Drinking on an empty stomach: a scoping review of the evidence on how consuming food with alcohol affects short-term outcomes.

BACKGROUND: Alcohol is a leading risk factor for death worldwide. Governments issue official guidelines on reducing the short-term risks associated with alcohol as do alcohol industry-funded organizations. Both sources frequently recommend consuming food with alcohol, however, it is unclear what evidence these recommendations are based on. The aim of this scoping review was to map and summarize evidence on the short-term effects of consuming food and alcohol. METHODS: A scoping review, following PRISMA Extension for Scoping Reviews, searched CINAHL, Cochrane Library, Embase, Medline, PsychINFO and NICE Evidence Search (published inception to June 2021). Studies in English, investigating co-consumption of food and alcohol and reporting short-term health outcomes or acute effects, were included. RESULTS: Of the 15 246 studies identified, 10 met the inclusion criteria. There was little evidence on the effects of food co-consumption on most short-term alcohol-related outcomes. Included studies were low in quality and inconsistent in their reported outcomes. CONCLUSIONS: Despite a weak and inconsistent evidence base, food co-consumption is often recommended by both official guidance and alcohol industry-funded sources. Food co-consumption as a harm reduction measure, while plausible, requires a stronger evidence base and more nuanced messaging due to the risk of encouraging heavier, sustained drinking.

Well-Being, Mental Health, and Study Characteristics of Medical Students before and during the Pandemic.

Medical students report high demands, stressors, pressure to perform, and a lack of resources, and are therefore at a higher risk for mental strain and burnout. Due to the COVID-19 pandemic, study conditions have changed, and new challenges have emerged. Thus, this study aimed to examine medical students' well-being, mental health, and study characteristics before and during the pandemic. Data from 988 Austrian medical students were included into the cross-sectional comparisons, and 63 students were included into the longitudinal analyses (variance analyses/t-tests or appropriate non-parametric tests). Well-being before and during the pandemic did not differ significantly but the peri-pandemic cohort reported higher study satisfaction, more social support from lecturers, and less emotional exhaustion, cognitive demands, and stressors (information problems, organizational stressors, work overload). Longitudinally, work overload was also perceived to be higher before the pandemic; however, study satisfaction was lower. During the pandemic, approximately every seventh student exceeded the cut-off value for generalized anxiety disorder, and approximately every tenth student exceeded the cut-off value for major depression. These unexpected peri-pandemic results concerning constant high well-being, study satisfaction, and the perception of conditions may be based on response shift effects that require further exploration. The scores exceeding the reasonable cut-point for identifying probable cases of generalized anxiety disorder and depression may reflect medical students' needs, calling for an in-depth analysis if further health promotion is necessary.

Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.

Reality Meets Belief: A Mixed Methods Study on Character Strengths and Well-Being of Hospital Physicians.

Positive psychology deals with factors that make life most worth living and focuses on enhancing individual potentials. Particularly, character strengths can positively contribute to well-being and work-related health, bearing a promising potential for professions, such as physicians, who are at risk for burnout or mental illnesses. This study aims to identify beneficial character strengths by examining the quantitative and qualitative data. In a cross-sectional multi-method study, 218 hospital physicians completed an online survey assessing their character strengths and their general and work-related well-being, comprising thriving, work engagement, and burnout dimensions (outcome variables). Quantitative data were analyzed for the total sample and by tertiary split. Additionally, interview-gathered opinions of four resident physicians and four medical specialist educators were collected to expand the perspective on which character strengths might be beneficial for the well-being of the resident physicians. The highest significant correlations between character strengths and outcome variables were found for hope and thriving (r = 0.67), zest, and work engagement (r = 0.67) as well as emotional exhaustion (r = -0.47), perseverance/leadership and depersonalization (r = -0.27), bravery, and reduced personal accomplishment (r = -0.39). Tertiary splits revealed that some correlations were not consistent across the entire scale continuum, for example, creativity was only significantly correlated with comparatively high levels of thriving (r = 0.28) or forgiveness with comparatively high levels of depersonalization (r = -0.34). Humility, social intelligence, and teamwork showed predominantly low correlations with all outcome variables (r = -0.17 - 0.34), although humility was stated by all interviewed medical specialist educators to be the most relevant for the well-being at work, and the latter two by three resident physicians, respectively. Different perspectives resulting from quantitative and qualitative data in terms of beneficial character strengths for work-related well-being may be driven by different work experiences, professional understandings, generational beliefs, or social expectations. Some significant correlations between character strengths and well-being outcomes varied depending on low, medium, or high outcomes. This raises questions about suitable work-related well-being interventions, as simple single intervention approaches (one intervention fits all) may not work for the respective outcome levels. These new findings warrant further research on how to foster the well-being of resident physicians at work.

