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On March 27th we organized a meeting with the students from Medical University – Sofia. In collaboration with the Association of Medical students in Bulgaria, we raised awareness on the topic of mental health. The event targeted the students, because the early prevention of “burnout” also prevents a pandemic of emotional stress. As future healthcare workers, it is good for the students to know not only the risks of the profession, but also how to recognize and prevent them.

Mental health is one of the bigger causes of Astra Forum Foundation and Science in the crisis. Due to the increased number of doctors, suffering from “burnout”, our team organized therapy groups with leading psychotherapists.


Professor Monica Bogdanova, psychoanalyst, was one of the lecturers at the event. She paid attention to psychosomatics – a medical subspecialty. In general terms, psychosomatics (originating from Greek: psyche – soul, soma – body) includes the interaction between the behavior (thoughts, feelings, actions) and physical illness. Psychosomatic medicine studies the influence of our emotions and fears over our health.

“Generally speaking – how to stress reflects our body.” Professor Bogdanova reminded that the primary shows of stress are dandruff, muscle tension and others. She shared her experience in the field of pediatrics and how often she observes children, dealing with mental stress through their bodies. The specialist also reminded that some of the most popular names in psychology were doctors, which confirms that the mental state has a direct relation to the physical state.

Bogdanova shared with the students that choosing a psychotherapist is difficult, but very important. “It is not easy to choose who heals your body, what’s left for choosing the person who heals your soul.” However, in her words, the first steps in psychotherapy are very complex, because it is a process that takes time and the results can not be realized from the first session.


Momchil Baev, MD, founder and chairman of Astra Forum Foundation, was the second lecturer at the event. He presented two topics, one of which was mental health and the Foundation’s initiative.

“Professional burnout is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon”, Baev said. This has been described in the chapter: “Factors, influencing the health status or contact with healthcare services” – which includes the reasons why people contact health services, but are not classified as diseases or health conditions. “Occupational burnout was also included in the 10th ICD in the same category as the ICD-11. The World Health Organization is about to undertake the development of primary evidential guidelines for mental well-being at the workplace”, Baev said.

He noted that due to the crisis, related to COVID-19, the authorities were unprepared and that was precisely what contributed to the mistrust in the healthcare system. The ones who suffered the most from this evaluation were the medical staff. “They were burdened with extremely difficult shifts.”


“Until recently, it was believed that “burn-out” is a phenomenon, associated with doctors at the end of their careers. However, research shows that young doctors, including medical students, are twice as threatened by burnout, compared to older medical specialists”, Momchil Baev emphasized.

It became apparent, that in the national research for education by General Medical Council for 2021, one third of the interns have reported they felt “burned out” to a high degree, due to their work, more than they did during the pre-pandemic years.

In April 2022, 62% of young doctors reported that they suffer from depression, anxiety, stress, burnout, emotional stress or other mental conditions, impaired by their job or education. Half of them believe that their condition deteriorated during the previous month.

The results are alarming, because the percentages are higher than the ones, recorded during the peak of the COVID-19 pandemic- 53%.

“Some of the reasons for burnout among medical students are well-known – high academic expectations, the demanding nature of the content, high stress levels from exams.”

At the end of his presentation, after it became clear that stress prevention for health workers is necessary, Momchil Baev spoke about the therapy groups for medical workers, organized by Astra Forum Foundation. He explained what the steps are for anyone who participates.

  • Initial conversation with a representative of the Foundation
  • Meeting with a psychologist and filling in documents
  • Questionnaire for quality of life evaluation
  • Questionnaire for evaluation of the individual performance at the workplace
  • Filling in a registration card
  • Declarations for confidentiality and personal data protection
  • Inclusion in the group with a psychotherapist and regular meetings


The next topic which Momchil Baev, MD, presented was regarding interpersonal communication between doctor and patient. “Healthcare workers have a key role in maintaining the public trust in immunization. The development of interpersonal communication capacity for immunization is of extreme importance”, Baev emphasized. He explained that a lot of the research, made in the Balkans area, state that the practical skills of medical staff for interpersonal communication about immunization, have space for improvement.

Momchil Baev, MD, presented the Astra Forum Foundation publication – “Interpersonal communication for immunization. Guidebook for healthcare workers”. All students who were present at the event received a gift – a copy of the guidebook.

“Interpersonal communication for immunization guidebook for healthcare workers” aims to assist and enrich the work of all healthcare workers, involved in the vaccination process in Bulgaria.

It is suitable as a work guidebook or as a general reading for healthcare staff, especially for every general practitioner. However, for some it is especially important – the students who are making their first steps in the field of healthcare. As you are aware, a professional starts his development from the beginning and does not stop, throughout his entire path”, Momchil Baev said.

He explained that in the guidebook the readers can find examples from practice, useful recommendations and strategies for overcoming the obstacles of routine immunization.

One of them is the so-called “motivational interview”.

Motivational interview uses the motivation of the parent, in order to achieve a significant change in the behavior, studying and answering questions, concerns and hesitations, regarding the vaccines. This method uses the resources of communication – open questions, reflective listening, identification of pros and cons for change of behavior, establishing how important that change is for the parent and how confident they are in their abilities to achieve that change, and finally a summary of the conversation.

Baev explained that it is important for the doctor to actively listen to patients, to show their understanding towards the concerns, to share their knowledge of vaccination and then recommend it. In his words, the doctor’s task is challenging – to motivate as many families as possible to accept the vaccines, in order to guarantee a full protection against preventable diseases and in that way, to contribute to the collective immunity.

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