Caring for Medical Students The NUS Yong Loo Lin School of Medicine Experience

Marie-Véronique Clément, phD

Associate Professor, Department of Biochemistry

Assistant Dean Education (Student Affairs)

NUS graduate school for integrative science and engineering

Yong Loo Lin School of Medicine

National University of Singapore TMEC 13th Nov 2019

Dr Lau Tang Ching

Group Director, NUHS Group Education Office

Vice Dean (Education), Yong Loo Lin School of Medicine, NUS

2

About the Yong Loo Lin School of Medicine

114 years of history and the only medical school in Singapore for 100 years

Established to train doctors for the local community

Has played an essential role to establish the local healthcare system and train many of Singapore’s healthcare leaders

About Our Students

The largest medical school in Singapore, with a cohort size of approximately 300

Includes nursing students, with student intake increasing from 49 in 2006 to a max of 235 in 2018

Teaching by our medical science cluster faculty extends to life science students

5

Education

Research

Administration Academic Affairs

Finance

300 students/cohort 5 years program = 1,500 students

NUS Medicine Dean’s Office

NUSMed DEAN

Vice Dean Undergraduate Education + team of Assistant Dean (4)

Yong Loo Lin School of Medicine

NUSMed Education team

6

Vice dean undergraduate

Education

Curriculum

Student

Affairs

Education

Technology

Centre for

Healthcare

Simulation

Educator

Relations

Education

Admin & QA Admissions

Assistant Dean, Undergraduate education (student Affairs)

The SA team is part of the Education team under the Vice-dean of Undergraduate Education

Yong Loo Lin School of Medicine

Student Support

Chong Siew Ling

Janice Ho

Syazwani Binte Abu Hussain

Dr Darren Chua-Career

Advisor

Luke SEAH

Student Life

Fanny Ng

Janie Tan

Zenn Goh

Eric Au Yong

Nazira Banu

Assistant Dean A/P Marie Clement

A dedicated and well resourced Student Affairs team

Yong Loo Lin School of Medicine

Wow! Learning Experience for our students To provide the best possible learning experience for students

To create a nurturing environment for students to excel

To foster character building and leadership development so as to produce all-rounded doctors

Create vibrancy in student life

The Vision, Mission of SA in NUS Medicine

Nurturing doctors of the future

NUSMed Student Affairs

The Two Pillars of Student Affairs

Nurturing & Vibrant

Environment

Student Support/care

Unit

• Academic Support

• Student Well-being

• OHC Secretariat

• Graduate Support Services

• Career Services

Student Life

Unit

• Advisement on student activities/ events

• Signature Events

• Student Leadership

• Houses

Student Life Unit

Student Life Unit

Advisement on student activities/events

- Medical Society

- Overseas Community

Involvement Projects

- Adhoc activities

Houses

- 10 houses

- 150 students/house

- 50 mentors

Student Excellence

- Award Appreciation Nite

- Nominations

- Testimonial

Signature Events

- Commencement

- White Coat Ceremony

- Keynote Address

Student Support/care Unit

Student Support

/care Unit

Academic Support

- Follow up of academically weak students

- Member of Phase Committee

- Member of Board of Examiners

- Registrar for NUS Med (UG)

OHC Secretariat

- Oversee functions of Occupational Health Clinic

- Vaccination and screening requirements for students

- Needle Stick/Splash injuries

- Exposure to infectious diseases

Career Services

- Career talks

- Career advisement

Student Well-being

- Student Care

- Leave Applications

- Financial/Conference Support

- Exam Welfare

- Training & Workshop

Graduate Support Services

- USMLE

- MSPE

- Verification of Post Grad training applications

Yong Loo Lin School of Medicine

Academic Support Committee and

Community

Active Student Life

Student Well-being/develop an awareness of the

importance of self-care

Our signature approach: An holistic Student-Care Programme

WE CARE! Your friendly introduction to

STUDENT AFFAIRS

Yearly briefing for all level of study

We Listen

I’m having trouble adjusting to life in medical school

Career guidance?

There are so many things to study. My head is going to explode

I’m having issues with my family. I don’t even want to go home

TALK TO US

Medical school is so expensive. I need to work part time to pay off the fees

I feel so alone sometimes

Yong Loo Lin School of Medicine

Confidential discussion :

If you have problem to cope with your studies, you need guidance being academic or otherwise or you just need a shoulder to cry on…

Talk to us we will listen and you may be surprised!! We may be

able to help. Contact us:

•Email: medstudentaffairs@nuhs.edu.sg •DID: 6772 3750/3770 (office hours/temporary) •For emergency situations, please call: 8328 0340 / 9455 4369 •For life threatening psychological emergencies, please call 24hr LifeLine NUS hotline : 6516 7777

Yong Loo Lin School of Medicine

Students Support Over 50 students supported for academic and other reasons (AY2014/15):

• 21 students with academic issues

• 10 students with medical issues

• 11 students with relationship/Clinical Group issues

• 12 students with other issues personal or school related issues

Processed by Student Care (AY2014/15): - 426 leave applications - 19 NSI/BS - 3 LOA applications (1 full AY) - 5 withdrawal/exit cases - 1 discipline related investigation(COI) - Some warning letters and discipline

related counseling…

Yong Loo Lin School of Medicine

134 140

119

NUS 26 weeks instruction- 5 students/week

In average for the past 3 years SA has met 10% of the students from year 1 to year 5

NEW DATA – we have increased the meeting with students by 3 X since 2014/2014 This is due to our pro-active/intrusive approach to student support (We do not wait for students to request for our help) and more awareness in the student population of what SA can do for them.

