Feature: Supporting wellness in meaningful ways

By Emily Leighton, MA’13
“It’s only two to five years.”
“It’s supposed to be hard.”
“It’s just something you need to get through.” 
Dr. Michelle Marlborough encounters these beliefs regularly in her work, particularly from learners making the transition from medical school to residency training. 
“Residency comes with this anticipation of difficulty, that it’s something to overcome,” she explained. “But does it have to be that way?” 
It’s a question that motivates the new Assistant Dean for Postgraduate Learner Experience. In the role, Dr. Marlborough supports the psychological and physical wellbeing of residents and fellows at the School – from addressing individual concerns to promoting awareness of physician health and wellness across the School’s residency programs.
Since starting the position in November, she is primarily focusing on pandemic-related issues, including disruptions to learning and assessment. Many of the School’s residency programs are also in the midst of the transition to competency-based medical education, which can cause stress for learners and faculty as they navigate new expectations and procedures. 
Dr. Marlborough embraces a flexible approach in promoting and supporting wellness initiatives at the School. “It’s important that we’re pivoting to fit what people need, because there isn’t a cookie cutter approach to addressing wellness,” she said. “We want to be sure whatever we’re doing is meaningful and helpful for our learners.” 
Looking to future priorities, Dr. Marlborough also hopes to address some of the larger systemic factors that contribute to stigma and shame around experiencing mental health difficulties in medicine. “The culture of stoicism, intolerance of error and putting the job before everything else – it can keep people really unwell,” she said. 
She shares a quote from Dr. Pamela Wible to demonstrate significance of these systemic issues. “If you’re in the coal mine and your canary dies, you don’t take deep breaths and do resiliency modules online or say we need more resilient canaries. You get out of the coal mine.”
In the coming months, she plans to connect with program directors, administrative staff and learners to learn more about existing wellness initiatives, better understand the challenges and share ideas about how to move forward.
Dr. Marlborough graduated with a nursing degree from Western, working briefly as an emergency room nurse before attending medical school at McMaster University. She completed her residency training in psychiatry at the University of Toronto.
“I don’t come from a family of people in health care, but I always intuitively felt like that was where I needed to be,” she said. “I joined a psychiatry interest group as a first-year medical student and as I learned more about the field it became clear that these were my people.”
Dr. Marlborough also serves as the Wellbeing Lead for the Department of Psychiatry, part of the School’s Peers for Peers program created by the Office of Clinical Faculty Affairs to support clinical faculty.
Her passion for physician wellness is driven by personal experience. As a resident navigating a number of stressful life events, she developed major depression and was hospitalized for suicidal ideation. 
Sharing this story publicly is difficult, but Dr. Marlborough understands the importance of talking openly about mental health. “We like to think that we’re more accepting of people who have had periods of mental illness, but it still can be somewhat risky to talk openly about that,” she said. “Having had somebody who I respected and looked up to go first in sharing their experiences and speaking about times when they weren’t doing well was very influential and inspiring.” 
The idea that someone so successful in their career could also face these types of challenges gave her hope and courage to share her own story and continues to inspire her advocacy. “The two can co-exist, we can struggle and still do amazing things.”