‘We’ve got to fix it’: Transforming curriculum and culture to help address veterinary mental health

Be Well focuses on nine dimensions of wellness: physical, emotional, financial, spiritual, social, career, intellectual, creative and environmental. A 10th dimension, focusing on digital wellness, is being added.

Tim Kolb, DVM, who graduated from the college in 1982 and has financially supported wellness initiatives, recalls the suicide and says the new efforts give him hope for sustained culture change.

“It really did shock people,” Dr. Kolb says. “That student did not lose his life in vain. I’m thrilled with the college’s commitment, courage and vision to shift the narrative. The ‘10 dimensions’ approach will only serve to help students in their careers, as will the emphasis on empowering them to seek help when they need it.”

The David J. Hilton Endowed Memorial Scholarship was established and funded in memory of the student, D.J. Hilton, who was a member of the class of 2018. This scholarship is given to a second-year veterinary student who displays a passion for helping others, specifically in health and wellness.

Evidence-based and mandatory wellness initiatives

Critical to the success of the College of Veterinary Medicine’s Be Well initiatives is that they are anchored in evidence-based outcomes, meaning they’ve been proven to work through research. MINDSTRONG, for example, teaches cognitive behavior skills and has been proven to build resilience and coping skills among different populations, Dr. Moore says. Data demonstrated a significant improvement in depression and anxiety among first-year students who completed the course, which led to efforts being expanded to interns and residents as well as faculty and staff.

Students attend 45-minute sessions each week for seven weeks, says Brenda Buffington, EdD, a Buckeye Wellness program manager embedded in the College of Veterinary Medicine.

“We care about our college community so much, and we care equally about the veterinary profession. We want to fix what hasn’t been working,” Dr. Buffington says. “We’re seeing some great outcomes through the implementation of these initiatives and are serious about making strides toward meaningful impact and change.”

Normalizing mental health care

Also critical are mandatory requirements of each student’s education, especially wellness check-ins, scheduled at stress points, before first-year students face their initial exams and when fourth-year students move from the classroom into hospital-based clinical rotations.

“We wanted to take away the stigma about counselors and make them part of the fabric of the school,” says Emma Read, DVM, MVSc, DACVS, associate dean for professional programs. “It’s taken a lot of the fear away because it’s normalized the fact that most everyone goes and visits with the counselor at some point and it’s part of the way that we operate. It’s something we encourage them all to take advantage of throughout their training.”

Addressing well-being through diversity and inclusion

Well-being initiatives must take into account the entire individual, and diversity, equity, inclusion and belonging have been part of the foundational principles in the College of Veterinary Medicine’s strategic plan for the past several years, says Mary Jo Burkhard, DVM, PhD, DACVP, associate dean for faculty success and planning.

“There’s more impact on health and well-being for those who are in cultures or come from demographics that are less well-represented, and sometimes even marginalized, even in our academic community,” Dr. Burkhard says.

Faculty and staff members in underrepresented groups have the responsibility of their positions, but also may be over-tapped to represent those groups on various committees.

“They then get the subtle, and sometimes not-so-subtle, microaggressions and biases, and are also impacted by the things that are happening in the community and society at large,” Dr. Burkhard explains.

She says the college addresses internal situations and comments of concern head-on publicly and acknowledges events that happen externally within our society with statements and actions, such as healing forums.

The college also supports affinity groups largely driven by students and supported by faculty, staff and administration, that provide a space for community, networking and mentoring. Examples include the Dr. J.H. Bias Black Affinity Group, a PRIDE group, a women’s group, a parents’ group, and groups for those who are Latinx, Asian and Native American.

Changing culture through curriculum

Stressors that impact a lifelong career often begin before a student ever steps through the doors of colleges of veterinary medicine. At Ohio State, more than 2,600 students apply for the 165 open positions each year, Dr. Read says. Students may have been focused and competitive for a long period of time, with few social outlets. A first step is encouraging them to view each other as colleagues and friends, rather than competitors.