Yong Loo Lin School of Medicine

Academic Support Committee and

Community

Active Student Life

Student Well-being/develop an awareness of the

importance of self-care

Our signature approach: An holistic Student-Care Program

ACADEMIC SUPPORT COMMITTEE AND COMMUNITY

STUDENT

Academic Support Committee:

• Assistant Dean, Student

Affairs (Chair)

• Chair of Faculty Assessment

Committee (Member),

• Chair of Electives Committee

(Member)

• Secretariat: SA

• Co-secretariat: Curriculum

Role: To review, moderate and

decide on remediation plan for

academically weak clinical students.

This forms the core of the

Academic Support Committee

ACADEMIC SUPPORT COMMITTEE

Phase Committee:

• Phase I

• Phase II

• Phase III

• Phase IV

• Phase V

• Secretariat: Phase

admin leads

Role: To provide support for student where

relevant. Assistant Dean, Student Affairs

will be the liaison between Phase

Committee and Academic Support

Committee. This is part of the Academic

Support Community

ACADEMIC SUPPORT COMMUNITY • Assistant Dean student affair

attends all Board of examiners

and is involved in student academic

performance discussions

House Mentors

Role: To provide support for

student where relevant. Asst

Dean, Student Affairs will be

the liaison between House

Mentors and Academic Support

Committee. This is part of the

Academic Support Community.

ACADEMIC SUPPORT COMMUNITY

Role: The Academic Support

Committee and Community will

support students through

coordinated efforts between

the academic assessment

structure and the Houses system.

The larger community involved in

the support of students e.g. UHC,

CPS, hospital Eds & tutors, NUH

Psy Med will also form the

Academic Support Community.

ACADEMIC SUPPORT COMMUNITY

NUS

Office of student affairs

provost of student life

Dean of students

Faculty/School

Students Conduct Unit Unit- (manages the Board of discipline)

University counselling center University health center

new frame work 2017 students emotional well-being

each faculty/School in NUS has a Student conduct liaison

each faculty has a Vice Dean/Assitant Dean of students

Each faculty/School in NUS As at least 1 student support manager and 1 student advisor

NUS level Student Support Services (S³) unit

The unit was set up in August 2017 as part of the University’s strategy to enhance student wellness and mental health support services in NUS. S3 seeks to:

(i) Provide pre-professional support to students to complement Counselling & Psychological Service (CPS) efforts.

(ii) Mitigate students’ stigma associated with mental illness and promote a strong culture of self-care and community care on campus, through activities and programmes.

(iii) Serve as a physical hub for students to interact with S3 staff and Peer Student Supporters.

25

How S3 can support?

• Outreach efforts to promote wellness to students/residents

• Befrienders initiatives

• Work with CPS/University Health Centre/Student Support Managers (SSMs)/Residential Colleges (RCs)/Halls to provide support to students, particularly for cases that came through S3

• Capacity building of SSMs, Residential Staff and student leaders

• Networking cum Sharing Sessions with SSMs/RCs/Halls/CPS

The YLLSoM Experience

It is a multi-agency, multi-modality effort

27

Faculty Led Student Led

A well-resourced Student affair team.

Personalized emotional and academic support

Medical Society Seniors’ teaching & mentoring Intra-batch support systems

Outcomes

• Increase the trust between students and school (more students are asking for help before it becomes too late

1. Purpose and existence of Student Affairs (SA) Office

• Students did not know the purpose of SA Office and/or did not know the existence of SA Office; they resolved issues or start projects on their own and did not know how they can get help/support

• Our solution

Increased visibility/presence of SA staff by being more frequently present at student events

SA structure and roles of staff are shared with students during FOC Welcome session and Start of AY briefings

Constant reminders on SA’s support during interaction with students

28

Past Challenges

Coverage of the yearly briefing for every level of study

The Two Pillars of Student Affairs

We Listen / We can help you

Financial Aid

Conference Support

Leave Application

Special Consideration

Incident & Accident Reporting

BBD & Immunization status

Non-Curricular Clinical Attachment

Code of Conduct

Plagiarism

Unprofessional Conduct

Unauthorized Access & Breach of Patient Confidentiality

Misuse of Social Media

Security Matters

NUS Email

Student & Education Service Centre

30

Current / On-going Challenges

Student support

1. Many students are still not coming forth to seek help (stigma and lack of trust that the school will help)

2. Difficulties in getting students to be student peer supporters

Student life

4. Maximizing House Mentors’ potential to support students

5. Make all our student organizations work together

Thank You

33

A – Alpha type B – Bothered C – Conflicted D – Drowning

Back-ground Ambitious high-

achiever The idealist

Forms clinical group with buddies

‘A’ student used to ‘old’ study strategies

Develop-ment Strives hard for

competitive residency

Disillusioned by reality, feels helpless.

Worn down by conflicts within clinical group.

Overwhelmed by ‘new’ clinical life, harsh tutors & poor results

Manifest-ation

Anxious, unethical or unprofessional behaviour

Loses interest, empathy & motivation.

Either withdrawal, or antagonistic response

Vicious cycle of low confidence - ineffective study - poor outcome

BURNOUT 1. Not all burnout is equal

2. Rarely clear phenotypes; often overlapping causes & manifestations

Beyond The Four Phenotypes

34

The burnout you see

Help all students cope better • Look at common precipitating &

perpetuating factors • Faculty messaging – careful • Pastoral care & mentorship • Student community is key

#3: It’s not just ‘troubleshooting’ burnout ‘problem students’

How to mitigate a hospital environment outside the school’s control?? • Efforts against burnout not limited to students • Can vaccinate students pre-emptively • Supplementary mentorship & support structures