have to, in essence, be the material, because when you go out in the world and practice as a physician, you know, being a doctor, just like you said, with the military, it has, it has it carries a lot of weight. So that preparation to be that person is where the wellness and the making sure that the student doesn't burn out, of course, and try to make them be aware of that even though they are driven to be this doctor of, cardiology or psychiatry or whatever the case may be. Now, you touched on a great point, which was themes that you see when students come to you. So what are the what are the common themes that you're, that you're hearing when students come to you, especially students in the beginning? Because of course, it it could be a little bit of a shock in the beginning. But then as you treat and see students through the whole four years of, of medical school, what are those themes that you're seeing? Well, I think that one thing that's really, fantastic is that, as I mentioned before, we have a huge range of ages with our students. And, the average typical student these days is, you know, more or less Gen Z age or maybe younger millennial and, you know, when you or I, were the same age, the amount of conversations that we would have had with friends, with loved ones about depression, stress counseling, medication, things like that, it's pretty rare, pretty minimal, and of course, even less for a generation above and a generation above that Gen Z and, and and close to it. While they are incredibly diverse, like all groups, there is definitely much more, psychological mindedness, well-being, mental health mindedness. And so, I'm really grateful and proud of our, of our students when I say that, many of them come to me just to check up, just to say, I know this is a good thing to do. I know that, mental health is real bright and valid and important. And so maybe I'm not even struggling right now, but I want to be a little buzz word. Be proactive. And, start thinking about that now. And of course, I also hear from just so many students who are just talking about what we've been talking about, just so much so, so hard. And I'm happy to work with students on a very, like, problem solving side of things, which is sometimes really, something that can really be, something they can connect with. Well, because, broadly speaking, if you're in medical school, you have a history of high achievement and so high achieving people, hey, and be more comfortable with, like, that problem solving aspect, like, okay, you're doing so much studying and there's so much more to do, and it just feel like it's not going anywhere. Oh, what is it like when you say, you know what? How much is your mind able to be on the page or the video? And how much is your mind on your last grade, your next grade, what your, you know, loved ones may be thinking about you or something like that. Yeah. I think that the, the, the biggest, takeaway that I could get from, from that is the check ins. The check ins are vital because sometimes you don't really know what's going on with somebody. And the fact that the students are in this generation, generation Z, that we're talking about, they feel the need to kind of just be like, I don't really have anything going on. I just wanted to check in with you and, you know, let you know that I'm doing fine. And this is happening and that's happening. And that's a great way to be, because that way no walls are put up. There's no sense of the person not sharing and not really giving you an idea of how, how they really are as opposed to how they appear on the page. So that's a that's a great point that you made. I, I will would say that the, the, the themes that, that you described are pretty consistent with, you know, with what students are talking about and what they've experienced now as a counselor, what are the challenges that you're seeing when students are coming to you? And for example, there's some students that are just you. You have to maybe dig deep or you may have to try something else in trying to help the student. What what do you think the biggest challenges that you're facing are right now? That's a really interesting question. The the biggest challenges that I face as a counselor, I think that, being able to speak a language that is, obviously, you know, nuanced to the individual person, they are more than just a medical student. While also, really developing my ability to speak to them as a medical student. And not just like, you know, learning what step one is and things like that, because I'm coming from outside of medical education. I mean, really trying to learn more and more from the students, directly from colleagues and from just research, you know, what the lived experience is of medical students and what the tools I have already used in the past that will be most relevant, what tools the research says is going to be most helpful and most relevant. Excuse me. And how in a non manipulative way, to make it more likely to have buy in from students. And that's that last piece, is where especially the sort of research element comes in. So like when, when I am looking more about, you know, treatment recommendations or things like that, I'm really trying to find, as you know, when I can find something that it is demonstrated to be good for students, stress levels and mental health and overall well-being and is connected to academic performance. My my favorite article that I got recently is about how different fine, different factors of mindfulness. Like, the ability to be non-judgmental, the ability to experience without, you know, being instantly reactive, that those qualities are, in this, you know, research demonstrated not only to be associated with lower medical students stress, they're also associated with your medical student, exam performance. And right when I can kind of package the overall wellness with at least an academic cherry on top, then I feel like that maybe make it easier to get buy in but it's also just respectful to the students actual life. It is respectful to them. If I am trying to come at it from a while, maybe medical school isn't really that important after all. There may be some big picture truth to that. But it's not speaking to their current lived experience where with obviously with exceptions with variation, it is in many ways the most important thing period in their lives right now. And and the, the, the best way. I mean that that was a very great explanation of why students and the faculty and students and the administrators of team are partners, their partners in their care, their partners in their success, their partners in their and then sometimes their partners in their mistakes, where we can all learn from what we are doing in order to get through this together. So the fact that I always say training is, is great. You know, counseling is all of those things are great, but you have to connect those to what you're doing in your daily life. And in the case of the medical students, you have to connect those concepts and those themes with them being successful in both their personal and professional lives. So I think