Widespread Programs, Limited Evidence: How U.S. MD-Granting Medical Schools Define, Measure, and Evaluate Student Well-Being Efforts
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Purpose
To characterize how U.S. MD-granting medical schools define wellness aims, assess student well-being, evaluate program effectiveness, and analyze and report outcomes.
Method
From June 2025 through September 2026, the authors surveyed all 159 Liaison Committee on Medical Education-accredited U.S. MD-granting schools using a web-based instrument. Analyses used item-specific denominators for partial responses. Among 84 schools answering five linked items, the authors examined completion of the sequence from defined aims to reported outcomes. Exploratory analyses examined associations between explicit wellness competencies and the remaining practices.
Results
Of 159 schools, 107 (67.3%) provided substantive responses. Of the 84 schools that answered all five linked items, 2 (2.4%) reported the complete sequence, and 22 (26.2%) reported none. Explicit wellness competencies were reported by 23/91 schools (25.3%); 38/91 (41.8%) were unsure whether any existed. Schools reported formal assessment of student well-being (48/91, 52.7%) and formal program evaluation (43/90, 47.8%). Among schools that evaluated, 39/42 (92.9%) used Association of American Medical Colleges national surveys, whereas 14/42 (33.3%) used any standardized longitudinal or pre/post measure. Schools rarely analyzed outcomes by student demographic characteristics (16/89, 18.0%), and none reported publishing outcomes in full. Schools with explicit wellness competencies reported more of the remaining practices (median 2 vs 1, P = .007), with associations concentrated in program evaluation and outcome reporting. Wellness infrastructure was common: dedicated curricula (65/107, 60.7%), learning communities (85/98, 86.7%), mistreatment reporting or prevention policies in clinical training (89/97, 91.8%), and wellness committees (73/84, 86.9%).
Conclusions
Responding U.S. medical schools commonly reported wellness infrastructure, but few reported a complete sequence from defined wellness aims to reported outcomes. Gaps in explicit wellness competencies, assessment, program evaluation, and outcome reporting limit schools’ ability to judge program effectiveness. Explicit wellness competencies were associated with more evaluation and reporting practices; whether they improve program effectiveness remains unclear.
