Individual Wellness Plan

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INSTRUCTIONS: This is your personal wellness plan that has been designed to help you during times of stress in the coming months. You may fill out the table in any order that you wish, although we recommend that you complete the “stressor” and “reason” columns after the first classroom session (The Basics) and the “potential barriers,” “action plan,” and “countermeasures” columns after the third classroom session (Mindfulness in Daily Life). An example entry for a single stressor is shown below:

STRESSOR (WHAT) REASON (WHY) ACTION PLAN (HOW) POTENTIAL BARRIERS COUNTER MEASURES
Step 2 CK Didn’t get a high enough score on Step I and worried that it might affect my interviews/match list When feeling overwhelmed by how much I need to study, take one minute to focus on breathing Forgetting my action plan Leave a sticky note above my desk that says “Remember to breathe”

REQUIREMENTS: A first draft of your plan should be submitted to the MEM curriculum director by the end of the third week, in order to receive feedback. You are expected to complete the “final” version of your wellness plan by the end of your Emergency Medicine rotation (although we very much encourage you to continue to add to it as needed once you leave us). You will need both signatures below to complete the plan.

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