• Erene Stergiopoulos, Brian Hodges, and Martimianakis Maria Athina Tina MAT.
• E. Stergiopoulos is a first-year resident, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. B. Hodges is professor, Faculty of Medicine and Ontario Institute for Studies in Education, University of Toronto, and chief medical officer and executive vice president of education, University Health Network, Toronto, Ontario, Canada. M.A. Martimianakis is associate professor and director of medical education scholarship, Department of Pediatrics, and scientist and associate director, The Wilson Centre, University of Toronto, Toronto, Ontario, Canada.
• Acad Med. 2020 Sep 1; 95 (9): 1350-1353.

AbstractThere has been a recent rise in calls for action around wellness and physician health. In medical education, wellness has been proposed as a physician competency. In this article, the authors review the history of the "wellness as a competency" concept within U.S. and Canadian residency programs and medical schools. Drawing from literature on the discourses of wellness and competence in medical education, they argue that operationalizing wellness as a physician competency holds profound implications for curricula, admissions, evaluation, and licensure. While many definitions of "wellness" and "competency" are used within medical training environments, the authors argue that the definitions institutions ultimately use will have significant impacts for trainees who are considered "unwell." In particular, medical learners with disabilities-including those with mental health, chronic health, learning, sensory, and mobility disabilities-may not conform to dominant conceptions of "wellness," and there is a risk they will become further stigmatized or even be considered unsuitable to practice in the profession. The authors conclude that framing wellness as a competency has the potential to legitimize support-seeking and prioritize physician health, yet it may also have the potential unintended effect of excluding certain learners from the profession. They propose a universal design approach to understand wellness at a systems level and to remove barriers to wellness for all medical learners.

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