Do More of What Makes You Happy? The Applicability of Signature Character Strengths and Future Physicians' Well-Being and Health Over Time.

Research on applying signature character strengths demonstrated positive effects on well-being, health and work behavior. Future health care professionals represent a group at risk for impaired well-being due to high study demands. This study investigates potential long-term protective effects on well-being. In total, 504 medical students participated in a longitudinal online study, with at least 96 providing complete data at all three time points (time lag: 1 year). Data on individual signature character strengths and their applicability, thriving (subjective and psychological well-being), work engagement, burnout, mental and physical health were collected. Longitudinal relations of signature character strengths' applicability and well-being, mental and physical health were tested with cross-lagged panel analyses. Moreover, indirect longitudinal mediation effects via work engagement and emotional exhaustion were considered. Cross-lagged panel analyses demonstrated significant positive effects of thriving on signature character strengths' applicability at later time points (ß = 0.20 to 0.27) indicating that higher levels of well-being might be mandatory first to have access to one's own signature character strengths in a naturalistic setting. Disentangling thriving, the effect was only significant for psychological well-being (t1-t2: ß = 0.23; t2-t3: ß = 0.27). Across all three time points, significant indirect effects via work engagement on the relation of the applicability of signature character strengths and well-being were identified (r = 0.15), whereas significant indirect effects on mental and physical health were only evident at t2 (both: r = 0.06) and t3 (mental health: r = 0.11). A longitudinal mediation analysis via work engagement revealed a significant indirect effect (a∗b = 0.13). These results call for further research as previous studies showed that the applicability of signature character strengths affected well-being, not vice versa. The 'broaden-and-build' theory (positive emotions broaden one's consciousness and hereupon individuals build new enduring resources and skills) and the assumption of well-being in a "top-down" model (trait-like predisposition to interpret life experiences in positive ways coloring one's evaluation of satisfaction in various domains accordingly) could possibly explain these novel results.

Communicative and social competence in the medical curriculum of the Medical University of Innsbruck: learning objectives, content, and teaching methods.

Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the promotion of communication and social skills in medical students. Method: This paper focuses on educators' descriptions of how communicating with patients is taught. The Medical University's longitudinal curriculum on medical interviewing is presented in detail. The courses on ethical principles in the dissection course, palliative medicine, and gender medicine are also outlined as examples. In addition, lecturers (n=536) participated in an online survey to determine the teaching and testing content regarding patient communication and to measure the value attached to the associated teaching and learning methods. Results: The examples given by educators to illustrate learning objectives, educational content, and the teaching methods used to impart communicative and social competence provide an overview of the courses which focus on this topic or intentionally address it during the course. The results of the online survey offer a broad overview of the awareness of the topic at the university. Different testing formats are used to assess the skills being taught. Conclusion: Familiarity with the various teaching methods used in the different courses is important for developing communicative and social competence in medical education. Active networking is necessary to anchor communicative and social competency as a major thread throughout an entire medical curriculum.

Perceived Socio-moral Climate and the Applicability of Signature Character Strengths at Work: a Study among Hospital Physicians.

