LAUSR

Recently, Haramati et al. published the findings of the CENTILE Conference 2015 on strategies to promote resilience, empathy and well-being in the health professions. We read these findings with great interest. This article, as well as previous work by Haramati and colleagues, has inspired us to design further research on decreasing mental distress prevalences among medical students (Van Venrooij et al. 2015), which we hope to discuss at the CENTILE Conference 2017. Haramati et al. describe that a solution to this problem lies in the medical curriculum environment (Haramati et al. 2017). We cannot agree more, that a change in curriculum is needed. Therefore, we would like to share our thoughts on what we believe is an important first step: acknowledging the problem. A common remark from people involved in medical education (e.g. senior clinicians) when we discuss our recent findings on burnout (Van Venrooij et al. 2015) is that ‘‘Burnout is a mental condition which can solely occur among people who work. Medical students do not work, they study. Therefore, it is not possible for a medical student to be ‘burned-out’.’’ As this example illustrates, discussions on mental distress among medical students are often about semantics. We consider this a sign that the mentality towards educating medical students has not yet changed. These semantics-oriented discussions can be seen as part of the hidden curriculum: the lessons between the lines. In our opinion, for an effective decrease in mental distress prevalences among medical students and junior doctors, we first have to abandon the message that ‘‘it’s all part of the game.’’ Burnout cannot be part of any game. In the words of Haramati and colleagues, as long as we do not invest in caring for the caregiver, the cost of caring may be high.