Trends in medical students’ stress, physical, and emotional health throughout training

Abstract

Background: Medical student wellness, including physical health, emotional health, and levels of perceived stress, appears to decline during training, with students reporting high levels of depression, anxiety, and burnout as early as the first year of medical school. The impact of curricular changes on health and stress remains unclear, and a modified curriculum that compresses training of the foundational sciences and its effect on wellness has not been studied. Oregon Health & Science University School of Medicine has recently instituted a unique competency-based model, which provides an important opportunity to assess the effects of curricular change on student wellness. Objective: Assess the effects of curricular change on student wellness. Design: Medical students at a single institution were administered the SF-8, an 8-item healthrelated quality of life survey, as well as the Perceived Stress Scale, a 10-item scale that measures the degree to which life situations are appraised as stressful, at baseline (matriculation) and at the end of Year 1, 2 and 3. Individual variables were assessed over time, as well as a trend analysis of summary domain scores over the 4 time periods. Results: Physical, emotional, and overall health were highest at baseline and lowest at the end of Year 1, after which they improved but never again reached baseline levels. Physical health declined less than emotional health. Perceived stress levels did not change over time but remained moderately high. There were no differences in health or perceived stress based on demographic variables. Conclusions: In a competency-based curriculum, physical, emotional and overall health significantly worsened during Year 1 but improved thereafter, while perceived stress remained unchanged. Early in training, stress and poor overall health may be related to concerns about self-efficacy and workload. Although advanced students show improved wellness, concerns remained about emotional difficulties, such as anxiety and irritability, and feeling a lack of control.

Predictive Factors for Impaired Mental Health among Medical Students during the Early Stage of the COVID-19 Pandemic in Morocco

“…In fact, as students enroll in medical studies, their emotional health significantly worsens during the first year. 37 Embarking on medical studies implies dealing with academic stress and competition, especially as programs include top performing students, and the failure to achieve previous school performance levels can be a source of distress, self-doubt, and anxiety. 38 Furthermore, the transition from preclinical to clinical training may be complex, and students may face challenges such as professional socialization difficulties, increased workload, and perceived knowledge deficiencies, also known as the "shock of practice."…”

Meta-analysis of Prevalence of Depression, Anxiety and Stress Among University Students

“…It varies from mild to severe ranges of symptoms and can lasts for longer time period without any apparent etiological factor 11,12 . Depression and other associate disorders affect the student's mental, physical and interpersonal functioning 13 , negative academic performance, causes clinical disorders like insomnia, anorexia nervosa etc. 14,15 .…”

Stress among Portuguese Medical Students: A National Cross-Sectional Study

“…Upcoming studies should also assess the temporal relationship between perceived stress among the six years of medical school, as the literature is controversial. A recent study suggests that stress levels do not vary significantly over training years, remaining moderately high [ 46 ], but this is not well-established yet. Finally, since saliva, blood, or hair cortisol levels are objective stress measures, it could be interesting to complement stress studies with them [ 47 ].…”