From the beginning of medical school to second year, depressive and anxiety symptoms have been shown to increase 26%-30%. 1 Additionally, feelings of isolation, compassion fatigue, imposter syndrome and burnout affect many medical students. These increasing mental health needs have prompted medical schools to adopt strategies to promote positive mental health and implement programmatic interventions that target wellness. 2 | WHAT WA S TRIED? UCF College of Medicine developed a Peer Support Program (PSP) in 2016. PSP's mission is to foster a culture in which students take an active role in the well-being of their classmates. PSP's goals are threefold: (a) to promote positive mental health through peer-topeer interactions, (b) to reduce stigma surrounding stress and psychological distress, and (c) to encourage students to seek support and streamline referrals to counselling services.

Introduction Emergency manuals (EM) are an essential component of the response to critical events by healthcare providers, and there is strong evidence to support the benefits of utilizing EMs in crisis management. Despite the widespread utilization of EMs by providers, there is currently no national standardized protocol for EM usage, accompanied by a deficit in research on EM usage. To develop a protocol for EM utilization, factors such as the best location for EMs to be placed and the EM reader role must be determined. Methods Anesthesiologists with experience in EM use from seven hospitals participated in a survey questionnaire that was distributed to all participants through WeChat using the WenJianxen software. Survey response numbers were converted into percentages and were used to summarize the categorical variables. Results Results showed the best location of EMs used during critical events was in the anesthesia station of the operating room and that the preferred reader of EMs during critical events is the senior physician. Conclusion Our study suggests that placing EMs within close reach of the health care providers may be most efficient and that the reader of EMs should be the leader of the clinical team. These results may be applicable to the development and implementation of a national protocol for EM usage.

Medulloblastoma is the most common type of aggressive pediatric primary brain malignancy. This case describes a 45-year-old Hispanic male with no significant past medical history who presented to the emergency department (ED) complaining of 15 days of 10/10 intractable headaches with one day of lightheadedness, confusion, and loss of balance. An urgent magnetic resonance imaging (MRI) of the brain revealed a 4.1 x 3.3 x 3.2 cm mass at the cerebellum, exerting a mass effect on the brainstem and mild tonsillar herniation. A pre-surgical physical exam revealed only a positive Babinski sign bilaterally with normal proprioception and cerebellar function. The intraoperative report concluded an undifferentiated neoplasm with a histological differential diagnosis of medulloblastoma, ependymoma, or other neuroepithelial neoplasms, suggesting a referral to a tertiary care center for further evaluation of the mass. Postsurgical complications included a severe vasogenic edema, causing obstructive hydrocephalus treated with frontal ventricular drainage, signs of meningitis treated with antibiotics, and hyponatremia. This case describes a rare occurrence of medulloblastoma in an adult patient, which required prompt diagnosis and urgent life-saving treatment.