that's a great way to demonstrate that to the students. And that's why, of course, we're where we're being successful in that area. And some students are sort of ready for a little bit more of a radical perspective where, you know, we acknowledge, like I alluded to, the idea that we are still using multiple choice questions as, the measure of whether or not someone is ready to move on as a physician is now actually highly, you know, profoundly evidence based from my awareness. The psychology of learning, which is not my area of expertise. And so there are some students that, are going to, respond really well to hearing that. Well, from a certain point of view, yeah, a lot of what we're asking you to do is, frustrating is, confusing. There are still things that are going on, like I talked about, you know, the weight of history. There are still things even with a school that is trying to come from a fresh perspective from a while, but from a perspective of what what do we think will actually work for students instead of just the old way? It's still not possible to completely disconnect from some of the structural things that have historically marginalized some people and empowered others. And so there are some students that that, you know, may really get something refreshing from someone saying, wow, you know what? When you put it like that, that sounds really unfair. I really hate that that's happening. And then at a certain point in the conversation, we have to arrive at, so now what do we do? Which is probably going to involve some level of accepting what's true right now. So that I can deal with it. And working on change where I'm given the opportunity. But, you know, there's there's we don't necessarily just start with, acceptance of everything. Sometimes we have to also be like, oh, wow. Yeah. No, that sucks. Right. And and that's a great way to put it. Sometimes it just it just does. You know, there's no other there's no other term you really could use. So so that's I've been kind of sucks right. I mean and what I love is that, you know everybody understands that term. They understand it and they can apply it to whatever's going on in their lives at that moment. So, I, you alluded to earlier about tools that you're using to help the students. So, for example, you have your, you know, your your virtual tool belt here and you reach into your tool belt. What are the techniques that you're using to address some of the maybe the common themes that you see from students? Or maybe there's things that you you've used throughout your career that have worked and are universal, no matter if they're in medical school or not. Well, I would say that I'm primarily a cognitive therapist, and I use a lot of mindfulness based, concepts and interventions. And the cognitive perspective, says that, there is the stuff that happens. There's how I feel about it, and that is mediated by my attitude toward and my beliefs about the stuff that happened. So my cheesy example is always you glance at the clock and you see it's

almost 5: 27:12

00, and you either feel great because the workday is almost over and you're heading home, or maybe you feel angry

because you expected it to already be 5: 27:23

00 and it's not. Or you feel ashamed because the workday is almost over and you didn't get done as much as you wanted to get done. So a lot of our students, being so high achieving, have really, really high standards for themselves that can cross over from being, you know, challenging themselves and driving themselves. It can turn into, shaming themselves or punishing me throughout this, something like that. And so, one one thing that comes up a lot is just kind of figuring out, well, what were you thinking about yourself with regard to that? What were you saying to yourself and then, well, so what if it was one of your classmates? What if it was one of your loved ones? How would you talk to that person about this? And routinely, you know, all of us can do this where it's like, oh, I called myself, I'm blah blah, blah, blah, blah, blah, blah blah for doing this. And if my spouse, my friend, my whoever had done the exact same thing, there is no what I would have said that to them, right? I don't want to make people paranoid about their language and, I wonder if that is affecting you in some level, right? I also really like the idea of, as I alluded to before, with, wellness not being something that is exclusive to physically healthy people who are in a good emotional state. Wellness is, you know, grows and shrinks and has all these different aspects to it. There are many things in life that will not be solvable but may be visible. So, in very excellent grammar, of course. And so as future physicians, it's really nice to be able to talk with them about, okay. Well, so is your, struggle with, you know, anxiousness or your struggle with even a diagnosis, ADHD or something like that? If that's something that is going to hang around and we don't know, but if it is, if it's going to hang around, how would you, want for your relationship with that aspect of yourself to be? If you think about working in the future with patients who are living with chronic pain, chronic illness, or chronic mental health difficulties, and the medicine thus far is not at a point, seeking cure because there just aren't there's a lot of conditions that are managed. What would you want to be modeling for them? What would your goals be for them? How can we apply that back to our selves, to to yourself right now? Because there's a lot of things where like say, I have really bad self-esteem and I can see it's negatively impacting me and I'm trying to do all of this medical school stuff. You know, I have, some triggering history or something with that with, trauma in my past, this is probably, going to be a difficult time to make, like major progress or major change and things like that. It is not impossible by any stretch, and it may not be where I want to invest my time right now. So what would it look like if I lived with this as a chronic thing in my life? And tried to have as much meaning and wellness as I can at the same time, allowing them to not be mutually exclusive, but to be a little bit paradoxical, but true. Well, and the, the the the key maybe or the the the the what students may be searching for is adaptability because they have these, these issues and they have to be able to adapt knowing that they can like you said, they can still live with the these conditions, but they also can adapt to where they can maybe eliminate some stress in their lives. They can do things to counteract that feeling of, let's say, the low self-esteem or maybe social anxiety or whatever it is. And they can do those things through counseling and through using the services that you provide to help them get through. Because I think it's all about, you know, when you wake up every day, especially as a student, you wake up every day, you have goals set for yourself, but you also want to be able to get through the day mentally. You want to be able to have that sense of wellness as you go through the day, because a lot of things are going to