Previous research demonstrated that the applicability of signature character strengths at work is associated with employee well-being. However, there is a lack of research on possible antecedents of the applicability of signature character strengths in the occupational domain. In this study we examined whether the perceived socio-moral climate of medical departments has a positive impact on the applicability of hospital physicians' signature character strengths and whether it relates to work engagement, hedonic subjective well-being (SWB) and eudaimonic psychological well-being (PWB). Based on cross-sectional data of N = 165 hospital physicians in Austria, we tested mediation models with perceived socio-moral climate as predictor, applicability of signature character strengths as mediator, and work engagement, SWB and PWB as outcomes. Additionally, we collected longitudinal data (time-lag T1-T2: 6 months) from a sub-sample (n = 69) for testing the relationship between the perceived socio-moral climate and the applicability of signature character strengths over time. The cross-sectional results showed indirect effects of the perceived socio-moral climate on work engagement and eudaimonic well-being via the applicability of signature character strengths at work. Results from a cross-lagged panel analysis suggested an impact of socio-moral climate at T1 on the applicability of signature character strengths 6 months later (T2), but also an even stronger reversed effect of the applicability of signature character strengths at T1 on perceived socio-moral climate at T2.

A little is better than none: the biggest gain of physical activity in patients with ischemic heart disease.

BACKGROUND: There is a relationship between physical activity and health-related quality of life (HRQL) in healthy people and in patients with ischemic heart disease (IHD). The purpose of this study was to determine whether this relationship between sports or recreational physical activity levels and HRQL has a dose-response gradient in patients with IHD. METHODS: Using one generic and three IHD-specific HRQL questionnaires, differences in HRQL scores (adjusted for confounders) were determined for physically a) inactive vs. active patients and b) inactive vs. patients being active 1-2, 3-5, or >5 times per week. RESULTS: Data were provided by 6143 IHD-patients (angina: N = 2033; myocardial infarction: N = 2266; ischemic heart failure: N = 1844). Regardless of diagnosis or instrument used, when patients were dichotomized as either inactive or active, the latter reported throughout higher physical and emotional HRQL (all p < 0.001; d = 0.25-0.70). When categorized by physical activity levels, there was a positive HRQL dose-response gradient by increasing levels of physical activity that was most marked between inactive patients and those being active 1-2 times per week (63 82%). CONCLUSIONS: Using generic and IHD-specific HRQL questionnaires, there seems to be an overall dose-dependent gradient betweenincreasing levels of sports or recreational physical activity and higher HRQL in patients with angina, myocardial infarction, and ischemic heart failure. The greatest bang for the public health buck still lies on putting all the effort in changing sedentary lifestyle to at least a moderate active one (1-2 times per week), in particular in cardiac rehabilitation settings.

Work analysis tool for higher education: Development and validation of the german student measure WA-S Screening.

BACKGROUND: Work demands, resources and stressors affecting health, well-being and motivation also exist in the work of university students. There is a shortage of measures for analyzing work characteristics in this setting. OBJECTIVE: This article addresses that shortage of measures and describes the development and the validation of the short Work Analysis Measure for Students (WA-S Screening). METHODS: In study 1 (N = 422 students in Austria) the final version of the measure was developed based on analyzing the factor structure and psychometric properties of items and scales. Study 2 (N = 333 German-speaking students in Germany, Austria and Switzerland) was conducted for a cross validation and analyzing the criterion validity. RESULTS: An eight-scale structure of the WA-S Screening was supported in study 1 and 2. The scales have shown to be significantly associated with burnout and work engagement in study 2. CONCLUSIONS: The examinations indicate that the WA-S Screening is a short, reliable and valid instrument to identify critical, health-promoting work characteristics in the context of studying at university.

Mycobacterial Cord Factor Reprograms the Macrophage Response to IFN-γ towards Enhanced Inflammation yet Impaired Antigen Presentation and Expression of GBP1.