At the Ohio State College of Veterinary Medicine, a new curriculum implemented at the start of the 2022-23 school year includes a pass-fail system with no letter grades, and Dr. Read says it appears it’s already encouraging students to come out of their silos and study together in group sessions.

Faculty sharing observations about experiences with the new first-year curriculum have noted that students appear more relaxed, happier and healthier, adding that compared with previous years, students seem less rundown and have asked more clinical questions, demonstrating more critical thinking.

To help prevent sending students into unsustainable practice models, Dr. Read says, a goal of the curriculum is to further prepare them not just for medicine and surgery, but also for effectively running a business, collaborating and communicating.

“How do you graduate competent, confident and resilient, as well as find a way to really connect with the clients that you’re serving, really enjoy your career, and continually renew your passion and interest for the rest of your practice life?” Dr. Read says.

“The well-being implications are huge, and we’re just starting to make inroads in how we educate and prepare veterinarians and how we teach them to work together and to take care of themselves along the way. We’re trying to change the future of veterinary practice.”

Easing the financial burden

On top of difficult working conditions, students of veterinary medicine graduate with an extremely large debt load, one that most struggle to pay with the salaries earned in the profession. For every $1 they borrow, they will pay back $2 to $2.50 over the course of the loans.

“Students tell us financial issues are their top stressor, so the more we can prevent their tuition from going up by providing scholarship support and folding in personal financial management strategies as part of the formal curriculum, the better,” Dr. Read says.

Dr. Moore has committed to not raising tuition more than 2% per year over the past eight years to hold students’ costs down. Additionally, during the same time period, the college has prioritized fundraising efforts for scholarships and has increased philanthropic scholarships by 730%, from $370,000 to nearly $3.1 million for the upcoming academic year.

However, the modest increases in tuition don’t cover the mandatory increases in faculty and staff compensation and inflation. This financial model isn’t sustainable without additional support from the state for its only college of veterinary medicine.

The goal is to distribute at least $5.8 million per year in philanthropic scholarships, which would enable the college to provide each student, over four years, the equivalent of one year of free in-state tuition.

Healing a profession facing a mental health crisis

Due to the demands and stressors that come with the career, mental health crises are not uncommon in the veterinary profession. Federal data published in 2019 in the Journal of the American Veterinary Medical Association showed that female veterinarians were 3.5 times as likely and male veterinarians were 2.1 times as likely to die by suicide compared with the general population.

With 36 years of recovery from substance use disorder, Dr. Kolb has worked at the state and national levels to help the industry make strides to ensure professionals with mental health struggles find support early on, instead of potentially losing their licenses.

He’s interacted with many veterinarians in support groups, even more so during the COVID-19 pandemic. While many recover and thrive, it’s given him an opportunity to experience firsthand how much veterinarians are struggling, some with mental health issues, some with burnout.

With the pandemic leading to early retirements at a time when demand for animal care was increasing, the top priority at the College of Veterinary Medicine for faculty and staff well-being remains to address retention and burnout through career development and other efforts, including embedding a well-being coordinator from the university’s employee assistance program.

Dr. Kolb, who serves on the college’s admissions committee, says he’d like students who have had lifelong dreams of becoming veterinarians to be able to hold onto some of their idealism and encourages them to ask for support when they need it.

“It just pains me that people at times become so disenchanted with the profession, or their experiences within the profession,” he says.

“Being a medical professional in any way is a difficult path, and yet the rewards of it are immeasurable.”

The College of Veterinary Medicine has been a national leader on well-being initiatives for years, including organizing and hosting the first two veterinary wellness summits in 2012 and 2013, which later became the American Association of Veterinary Medical Colleges (AAVMC) Wellness Summits.

Dr. Moore says the involvement has served to further help the college address issues through ongoing reflection that ultimately enables the community to pivot and identify areas that need improvement.

“In order to truly ignite change surrounding the longstanding mental health issues that have plagued the veterinary profession, we must push ourselves to do better and be better,” he says. “If we’re not continually aspiring to Be The Model, we’re not pushing ourselves enough to change the landscape of veterinary medicine. We will be steadfast in our commitment and dedication to ensuring the health and well-being of our college community and beyond.”