Wellbeing vs competency? Debunking the false dichotomy in medical education

Area of Science:

• Medical Education
• Physician Wellbeing
• Healthcare Professional Development

Background:

• Medical learners exhibit lower wellbeing compared to the general population.
• Medical learner wellbeing has gained prominence, driving improvements in training environments.
• A debate exists on whether wellbeing initiatives impact medical competency development.

Purpose of the Study:

• To challenge the notion that wellbeing and competency are mutually exclusive in medical education.
• To argue that a historical culture of "toughness" in medicine creates a false dichotomy between wellbeing and competence.
• To propose actionable strategies for integrating wellbeing into medical training to enhance both personal health and professional development.

Main Methods:

• Literature review and synthesis of existing research on medical learner wellbeing and competency.
• Analysis of the historical cultural factors influencing medical training environments.
• Development of a framework for actionable steps to support learner wellbeing and professional growth.

Main Results:

• Evidence indicates that enhanced learner wellbeing positively correlates with increased competency and patient safety.
• The traditional "toughness" culture in medicine blurs the line between productive stress and harm, creating a detrimental hidden curriculum.
• Wellbeing initiatives, when properly integrated, do not detract from but rather support the development of medical competence.

Conclusions:

• The perceived conflict between wellbeing and competency in medical training is a false dichotomy.
• Supporting learner wellbeing is essential for fostering competence, resilience, and compassion in physicians.
• A cultural shift is needed in medical education to embed wellbeing into systems and policies, recognizing it as foundational to professional excellence.