Are we preparing our medical students to fail with a reactive not proactive approach to managing workplace stress, reducing burnout and addressing mental health problems?

Stress, burnout and mental health problems are pervasive among medical students globally. Mental health difficulties during undergraduate training may persist throughout medical careers, yet current support remains predominantly reactive, addressing problems only after they emerge. This approach is problematic: harm has already occurred, students must self-identify difficulties despite documented help-seeking barriers, and psychological support resources remain insufficient. We argue for a paradigm shift towards proactive, preventative interventions that prepare students for the predictable stressors of clinical education and practice. Our preliminary research evaluating a cognitive-behavioural intervention demonstrated improvements in resilience, confidence and burnout indicators in medical students, and we are now building upon this with a randomised controlled trial of Thumos, an intervention based upon cognitive-behavioural principles. While acknowledging that individual-level interventions cannot address systemic causes of occupational stress, evidence-based proactive approaches should be prioritised alongside organisational change. International collaboration is essential to develop and implement effective preventative programmes.