Background: Medical student exposure to stressors is associated with depression, burnout, somatic distress, decreases in empathy, serious thoughts about dropping out of medical school, suicidal ideation, and poor academic performance. Despite this, there have been no recent, multicenter, qualitative studies assessing medical students’ perceptions of their greatest stressor(s). Objective: The goal of this study was to identify the most significant stressors noted by medical students themselves, in order to inform the development of programs and policies to reduce medical student distress. Design: Medical students from the nine schools in the state of Florida were invited to complete an anonymous online questionnaire assessing wellness and distress. Students were notified that all responses were voluntary and that individual responses would not be linked to themselves or their program. This paper focuses on students’ responses to fixed-response items regarding their experience of stress and open-ended responses to the following question: ‘What do you consider to be the greatest stressor(s) facing medical students?’ Qualitative data were analyzed using the Grounded Theory method of data analysis. Results: Results confirmed the impact of several stressors highlighted in previous studies (e.g., excessive workload, difficulties with studying and time management, conflicts in work–life balance and relationships, medical school peer relations, health concerns, and financial stressors). However, students also reported unique system-level concerns that have not consistently been highlighted in past research (e.g., medical school administrative failures, concerns about lack of assistance with career planning, and assessment-related performance pressure. Conclusions: Though individually focused interventions have demonstrated some success, medical students self-report stressors that may be better addressed through system-level changes.

Purpose -The purpose of this paper is to evaluate key organisational processes in managing ''safeguarding'' in relation to the independent sector, the local authority delivery arm for care.Design/methodology/approach -The methods employed were a telephone survey (one in five random sample of all residential and domiciliary providers in a local authority area) and follow up focus groups (n ¼ 2) of local authority staff and independent sector domiciliary and residential providers, in an action research framework. The survey was developed through expert members of a multi-agency Project Reference Group.Findings -Three survey domains (on ''information'', ''training'' and ''support and advice'') indicated high satisfaction, but ''experience of investigations''' low rating raised questions for further exploration and were followed up in detail in the focus groups selected from providers with experience of safeguarding alerts. A number of issues were raised for local policy and for safeguarding more broadly.Research limitations/implications -The paper only assesses one local authority area. A more balanced systems approach is needed to manage safeguarding.Originality/value -The involvement of the independent sector in safeguarding is under-researched and the development of processes that encourage a research culture and a systems approach are exemplified.

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Students are a valuable resource in promoting a safe school climate. Their participation in safe schools' initiatives leads to long-term ben efits and fosters healthy interpersonal relationships that will assist them for the rest of their life.

Vision and unique approaches are required to foster, mentor, and encourage talented, dynamic people to accept today's school administrative challenges.Marie Somers Hill is assistant professor at East Tennessee State University and Dorothy W Lynch is director of training and development for the Orange County (Fla.) Schools.ith a commitment to locate the finest candidates for future leadership, the Orange County (Fla.) Public School system and the University of Central Florida collaborated to devise a more effective process to select candidates for an educational leadership program. The selection process involved principal nomination, an application, and interviews.Such cooperative implementation is in contrast to the traditional pattern of student self selection into graduate programs in educational leadership that Wendel and Breed (1988) noted prevailed for more than 30 years. Administrative aptitude and talent were rarely used as a basis for program admission. Instead, Graduate Record Examination scores and undergraduate Grade Point Average were the usual entrance criteria for graduate programs.

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