Mycobacteria survive in macrophages despite triggering pattern recognition receptors and T cell-derived IFN-γ production. Mycobacterial cord factor trehalose-6,6-dimycolate (TDM) binds the C-type lectin receptor MINCLE and induces inflammatory gene expression. However, the impact of TDM on IFN-γ-induced macrophage activation is not known. In this study, we have investigated the cross-regulation of the mouse macrophage transcriptome by IFN-γ and by TDM or its synthetic analogue trehalose-6,6-dibehenate (TDB). As expected, IFN-γ induced genes involved in Ag presentation and antimicrobial defense. Transcriptional programs induced by TDM and TDB were highly similar but clearly distinct from the response to IFN-γ. The glycolipids enhanced expression of a subset of IFN-γ-induced genes associated with inflammation. In contrast, TDM/TDB exerted delayed inhibition of IFN-γ-induced genes, including pattern recognition receptors, MHC class II genes, and IFN-γ-induced GTPases, with antimicrobial function. TDM downregulated MHC class II cell surface expression and impaired T cell activation by peptide-pulsed macrophages. Inhibition of the IFN-γ-induced GTPase GBP1 occurred at the level of transcription by a partially MINCLE-dependent mechanism that may target IRF1 activity. Although activation of STAT1 was unaltered, deletion of Socs1 relieved inhibition of GBP1 expression by TDM. Nonnuclear Socs1 was sufficient for inhibition, suggesting a noncanonical, cytoplasmic mechanism. Taken together, unbiased analysis of transcriptional reprogramming revealed a significant degree of negative regulation of IFN-γ-induced Ag presentation and antimicrobial gene expression by the mycobacterial cord factor that may contribute to mycobacterial persistence.

Possession and Applicability of Signature Character Strengths: What Is Essential for Well-Being, Work Engagement, and Burnout?

Signature character strengths can foster health-related outcomes in work and private life, thus being particularly important for endangered occupational groups like physicians. However, situational circumstances need to allow character strengths demonstration (applicability) first to enable their application. Therefore, this study addresses the role of (1) applicability of signature character strengths in work and private life beyond their possession and (2) relationships with well-being, work engagement, and burnout dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment). Hospital physicians (N = 274) completed an online survey examining their signature character strengths and applicability, well-being, work engagement, and burnout dimensions. The top-five individual signature character strengths were fairness, honesty, judgment, kindness, and love. Hierarchical multiple linear regressions revealed that the possession as well as the applicability of signature character strengths was important in work and private life, but to different degrees. Possessing fairness, honesty, or kindness indicated significant positive relations with subjective well-being, whereas judgment and kindness seemed to negatively interact with reduced personal accomplishment. Hospital physicians' applicability of fairness, honesty, judgment, and love was particularly essential for their psychological well-being and work engagement, whereas the applicability of fairness (reduced personal accomplishment) and judgment (emotional exhaustion, depersonalization) at work interacted negatively with the respective outcomes. Therefore, creating awareness for individual signature character strengths as well as providing applicability in hospitals and private life could be a promising approach to improve physicians' well-being and consequently patient care as well as the performance of the health-care system in general.

Identifying thriving Workplaces in Hospitals: Work Characteristics and the Applicability of Character Strengths at Work.

In most of their work settings, the health and well-being of hospital physicians are at risk. Trends of work intensification and changing laws in the European Union and beyond have heightened the call for taking a closer look at the workplace and training conditions of hospital physicians. This study aims to identify specific work characteristics (such as autonomy, social support, cognitive demands, and skill adequacy), in order to determine conditions for the applicability of individual character strengths at work and in turn for increased work engagement and well-being. We examined our hypotheses based on cross-sectional (N = 173) and longitudinal self-report data (N = 72) of hospital physicians in Austria. The results identified significant indirect effects of skill adequacy, cognitive demands, autonomy, and social support at work - via the applicability of individual character strengths at work - on work engagement and general well-being. Longitudinal analyses additionally confirmed autonomy as a thriving work characteristic for promoting the applicability of individual character strengths over time (time lag: 6 months). This study revealed the value of enabling and preserving the applicability of character strengths in a hospital work setting and focused - for the first time - on its predicting work characteristics. Furthermore, it emphasizes the importance of securing skill adequacy early in the training of young physicians and encouraging, as well as, sustaining autonomy in their daily work life.

