Health professions students face ethical, personal, and psychological learning challenges that are not elements of formal curricula; medical errors, difficult patients, verbal or physical abuse, requests for unethical acts, disagreements with superiors, and personal burnout, among others.

Resources available to these learners in their formal educational programs may not address these challenges. The learner may be embarrassed to bring up an issue with a superior. He or she may feel there is no one to talk with about the issues, particularly around the time of the event. Learner’s anxiety about their performance and feeling that they are the only ones struggling intensifies feelings of isolation and makes it difficult to speak even with colleagues. Further, the professional and academic culture can appear defensive and punitive and therefore discourage rather than foster dialogue around the issues.

How serious are these challenges and how do learners address them? Feedback from our survey of over 2,000 medical students and residents suggests that some of the challenges have a significant long term negative impact, that local resources available to them during their training are not well developed or utilized and that on line advice including an anonymous online consultation with a senior physician, selected for his or her expertise, would be welcomed.