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Sian Cotton, PhD, director of the UC Center for Integrative Health and Wellness

Sian Cotton, PhD, director of the UC Center for Integrative Health and Wellness

John Sacco, MD, volunteer faculty
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Publish Date: 08/11/17
Media Contact: Angela Koenig, 513-558-4625
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Med School Orientation Lesson: Self-Care Is a Must

Applying to and getting into medical school is a lot to handle. There’s the competition, the financial obligations and the rigorous academics. Then there’s actually becoming a physician, where burnout rates are reported to be higher than ever.

How to cope?

"Self-care is not optional, self-care is a must,” Sian Cotton, PhD, tells 173 first-year medical students and 30 master’s students at the University of Cincinnati (UC) College of Medicine during class of 2021 orientation.

Cotton, a professor of family and community medicine at the college and the director of the UC Health Center for Integrative Health and Wellness, has led the efforts at UC to teach students in all the health professions colleges—medicine, nursing, pharmacy and allied health sciences—that seemingly simple, non-traditional approaches to health care (i.e. mindfulness training, breathing techniques, relaxation practices) are as important to their health as to the health of their future patients.

Interestingly, Cotton doesn’t just tell the students to go explore for themselves, she gives them a taste, so to speak, of how guided imagery can help calm the mind and body. In just minutes, by having them close their eyes and let her words lead them into a kitchen scenario where they eventually "bite” into an imaginary lemon, she’s proven her case: Students commented: "My mouth puckered.” "I could feel the waxy skin of the lemon.” "A sense of calm came over me.”

"We need to give them tools, things they can do individually to offset burnout and build resilience early on in their medical school careers,” Cotton says, pointing to an exercise her co-lecturer, volunteer faculty John Sacco, MD, conducted in a similarly short time period. Sacco led the group through a breathing exercise called 4-7-8: Breath in for four seconds, hold for seven seconds, and exhale for eight seconds.

One could almost feel the stress leave the building. 

"For the vast majority of human existence there was immediate stress and a fast recovery response, but today we have chronic stress over and over every day that the system can’t repair, which leads to relationship issues and professional issues, and eventually burnout,” says Sacco, adding that complementary techniques such as purposeful breathing can reset the body’s stress responders and heal physiological damage caused by stress.

Cotton says UC is one of 73 academic health centers and health systems in North America  that, belong to the Academic Consortium of Integrative Medicine and Health ( where they are bringing integrative medicine concepts into clinical, research and educational activities within their medical schools.

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