Psychometric Characteristics of the German Values in Action Inventory of Strengths 120-Item Short Form.

The original Values in Action Inventory of Strengths (VIA-IS) is an international 240 item validated self-report questionnaire measuring character strengths. A validated and reliable English 120-item short form (VIA-120) is available. However, there is limited information about the psychometric properties of the German VIA-120. This article addresses this gap and reports the reliability, validity and comparability of the German VIA-120 with the German VIA-240 version. Two independent samples were recruited: a general population sample (N = 1073, Sample 1) and a sample consisting of medical students and physicians (N = 685, Sample 2). Internal consistency of the VIA-120-scales ranged from α = .58 (modesty) to α = .87 (spirituality) in Sample 1 and α = .63 (honesty) to α = .90 (spirituality) in Sample 2. Intercorrelations between the scales of the 120-item version and the original 240-Items version (Sample 1) ranged from r = .52 (hope) to r = .89 (prudence). Criterion validity with the Satisfaction with Life Scale (SWLS) and the Brief Inventory of Thriving (BIT) was demonstrated. The comparison of the factor structure between the original and the short form showed a good convergence (Tucker's Phi .93-.99 Sample 1, .95-.98 Sample 2). Overall, the German VIA-120 was reliable, showed good convergence with the German VIA-240 and thus presents a similar level of validity for the assessment of character strengths. This study provides the first indication that the VIA 120 short form is comparable regarding the validity and reliability of the original VIA 240-item version indicating its potential to be used in large scale research studies.

Development of Cynicism in Medical Students: Exploring the Role of Signature Character Strengths and Well-Being.

Reports of medical students experiencing burnout-related symptoms (e.g., cynicism) have increased in recent years. Little is known about the developmental process of this phenomenon and its relations with signature character strengths and well-being. The aim of this longitudinal analysis was to explore changes in the level of cynicism of medical students while in preclinical education. We further examined how the applicability of signature character strengths and well-being are related to this developmental process. Medical students (N = 99) participated in three online surveys over 3 years during medical school. Latent growth modeling, latent class growth modeling, general mixed modeling was conducted, and post hoc mixed ANOVA, Friedman test and Welch test analyses were examined. The results showed an increase in cynicism among medical students from first to last measurement. Two groups with distinct developmental trajectory patterns of cynicism were identified. Students with high levels of cynicism (high-level group) and students with changing levels of cynicism (increasing group) perceived higher applicability of signature character strengths in private life compared to the study context. Moreover, the high-level group experienced significantly lower psychological well-being (in particular mastery, optimism, and relationship) in their first year of medical education. This explorative study offers a comprehensive understanding of cynicism development in medical students during medical school and its relations to the applicability of signature character strengths and well-being. Prospective replication studies are needed to replicate the results obtained in this study.

Character Strengths Profiles in Medical Professionals and Their Impact on Well-Being.

Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven 'virtues' associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengths fairness, honesty, kindness, and teamwork were considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N = 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengths fairness, honesty, judgment, kindness, and love had the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g., honesty (d = 1.02) or prudence (d = 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g., perseverance on physicians' work engagement) but also significant negative effects (e.g., appreciation of beauty and excellence on students' well-being). Further, hope was significantly associated both positively with physicians' well-being and negatively with students' work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician's pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy.

Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients.

