scholarly journals Effect of medical student debt on mental health, academic performance and specialty choice: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029980 ◽  
Author(s):  
Monique Simone Pisaniello ◽  
Adon Toru Asahina ◽  
Stephen Bacchi ◽  
Morganne Wagner ◽  
Seth W Perry ◽  
...  
Keyword(s):  
Mental Health ◽  
Academic Performance ◽  
Medical Student ◽  
Medical Students ◽  
Well Being ◽  
Medical Specialty ◽  
Specialty Choice ◽  
Student Debt ◽  
Medical Subject Headings ◽  
Debt Levels

ObjectivesWith the high and rising total cost of medical school, medical student debt is an increasing concern for medical students and graduates, with significant potential to impact the well-being of physicians and their patients. We hypothesised that medical student debt levels would be negatively correlated with mental health and academic performance, and would influence career direction (ie, medical specialty choice).DesignWe performed a systematic literature review to identify articles that assessed associations between medical student mental health, academic performance, specialty choice and debt. The databases PubMed, Medline, Embase, Scopus and PsycINFO were searched on 12 April 2017, for combinations of the medical subject headingsMedical StudentandDebtas search terms. Updates were incorporated on 24 April 2019.Results678 articles were identified, of which 52 met the inclusion criteria after being reviewed in full text. The majority of studies were conducted in the USA with some from Canada, New Zealand, Scotland and Australia. The most heavily researched aspect was the association between medical student debt and specialty choice, with the majority of studies finding that medical student debt was associated with pursuit of higher paying specialties. In addition, reported levels of financial stress were high among medical students, and correlated with debt. Finally, debt was also shown to be associated with poorer academic performance.ConclusionsMedical student debt levels are negatively associated with mental well-being and academic outcomes, and high debt is likely to drive students towards choosing higher paying specialties. Additional prospective studies may be warranted, to better understand how educational debt loads are affecting the well-being, career preparation and career choices of physicians-in-training, which may in turn impact the quality of care provided to their current and future patients.

Medical students’ attitudes towards mental health disclosure: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ryan Christy
Keyword(s):  
Mental Health ◽  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Mental Health Problems ◽  
Medical Curriculum ◽  
Well Being ◽  
Health Problems ◽  
Medical Council ◽  
Content Type

Purpose In 2013, the General Medical Council conducted research into best practice for supporting medical students with mental health concerns, producing a document outlining University’s duty of care. It also outlined reasons as to why medical students are susceptible to mental illness. The purpose of this paper is to explore what factors affected medical students' disclosure of mental health problems and their help-seeking behaviour today and if these differed from the GMC’s findings from 2013. Design/methodology/approach A questionnaire was issued to all University of Glasgow medical student year groups. In total, 72 people responded. All responses were then analysed by the primary researcher using Mayring’s six-step approach of systematic, rule guided qualitative text analysis. Findings Four main barriers to disclosure were revealed: fear of repercussions, medical student “expectations”, judgement and lack of support. Respondents feared being deemed unfit to practise, displaying “weakness” or being treated differently. They believed support provided was inadequate or inaccessible. Less than half felt the Medical School made mental health support easily available and only 11% were even aware of the GMC document. Respondents believed medical students were psychologically vulnerable due to Medical School environment, work load, “expectations” and course content. They perceived the Medical School was “a pressure cooker” for mental health problems and yet student well-being was not prioritised. Originality/value The research highlighted some key areas that universities should address, such as promoting support services available, recognising the unique stresses of the medical curriculum and the need for provision of resources that can be accessed without fear, stigmatisation or uncertainty.

Meditation buffers medical student compassion from the deleterious effects of depression.

2017 ◽  
Author(s):  
Jennifer S Mascaro ◽  
Sean Kelley ◽  
Alana Darcher ◽  
Lobsang Negi ◽  
Carol Worthman ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Well Being ◽  
Daily Functioning ◽  
Wait List ◽  
School Students ◽  
Social Emotions ◽  
The Face ◽  
Second Year

Increasing data suggest that for medical school students the stress of academic and psychologicaldemands can impair social emotions that are a core aspect of compassion and ultimately physiciancompetence. Few interventions have proven successful for enhancing physician compassion inways that persist in the face of suffering and that enable sustained caretaker well-being. To addressthis issue, the current study was designed to (1) investigate the feasibility of cognitively-basedcompassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreasesdepression, enhances compassion, and improves daily functioning in medical students. Comparedto the wait-list group, students randomized to CBCT reported increased compassion, and decreasedloneliness and depression. Changes in compassion were most robust in individuals reporting highlevels of depression at baseline, suggesting that CBCT may benefit those most in need by breakingthe link between personal suffering and a concomitant drop in compassion

scholarly journals Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

2021 ◽  
Vol 10 ◽  
pp. 216495612098848
Author(s):  
Elaine O Cheung ◽  
Ian Kwok ◽  
Allison B Ludwig ◽  
William Burton ◽  
Xinzi Wang ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Positive Psychology ◽  
Positive Emotion ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
Well Being ◽  
Preliminary Evidence ◽  
Lessons Learned ◽  
Psychology Program

