The Psychiatric Burden on Medical Students in New York City Entering Clinical Clerkships During the COVID-19 Pandemic

Abstract

For medical students first entering the clinical space in July 2020, the unique challenges related to the coronavirus pandemic threatened to amplify the psychological distress associated with clerkship rotations. This study aimed to characterize the mental health of thirdyear medical students starting clinical clerkships in the midst of a pandemic by assessing symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) as well as risk, coping, and protective factors associated with psychological outcomes. Of 147 third-year medical students at the Icahn School of Medicine at Mount Sinai in New York City, 110 (75%) participated in this prospective survey-based study with 108 included in the final analysis. 43 (39.8%) respondents screened positive for symptoms of either MDD, GAD, or PTSD. Multiple regression analyses revealed that greater overall symptom severity was associated with more avoidant coping, more traumatic events witnessed, poorer student and leisure functioning, lower trait emotional stability, and lower social support. Worries related to COVID-19 did not significantly influence outcome variables. To better understand the role of the pandemic on psychological outcomes in third-year medical students, additional research should focus on the trajectory of these outcomes over the year during the coronavirus pandemic.

The Consequences of the Pandemic on Medical Students’ Depressive Symptoms and Perceived Stress: A Repeated Cross-Sectional Survey with a Nested Longitudinal Subsample

“…We argue that these results give a meaningful insight of the actual impact of the pandemic on medical students’ mental health as the two timepoints of the repeated cross-sectional study are highly comparable since they possibly share the same sociocultural features and, in addition, many mental health-associated variables were recorded in both timepoints, thus giving further substantial evidence to the findings of the review conducted by Mittal and colleagues [ 17 ]. Furthermore, the other variables that resulted significant in the models of Study 2 were mainly the same that the ones commented above (i.e., family cohesion, sexual orientation, economic situation, judgment of medical school choice) and also female gender, consistently with depression epidemiology [ 50 ] and with data on medical students’ stress [ 5 ], and relationships with peers, as shown in other studies on medical students both before and during the pandemic [ 21 , 40 ]. In addition, attending the last year of medical school reduced the risk of symptoms.…”

“…Indeed, available reviews about mental health among medical students during the pandemic have highlighted high levels of depression, anxiety, stress, and exhaustion, suggesting a rise in those symptoms [ 17 , 18 ]. However, most of studies had a cross-sectional [ 17 ] or a longitudinal design [ 19 , 20 , 21 ] without taking into account pre-pandemic periods, thus not allowing inferring about an actual worsening of mental health conditions compared with pre-pandemic years. To date, very few studies focusing on medical students have presented prospective (repeated cross-sectional or longitudinal) data beginning from a pre-pandemic period [ 22 , 23 , 24 , 25 ].…”

Magnitude of Psychological Distress among Medical and Non-medical Students during the Late Phase of COVID-19 Pandemic in West Bengal: A Cross-sectional Study

“…This is consistent with a study which found that psychological burden was higher with students having avoidant coping styles. [14,26] GAD-7 scores were significantly higher in participants who had themselves suffered or had experienced their family members or relatives suffering or dying from COVID-19. [15,21] Substance use and presence of comorbidities were not significantly associated with psychological distress, contradicted by earlier studies.…”

“…[15] Fear of COVID-19 was neither significantly impacted by any of the socio-demographic correlates nor by academic course, compliant with other studies. [26] This is most likely because of the time elapsed since start of the pandemic. The decrease in number of hospitalizations, deaths due to COVID-19 and pan-India vaccination might have helped in allaying fear of getting infected.…”

“…[30] Students should be encouraged by college faculty to adapt to coping mechanisms like, planning, acceptance, humour, active coping, use of instrumental and emotional social support instead of gambling, substance use, avoidant coping and behavioural disengagement; which was found helpful in maintaining well-being. [26] As students benefit most by discussing their distress with their colleagues and teammates, colleges can conduct interpersonal support groups. Student mentoring programs by faculty has also shown reduced relative prevalence of depression and anxiety in a study conducted among Indian medical students.…”