PURPOSE: The aim of this study was to evaluate psychometric properties of the core disease-specific 14-item German HeartQoL questionnaire. METHODS: As an extension of the international HeartQol Project, cross-sectional and longitudinal health-related quality of life (HRQL) data were collected from 305 patients with angina (N = 101), myocardial infarction (N = 123), or ischemic heart failure (N = 81) in Austria and Switzerland using German versions of the HeartQoL, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale. The underlying factor structure was examined with Mokken Scaling analysis; then convergent, divergent, and discriminative validity, internal consistency reliability, and responsiveness were assessed. RESULTS: The highest HRQL scores were reported by patients with myocardial infarction followed by ischemic heart failure and then angina. The two-factor structure was confirmed with strong physical, emotional, and global scale H coefficients (> .50). Divergent and convergent validity (from r = .04 to .78) were shown for each diagnosis; discriminative validity was verified as well (partially: age, sex, and disease severity; largely: SF-36 health status/transition; totally: anxiety and depression). Internal consistency reliability was excellent (Cronbach's alpha = .91). In terms of responsiveness, physical and global scale scores improved significantly after percutaneous coronary intervention (p < .01) while after cardiac rehabilitation all scale scores improved significantly (p < .001). CONCLUSIONS: The German HeartQoL questionnaire is a valid and reliable HRQL instrument with these data supporting its potential use in clinical practice and research to assess and compare HRQL in German-speaking patients with ischemic heart disease. The shortness of the tool may prove to be helpful particularly in clinical practice.

Antiapoptotic Effect of Granulocyte-Colony Stimulating Factor After Peripheral Nerve Trauma.

BACKGROUND: Granulocyte-colony stimulating factor (G-CSF) has been observed to have direct protective effects on neurons after stroke in experimental models and in humans. In the present study, the antiapoptotic effects of G-CSF on spinal α-motoneurons after inducement of peripheral sciatic nerve lesions were evaluated in a rat model. METHODS: Of 48 rats, 24 were treated with G-CSF and 24 were treated with glucose 5% solution (control group). The spinal cord of 6 rats in each group were removed at days 1, 4, 7, and 14. The α-motoneurons of spinal cord section L4-L6 were counted and investigated for the expression of choline acetyltransferase (ChAT), G-CSF receptor (G-CSFR), and Bcl-2 and Bax proteins. Additionally, α-motoneuron fluorescence double staining was performed for ChAT/Bcl-2, ChAT/Bax, and ChAT/G-CSFR. RESULTS: Without G-CSF treatment, the number of ChAT-positive α-motoneurons on the lesion side was significantly decreased (P < 0.001). The number of α-motoneurons with Bcl-2 and G-CSFR positivity on the lesion side was significantly decreased (P < 0.05). In contrast, the number of α-motoneurons with Bax positivity was significantly greater (P < 0.05). After G-CSF treatment, the differences in the number of α-motoneurons on the 2 sides were not statistically significant. Fluorescence double staining of α-motoneurons was positive for ChAT/Bcl-2, ChAT/Bax, and ChAT/G-CSFR. CONCLUSION: The results indicated that G-CSF has neuroprotective properties in spinal α-motoneurons and contributes to antiapoptotic effects after peripheral nerve lesions. The relevance of G-CSF, its precise mode of action, and the effect of these findings in clinical situations remains to be elucidated and require examination in further studies.

Associations between the Application of Signature Character Strengths, Health and Well-being of Health Professionals.

Previous research has shown a positive relation between character strengths, well-being and health. The aim of this analysis was to identify relations between the application of signature character strengths (ASCS) at work, and well-being and health, among medical students (Study 1) and resident physicians (Study 2). We expected positive direct links between the constructs and indirect effects through emotional exhaustion. To test these hypotheses, 387 medical students in their first year and 136 resident physicians completed five scales measuring well-being, mental/physical health, character strengths, the application of their five individual signature strengths, and emotional exhaustion as an indicator of burnout. Partial correlations were examined, and mediation analyses performed. ASCS at work was positively linked with well-being and mental health but not with physical health. All links were mediated by emotional exhaustion in Study 1 and (except for mental health) also in Study 2. Future studies would therefore do well to investigate the promotion of ASCS at work of people operating in medical education and its potential in fostering well-being and preventing burnout from the outset.