The joy initiative
just what the doctor ordered

Jessica Neuroth was feeling overwhelmed. As a first-year student in MSU’s College of Osteopathic Medicine, she was finding that balancing an extremely demanding course of study and family issues was more stressful than anticipated.

“I had quite a few coping mechanisms in place already,” she says, “but I needed a few ideas on how to ramp them up to meet the demands I was facing.”

Neuroth found the support she needed through the Joy Initiative, an MSU College of Osteopathic Medicine (COM) program designed to help medical students envision and incorporate happiness into their lives.

The brainchild of MSU psychiatry resident Miko Rose, the initiative focuses on emotional resilience training and the development of mindfulness, employing a variety of tools, including group discussions and meditation, to help medical students not only cope, but also thrive.

Rose first identified the importance of providing opportunities for community to help people under stress before she began medical school while working with battered women and others in need of basic services in Boston and San Francisco.

“I had a pretty challenging childhood and I found that things like psychotherapy were not enough for me,” she says. “And it wasn’t typically enough for the folks I saw as clients when I worked in shelters with people who were running from incredibly dangerous or abusive situations.”

Managing side effects of med school

The stress of medical school can be unnerving. Often compared to drinking from a fire hose, there are volumes of books to read and facts and data to retain, plus grueling hours and a hypercompetitive environment—all in the context of preparing to make, literally, life-or-death decisions.

Add to that the stress of everyday life, and it’s easy to see how some medical students can feel pushed to the brink.

“There is pressure to succeed. There are economic issues,” says Celia Guro, director of personal counseling and health promotion in MSU’s College of Osteopathic Medicine. “This might be the first time some of these students are not at the very top of their class and they may have some self-doubts.”

According to recent surveys and polls, physicians and physicians-in-training often are not a happy bunch of people.

In fact, according to U.S. News & World Report, as many as 50 percent of medical students suffer burnout, a problem that can sometimes carry into their postgraduate practices.

Burnout can have nasty effects not only on students and physicians, but also on the compassion they feel for patients and the effectiveness of care they provide.

Even more concerning is that, according to some Pew research, as many as 11 percent of doctors will have suicidal thoughts in their lifetimes.

“We know that physicians have a much higher suicide risk than the general population,” says Alyse Ley, Department of Psychiatry residency director who oversees the Joy Initiative.

Finding a happy place

Aimed at making a positive impact on those negative numbers, the Joy Initiative began in earnest in February 2012 as a 10-week pilot course for COM students. Resident physicians Dan Cote and Zach Gleeson assisted Rose with the program, which included sessions on happiness, mindfulness, meditation and cognitive behavioral therapy.

Medical student Neuroth says the program helped her to “be here now.”

“It helped me live in the moment more often, rather than letting myself get worked up about things that haven’t even occurred yet,” she says. “Being in a study-intensive program, it’s easy to forget that there is a great big and wide outdoors, with fresh air, green grass, blue skies and mirror lakes.”

Other participants felt the same way. At the end of the 10-week course all the students reported they were happier and had decreased levels of anxiety.

“We received a lot of qualitative data showing that these students felt they had a touchstone, they had people they could go to,” Ley says. “And they had tools you normally wouldn’t get in any kind of professional school program.

“They were given real skills and tools they can use with their patients and for themselves when they need them.”

As the Joy Initiative pilot program was winding down in May 2012, Rose got some good news: she was awarded the American Psychiatric Association’s Substance Abuse and Mental Health Services Administration Minority Leadership Fellowship, which enabled her to receive training and a grant to focus on minority mental health.

The timing couldn’t have been better. Rose had begun to hear reports that minority students in particular were feeling the stress and anxiety of med school.

“There was nothing out there in terms of happiness classes geared toward medical students, let alone minority medical students,” she says.

So rather than using the grant for another 10-week course, it was used to fund what Rose calls “focus group dinners” for minority medical students, using the same principles of resiliency training that were used in the original Joy Initiative.

All MSU medical students were invited to the dinners, and College of Osteopathic Medicine Dean William Strampel and other college administrators and faculty were among the first to attend.

Rose recalls her approach to the first dinner.

“One of the first things I said when everyone sat down was, ‘Let’s just pretend we’re all sitting around a campfire. Whether you’re sitting next to Dean Strampel or your best friend or a classmate, let’s all just tell our stories and talk at the same level. We’re here to listen to you,’” she says. “We were honored that the dean and others were listening to the students’ concerns. The power of their stories created both communication and community that day.”

As a result of their success, the dinners have been incorporated into the college’s regular schedule of events. Held on a monthly basis, they often include a guest speaker.

For example, on October 14 William Anderson, COM clinical professor, past president of the American Osteopathic Association, and a nationally known leader of the civil rights movement, discussed his experiences as a minority medical student. And on November 4, Lansing-area physician Farha Abbassi is scheduled to speak about the challenges she faced as a female Muslim physician immigrating to the United States.

The success of the dinners also inspired the introduction of a minority medical student breakfast that is now part of the college’s orientation session.

“Students pointed out that they got to orientation and found there were very few minorities,” Rose says. “They felt alone and alienated. The breakfast helps ease that anxiety.”

Additional positive responses to the initiative include the development of a sensitivity training program, the appointment of an officer of Outreach and Inclusion, and agreement by the COM Office of Student Services to cover the costs of running the events.

Staying strong, embracing joy

Rose, who says she gets much of her own strength from her mother, who, at age 12, survived the atomic bomb dropping on Hiroshima, knows first-hand the importance of emotional resilience.

“I come from a long line of women who have had this emotional resilience,” she says. “My mom had teachings from her mother. There are so many aspects of Japanese culture that focus on emotional resilience and staying strong.

“The idea of embracing joy in psychiatry, much less in working with a medical school, is something I believe is unique to MSU,” she says. “I came to this department because there’s a focus on looking at the whole patient as a person. There’s also an openness and support here that, if you have an idea and want to do something, folks are open to it.”

Many, including Jessica Neuroth, are grateful for the results of that openness and support.

“The Joy Initiative made a profound impact on my life and assisted with my success during the first two years of medical school,” says Neuroth. “I am in my third year, and it is helping even now.”

Story by Tom Oswald - Design by Deon Foster