Marie-Anne Pham, who graduated with a medical degree in 2022, is currently conducting research on the mental health of medical students as part of her MD, and co-authored the RMS article. "In 2019, along with other students, we were already keen to take better account of the mental health of our peers," she says. "The surveys we did at the time showed high levels of stress - more than among other young people of the same age - and a lack of awareness of the resources available."  This led to the SaMe project, run by the Geneva Medical Students' Association (AEMG), which offers different types of activities and resources to support students and encourage peer mentoring.

“The PROFILES objectives, which define the competencies to be acquired in the Swiss medical curriculum, include personal skills, in particular the ability to take care of oneself: taking care of others also means taking care of oneself," points out Professor Mathieu Nendaz, Vice-Dean for undergraduate training and development of professional identity. "The Faculty of Medicine therefore has a duty to support students by providing them with the tools they need to build a solid professional identity.”

Rethinking clinical supervision training

These issues also have an impact on medical careers: a third of students are thinking of abandoning their studies after their first clinical experience, and 10% of trained physicians will not practice. "In a context of growing medical shortages, this has a significant impact on the healthcare system," notes Marie-Anne Pham. "Stress stems from both internal factors, specific to each individual, and external factors, linked to study or working conditions. In my view, educational institutions could do more to address the latter.”

While the competitive examination at the end of the first year remains a major stress factor, starting a clinical placement can also be destabilising: understanding the dynamics, finding your place, knowing how to react in complex situations - such as those linked to the end of life - is not easy. "Being a doctor involves difficult day-to-day situations, irregular working hours, and a professional-private balance that sometimes fails," notes Marie-Anne Pham. "It's not a question of eliminating the difficulties, or the demanding selection process in the first year, but of better equipping students, training the physicians in charge of supervision, and above all not minimising the impact of these situations on mental health."

The medical profession, which is often still very hierarchical, sometimes finds it hard to challenge itself. "Just as in the case of sexism, racism or harassment, the rigid structures and the “survival of the fittest” philosophy that still prevail in some departments is harmful, both for carers and patients," adds Marie-Anne Pham. "This is beginning to change, thanks also to the willingness of the Faculty of Medicine to take up this issue.”

Preparing for the reality of the profession

Medicine is not just a sum of technical gestures but involves a set of skills that together will form a professional. "Leadership skills are also key," analyses Mathieu Nendaz. "How to take one's place in a healthcare team, how to position oneself as a leader, how to deal with constraints and difficulties: all these elements are at the heart of the discussions on teaching that we are currently conducting, and in which students and younger colleagues are also involved.”

“It is also important not to lock oneself into a path that does not suit one’s perspectives. But studying medicine is such an investment that changing course is a difficult decision”, adds Marie-Anne Pham.

Resources are available

In recent years, a number of mechanisms have been developed to support those experiencing difficulties: a learning support group for the academic aspects, as well as mentoring and healthcare resources (see below).  "We'd also like to set up a neutral supervision system for the Masters years to deal with all sorts of anxiety-provoking or stressful situations without going through the supervisors. This would make it less dependent on the sensitivity of the clinical teams and the person in charge of supervision. And above all, never hesitate to ask for help," concludes Marie-Anne Pham.

Dr Marie-Anne Pham
Doctoral student at the Faculty of Medicine's Institute of Family and Child Medicine (IuMFE)
Internist in post-graduate training in general internal medicine

Pham, M., Bochet, P., Jermann, F., Haller, D., M., Piguet, C. (2025), Soutenir la santé mentale des futurs médecins: pistes de réflexion, Rev Med Suisse, 21, no. 917, 957-961. https://doi.org/10.53738/REVMED.2025.21.917.47201

Resources at UNIGE

• Learning support and follow-up group
• SaMe - AEMG project (@samegeneva)
• Student Health Service
• Psychological consultation at CHF 25
• Student sentinel programme
• Help - UNIGE - harassment, discrimination, conflicts, violence
• Psyline - free helpline for psychological support