LCME Element 12-3 – Personal Counseling/Mental Health/Well-Being Programs

A medical school has in place an effective system of counseling services for its medical students that includes programs to promote their well-being and to facilitate their adjustment to the physical and emotional demands of medical education.

Hidden Curriculum

It is worth emphasizing that the LCME has shifted the ISA from ‘satisfaction’ questions to ‘agreement’ statements, focusing on if students “agree” regarding the awareness, availability, and accessibility of resources in line with the intent of the element. Responses will now be reported as Agree, Disagree, or N/A. This element includes five highly significant ISA questions.  Remember that if students choose N/A, it is really important to know why! While a rational person may assume the N/A response is because they aren’t using the services – that is NOT the rational conclusion the LCME comes to. They will wonder if the N/A is because students don’t know about services or because students are afraid to use services etc. So ensure your ISA committee is aware that it’s best if N/A responses are explained! Additionally, time will tell if students use “disagree” to take a stance on if they feel they are being provided a good service – versus – just agreeing that services are available.

Best Practice

Mental health services, personal counseling and well-being programs should be accessible to all medical students, regardless of whether your institution operates as a single medical school, part of a health system, or across regional campuses. It is essential to ensure that students at all assigned sites have access to a comprehensive system of services, including programs designed to promote their well-being. Keep in mind that any personal counseling provided by school deans, learning community advisors, mentors, or non-clinical staff must comply with FERPA protections and should be LIMITED. You really do NOT want to be getting too involved in this!! Please refer out appropriately!  Similarly, mental health services delivered by licensed providers should adhere to HIPAA regulations and any applicable state laws.

This is also a good time to review your Educational Conflicts of Interest Policy. It is critical to ensure that educators who provide healthcare, including psychological care, are not involved in the academic assessment or promotion of students for whom they have provided or are currently providing healthcare services. Moreover, you should have a policy that states that students are allowed to access healthcare services and how that approval works – meaning – the LCME wants to know that a student who, for example, needs to see PT a couple times/week, is able to do so. Students should be informed about these services and where they can be located. Students can be informed during medical school orientation and consistently throughout their four years via emails, weekly newsletters, and online platforms such as your school’s learning management system, student handbook, and school website. Importantly, it is expected that mental health counseling does NOT occur at sites where clerkships occur to help protect the privacy of students.

Continuous Quality Improvement

Even if your next site visit is years away, it is a good practice to include the ISA questions in your school’s annual surveys. This helps you understand students’ perspectives and make appropriate adjustments based on the data. Regularly monitoring and evaluating these services allows your school to identify potential gaps in accessibility, effectiveness, and student satisfaction early on. This continuous feedback loop ensures that mental health services, personal counseling, and well-being programs remain aligned with students’ evolving needs and the intent of LCME standards. Additionally, it reinforces a culture of responsiveness and commitment to student wellness, which is critical for fostering a supportive learning environment.