Many medical schools today offer wellness programs that aim to strengthen the ability to cope with the demands of curricula through techniques such as mindfulness. However, although these efforts are well-intentioned, they have yet to completely resolve the issues of isolation. It is critical for students and faculty to explore innovative methods to tackle feelings of isolation, such as through the use of improvisational and comedic theater. Here, we suggest that more schools consider incorporating aspects of comedy into medical curricula — particularly within the preclinical years — to combat feelings of seclusion.
Medicine has been previously described as “one of the loneliest professions.” A 2016 study revealed that nearly one in three medical students worldwide suffers from depression. Further, medical students in their first year (mostly pre-clinical study) were reported to have the highest rates of depression.
Depression and loneliness are deeply intertwined. Since studying is usually a non-social activity, allocating a substantial portion of one’s time to studying likely leads to feelings of isolation. The cost of this isolation on one’s physical and mental health has been extensively documented, including “negative health and behavioral outcomes” as well as “increased morbidity and mortality risk.” Further, loneliness is related to worsened mental health in the form of higher rates of psychosis, suicide, and depression. Interestingly, loneliness is linked with a poor ability to self-regulate, which leads to destructive behavioral loops such as alcohol abuse and poor physical activity.
The authors are confident that the characteristically playful and interactive nature of comedic seminars may work to remedy feelings of isolation among medical students. However, as improv comedy is to-date the most widely studied form of comedy, we propose that medical schools start to combine comedy into their wellness activities with this practice.
Dr. Katie Watson of Northwestern University has thoroughly discussed the overlapping nature of improvisational theater and medicine. One of the authors, Marc Perlman, expresses enhanced self-fulfillment, confidence and feeling of unity with classmates after his own experiences in an undergraduate improvisational comedy class. By encouraging comfortable interaction in impromptu situations, comedy may serve to replenish medical students’ emotional wellbeing and encourage camaraderie among classmates. These enhancements can work to alleviate feelings of isolation that are common among medical students.
More medical schools may benefit from incorporating elements of currently established medical improvisational seminars. The example at the Feinberg School of Medicine at Northwestern University provides a model for “medical improv” sessions that have been favorably rated by students. First- and second-year students at this institution are required to take a certain number of medical humanities and may elect to take five-weekly, two-hour medical improv seminars. In these seminars, students are encouraged to act on their feet, creating and responding to scenarios, with the driving motivation being to accept anything that other students contribute and to contribute a novel action (a “yes … and” mindset). Feedback from students indicated “attitude improvement … stress relief, self-esteem building, and group bonding.” Adaptations of this model may be incorporated into existing wellness programs at many medical schools.
By no means does the addition of comedic dialogues fully address the current state of student isolation in medical schools. Nevertheless, in a rigorous educational setting, professional outlets for comedic relief demonstrate some potential to combat feelings of dejection.