Wellness warriors

Research shows that medical students experience higher rates of anxiety and depression than their non-medical peers. And according to a 2020 study, medical students are less likely to seek mental health care due to stigma, the pressures of medical training and fear of compromising their career progression.  

Student leaders Bob Jones and Rhea Sharma have spent the past four years helping the Class of 2023 destigmatize the need for mental health care and support. They arrived at VCU School of Medicine in the fall of 2019 with different backgrounds but parallel passions for wellness, and their classmates have elected them as peer advocates every year since.  

According to Nicole Deiorio, M.D., associate dean for student affairs, the role has evolved from its original scope of boosting class morale. She said peer advocates have always sought ways to support their classmates, but Jones and Sharma have been proactive in looking out for students who may need mental health support, with an eye toward initiatives that have longitudinal value. 

“It’s important that we have peers promoting positivity and a sense of community, but also being on the alert for times when people aren’t well,” Deiorio said. “As faculty, we might not be aware of what resonates best with students, nor may struggling students feel comfortable asking for help from the Office of Medical Education or deans. Rhea and Bob fill this important gap.”

Expanding the scope of wellness 

One of their first initiatives in the role was to survey their classmates’ stress levels and coping mechanisms to “spark conversations and decrease stigma surrounding common issues we face,” according to Sharma. The survey revealed that during the first semester of medical school, 76% of the class experienced self-doubt, 70% dealt with anxiety and 54% felt lonely.   

“I think it comes from this pressure we have to do so well. VCU does a great job at minimizing the competition and maximizing cooperation, but ultimately in the end, you are compared to your peers,” Jones said.  

He noted that for those who were drawn to medicine by a desire to help people, the first year and a half of medical school can be "exhausting, and honestly, not that rewarding,” especially if study skills don’t come naturally.   

After a particularly challenging physiology exam — one of the first major medical school milestones — pushed many students out of their comfort zones, Jones and Sharma partnered with the Division for Academic Success to facilitate a series of study skills workshops. Attendees shared their strengths and weaknesses as students and discussed how to capitalize on those strengths throughout medical school.  

“As peer advocates, we really tried to expand the scope of wellness,” Jones said. “If in medical school the only measure of your success is academics, and you’re not doing well academically, your well-being and mental health are likely to be impacted.” 

Other initiatives Jones and Sharma introduced to their classmates include: weekly meditation and breathing exercise sessions called Mindfulness Mondays; regular office hours where they met with peers seeking one-on-one support; compiling resources for students to access if they’re in crisis; hosting a virtual hope and resiliency panel; and working with the Medical Student Government to create a yearbook full of memories and class superlatives. They also collaborated with fellow M4 Gerald Coronado to implement an idea they called the Sending Kindness Project, which involved gathering positive and encouraging personal notes about individual students from their classmates and distributing the messages right before taking Step 1 of the USMLE.   

“It’s been really rewarding, working with Bob to come up with creative solutions for challenges our classmates are facing,” Sharma said. “And being in that space has helped remind me why it’s important. If I'm going to tell you that you need to prioritize your mental health and wellness, then I should be doing those things for myself.”

Drawing from experience

Both Jones and Sharma know first-hand the impact that a strong support system can have.  

Affectionately known amongst her classmates as the wellness queen, Sharma describes herself as “somebody who has always reached out for support” when she needs it. As both a peer advocate and chair of the Medical Student Government’s wellness committee, she strives to normalize seeking help.  

About a year into medical school, she faced her toughest mental health challenge yet: grief. Her older brother was a happy-go-lucky world traveler who loved sports, had an “infectious personality” and was the type of person who made friends out of strangers on airplanes. His sudden death turned her world inside out.  

"I learned a lot about self-care and coping through grief, and it was a time when I had to really practice what I was preaching and prioritize taking care of myself,” Sharma said. “When you feel that moment of grief wash over you, how do you take a step back and advocate for yourself?”   

For Sharma, advocating for herself meant spending part of the semester in Northern Virginia with her family. Classes were online due to COVID-19 restrictions at the time, which allowed her to spend time at home while keeping up with her coursework. It also meant reassessing her commitments in order to prioritize her personal and academic needs.  

“Unfortunately, with medical school, if you need to take a couple months off, it’s really hard. It feels like you can either take a whole year or no time,” she said. “But having a close, inner circle of friends supporting me from afar helped me continue my education without a gap. Honestly, it’s what I wanted, and what my brother would have wanted for me.”  

When Sharma needed a temporary break from her duties as a peer advocate, Jones didn’t hesitate to step up. He had previously taken a leave of absence, deferring his start to medical school by a year after a series of disruptive events in his personal life. The culmination of his mother’s cancer diagnosis, a career change, a traumatic break-up and a reckoning with his sexuality led him to what he described as rock bottom.  

“Some things in my life all of a sudden kind of fell beneath me, and the stability I’d had was no longer there when I first started medical school,” he said. “I’m so grateful that the Office of Medical Education gave me the opportunity to figure out my stuff and get my stability back.”  

That time off was what sparked his interest in wellness, and he has openly shared the experience with his classmates since the day he first ran for the peer advocate position. Jones said he initially wasn’t sure what to expect in the role, but advocating for the Class of 2023 alongside Sharma has given him an additional sense of purpose during medical school.  

“Even in times when I’m feeling discouraged, knowing that I can give back helps me keep going,” Jones said.