Dear colleague,

I am a medical student interested in studying physician wellness and burnout prevention, and I am completing a summer project with MOLA. The goal of the project is to better understand wellness in Latino physicians and medical students affiliated with MOLA so that underrepresented minorities can better thrive in medical careers. We would like to request your voluntary and anonymous participation in a short survey to assess your own sense of well-being as a medical student or physician.

Who can participate? Medical students, residents, or physicians at any level of training or type of practice.

Thank you for your consideration and support of this wellness project to improve MOLA’s support of its members and students!

Questions can be directed to Gabriela Fuentes at gabfuen4@gmail.com.

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* 1. How do you self-identify? (Please select all that apply)

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* 2. In what City/State did you attend medical school?

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* 3. Current level of training

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* 4. What year did you graduate or do you expect to graduate from Medical school?

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* 5. What do you view as your primary role(s) or largest percentage time as a physician or, if you are currently in training, as a future attending physician? (Please select all that apply) 

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* 6. Please indicate the extent to which you agree with the following statement: My medical school prepares students to effectively communicate with people across a broad spectrum of backgrounds..

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* 7. Please indicate the extent to which you agree with the following statement: I often feel as if my performance is being judged as a member of the identity group that I belong to more than as an individual.

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* 8. Please rate how often your medical school's faculty demonstrated behaviors consistent with Respecting Diversity?

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* 9. For each of the following behaviors, please indicate the frequency you personally experienced that behavior during medical school. Include in your response any behaviors performed by faculty, nurses, residents/interns, other institution employees or staff, and other students. Please do not include behaviors performed by patients. During medical school, how frequently have you...Been denied opportunities for training or rewards based on race or ethnicity?

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* 10. For each of the following behaviors, please indicate the frequency you personally experienced that behavior during medical school. Include in your response any behaviors performed by faculty, nurses, residents/interns, other institution employees or staff, and other students. Please do not include behaviors performed by patients. During medical school, how frequently have you...Been subjected to racially or ethnically offensive remarks/names?

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* 11. For each of the following behaviors, please indicate the frequency you personally experienced that behavior during medical school. Include in your response any behaviors performed by faculty, nurses, residents/interns, other institution employees or staff, and other students. Please do not include behaviors performed by patients. During medical school, how frequently have you...Received lower evaluations or grades solely because of race or ethnicity rather than performance?

Please answer the following questions about your current well-being as pertains to your current work as a physician or physician-in-training.

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* 12. I always find new and interesting aspects in my work/ at school

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* 13. There are days when I feel tired before I arrive at work/school

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* 14. It happens more and more often that I talk about my work/school in a negative way

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* 15. After work/school, I tend to need more time than in the past in order to relax and feel better

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* 16. I can tolerate the pressure of  school/work very well

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* 17. Lately, I tend to think less at work/school and do my job almost mechanically.

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* 18. I find school/work to be a positive challenge

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* 19. During school/work, I often feel emotionally drained

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* 20. Over time, one can become disconnected from this type of work.

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* 21. After school/work, I have enough energy for my leisure activities.

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* 22. Sometimes I feel sickened by my school/work tasks

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* 23. After school/work I usually feel worn out and weary

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* 24. This is the only profession I can imagine myself doing.

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* 25. Usually,  I can manage the amount of work I have.

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* 26. I feel more and more engaged in school/work.

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* 27. When I am at school/work I feel energized

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* 28. Please share two ideas you think MOLA could do, organize or provide to improve physician or medical student wellness: 

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* 29. Please share two ideas you think MOLA could do to improve or support medical schools’ climate toward underrepresented minority students:

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