Background/Purpose
Undergraduate medical education is reported to pose high levels of academic stress on students due to many factors attributed to the nature of the study and the frequent assessments. Besides, international students face many additional challenges upon their enrollment, partially related to their engagement with their learning and inclusion, and adaptation to the new context and culture. Student wellbeing programs are mostly carried out in parallel to instruction programs and according to students’ inquiry, which makes it time-consuming, resource-demanding, and selective. This work describes a promising integrated wellbeing-instruction innovative approach promoting students’ wellbeing.

Methods
This work describes how to integrate one of the positive psychology theories into medical education, creating a positive learning environment leading to enhanced domestic and international students’ wellbeing, engagement, and relationships with their peers, besides other learning outcomes. Incorporation of the PERMA theory of happiness and wellbeing, developed by Seligman (2011), with the instructional design for undergraduate medical education in selected pathology courses was done in the faculty of medicine, in a public university in Egypt. Courses were offered during the preclinical and clinical academic phases.

Results
Students’ satisfaction with their learning was high. Their academic performance in end-of-course formative assessments was significantly higher than that who were absent from the designed activities. Thematic analysis of students’ narrative responses about their perceptions of their learning showed that all the instructional strategies implemented actively fostered all components of the PERMA theory of well-being.

Conclusion
The instructional design of medical education can be crafted to incorporate domestic and international students’ wellbeing at its foundational core, leading to a positive learning environment and outcomes.