come at you. And, and the fact that you're you, you and the department are focusing on those things is just it's fantastic. I'm so happy to hear that. That's a major part of what we, we help our students with. So, the last, topic that I wanted to talk to you about is, I know that WAUSM has done some specific events and has targeted to, to get students obviously knowing that mental wellness, the mental health and student wellness is, is, is a thing that while some can help them with, I know that you have, some, a program called Shrink the Stigma. Can you tell us a little bit about that? Yeah, absolutely. So next month will be our our third annual all, which helps to continue to make annual shrink the stigma. And as I said, lots of trying to find research about, not just what's good for people in general, but because of the relatively unique experience of medical school, what has been done to support medical students in general. And there was some research where at the end of a psychiatry unit in pre clerkship, in the first year or two of medical school, the instructors who had been teaching those students sat down for a panel discussion where the instructors said so back when I was in counseling and when I was diagnosed with depression and when I was and just talking about that. And then the students had the opportunity to discuss it. So for us, we we made it a campus wide, event. And that is currently our our pre clerkship campus, as opposed to incorporating clerkship campuses as well. But, we have 2 to 3 of our physician faculty members specifically who are willing to sit down in front of as many students, as many colleagues as want to show up. And I ask them about, so what was your understanding of like, mental health as you were growing up? Tell me about your experience of realizing you needed some sort of mental health help, whatever that looked like. What was that journey like for you? And then since then, you know, what would you like to share with us about, you know, your your mental health difficulties, your mental health, progress, things like that. Our students get the chance to ask questions, and then our students get the chance to have small group facilitated conversations with other colleagues or faculty where, we address things like the, the stigma in the medical field, which spills over into medical school against seeing a counselor taking a mental health medication, having a mental health diagnosis. And some of the legitimate fears that still exist in the field as far as what the impact would be if it were found out that I were mentally ill, you know, had depression, anxiety, even ADHD. Of course, we absolutely have, physicians with what we consider, you know, to classify as more serious, mental illness, schizophrenia, bipolar. These things can be managed and lived with, live with at all. And and yet there's still there is some risk to living authentically with those difficulties. But again, kind of from the outside, all I can do is research what I have learned. What I have read is that the actual likelihood of damage to your career is much, much, much less than that. That weight of history, fear and because I value autonomy greatly, I'm always going to acknowledge, even if the realistic risk to your career is this big, if that's what you choose, that is a risk you don't choose to take. You're a grown person. And let's hear from these physicians who say, hey, not only did I take that risk for myself, I'm broadcasting the fact that I took that risk. I'm letting you ask me questions about it. And it's been a really great we've had incredible conversations out of it. I'm incredibly grateful to to all the physicians who've stepped up that way. And, we do it not on the day, but around the same time as National Physician Suicide Awareness Day, because all of this stigma and a lot of other things do actually make, you know, medical students as well as physicians. In some ways differentially or uniquely at risk of dying by suicide. It doesn't help anyone for us to be so cautious and polite that suicide becomes a dirty word. So we'll try to do quite the opposite. We're trying to make it so, valid and real and genuine to talk about depression, mental illness, counseling, medication, suicide, that maybe, you know me and you are talking about it, and by us talking about it in an open, respectful, non shamed, not ashamed way, someone over here hears it. Someone hears it. And not only is it good for us to yourself say that, but maybe it's good for someone that we didn't even know was listening. Well, the fact that the school is taking that step to make sure that that that stigma. A lot of people think doctors are invincible and they're not. They're they're people just like we are. And they have their issues, whether it be, you know, physical issues, mental issues, family issues, whatever it is. And the fact that we can talk about that in an open forum is a great dynamic way that the students can learn while in medical school that these things are not a hinderance. They're actually a way that we can all kind of work together to support each other, because once they get their network of people around them that way, that they'll they'll be able to to make it through, as opposed to thinking that they're the only one who has experience in which, of course, as you know, is not the case. A lot of people have very similar, things that are going on with them, and it's very relatable. So with that, a little bit with that radical perspective or totally people that think that you can't or shouldn't be a physician if you've ever seen, a counselor or if you take medication for ADHD, or if you are overweight or if you are, or anything like that. Absolutely. There are people who believe that and and that that sucks. And we'll try to keep, you know, finding the places where we can influence that. And does the fact that some people still think that way mean we agree with them? We'll probably not. And that's, that's a battle. You know, it's, it's we may not have won the war, but we've won a battle or two by getting rid of those stigmas and making it be okay that all of those things are happening because they do happen. It's not a you know, we're not operating in a vacuum, as they say. And I think the phrase of the day is that sucks. So that's good. That's a great way to end the podcast, with a with a comic note. But Melanie, thank you so much for your time today. Very, very informative. I hope that everybody got, a sense of what student wellness is and how you're helping our students every day. And, thank you so much for your time today. Really appreciate it. Thank you very much. I enjoyed it greatly. Nice talking with you. you too. So for everyone out there who would like to, apply to us, where we would love to have you, you can email us at Admissions at Awesome Education or visit our website at blossom Dot education. We have three starts, January, May and September, and we're currently accepting applications for the January term. And we would love to, have you begin your journey with us and, join us again for another episode of Vital Signs. Have a great day, everybody. Thank you.