Background Mental health tends to worsen over the course of medical school, with steep declines in well-being in students’ clerkship year (M3). Positive emotion promotes adaptive coping to stress and may help preserve medical student well-being. Objective This study describes the development of LAVENDER (Leveraging Affect and Valuing Empathy for Nurturing Doctors’ Emotional Resilience), a program aimed at increasing positive emotion to preserve well-being in medical students. Methods We conducted a single-arm pilot of LAVENDER, a positive psychology intervention developed for medical students delivered in an interactive classroom format to a cohort of 157 third-year medical students at the Albert Einstein College of Medicine. Our primary outcome was the acceptability of LAVENDER. We also examined preliminary efficacy using measures of emotion, stress and burnout collected at each intervention session. Results LAVENDER showed good acceptability: 76% of participants agreed that the LAVENDER skills were useful and 72% agreed that they would recommend the LAVENDER program to others. Qualitative feedback suggested that medical students enjoyed the program and found the skills to be useful for coping with stress, but also reported the following barriers to engagement: lack of time to practice the skills, resistance to the mandatory nature of the wellness sessions, and difficulty integrating the skills in daily life. We did not find support for the preliminary efficacy of LAVENDER for improving medical student well-being in students’ clerkship year. Participants showed decreases in positive emotion and increases in symptoms of burnout over the intervention period ( ps < .01). Conclusion The current paper describes the development and a single-arm pilot test of LAVENDER, a positive psychology program tailored for medical students. Although we found preliminary evidence for the acceptability of LAVENDER, we did not find support for the preliminary efficacy. Lessons learned and next steps for the program are discussed.

First the Pandemic then the Tsunami: COVID-19 and Its Impact on Mental Health

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Keng Chuan SOH ◽  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Systematic Reviews ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Large Population ◽  
Well Being ◽  
Health Impact ◽  
Mental Wellbeing ◽  
Behavioural Patterns

Introduction: COVID-19 has undeniably and profoundly impacted everyday lives of the general public. One particular emphasis is the mental wellbeing of populations. This review serves to examine the mental health impact of the current pandemic. Methods: A review of the literature on PubMed was conducted, drawing from systematic reviews and large population studies about mental health consequences of the COVID-19 pandemic. The content was synthesized with the writer’s experience of daily life across different perspectives. Certain demographic sub-groups were examined, such as those under home quarantine or isolation, those who had contracted COVID-19, those with pre-existing psychiatric disorders, as well as healthcare workers and medical students. Results: Psychological well-being was adversely affected by the pandemic, although there is some controversy about the magnitude of this impact which is likely in relation to the timeline of the pandemic’s progression. Behavioural patterns such as spending habits during lockdowns might provide an early indication of mental health problems. Those who had contracted COVID-19 were found to have heightened levels of posttraumatic stress symptoms and depressive symptoms. Healthcare workers and medical students have faced comparable levels of anxiety, depressed mood and insomnia. The final results of some of the systematic reviews are still pending. Conclusion: The COVID-19 pandemic has profoundly impacted everyday life. If not already thecase, there is likely to be an anticipated tsunami of mental health concerns. This wouldmake a strong case for the anticipatory need of increased resource allocation to allowmental health services to meet this demand.

Essentials for Education and Training for Tomorrow's Physicians

2017 ◽  
pp. 230-252
Author(s):  
Timothy Edward A. Barrett
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Personal Growth ◽  
Growth And Development ◽  
Well Being ◽  
Education And Training ◽  
Current Approach ◽  
Changing Times ◽  
Health And Well Being ◽  
And Training

Education and training of medical students and postgraduate residents must undergo a critical review in light of the changing times and attitudes. The demands of life in general are enough to provide significant stressors for today's students in addition to coping with pressures of balancing passing exams with meeting the expectations of family and instructors. This chapter will highlight the realities of the effect of the pressures of study on the students' mental health and well-being. It will then describe several changes that can be made to the way medical students are trained which then shifts the focus to personal growth and development and away from the traditional goals of knowledge, skills and competencies for the goal of passing the exams. In the end, this chapter will challenge readers and institutions to pause and reconsider the current approach to training of medical students.

Cyberchondria and Medical Student Syndrome

2022 ◽  
pp. 98-113
Author(s):  
Afkar Aulia ◽  
Budi Pratiti
Keyword(s):  
Mental Health ◽  
Medical Student ◽  
Medical Students ◽  
Medical Information ◽  
Health Anxiety ◽  
Health Condition ◽  
Medical Doctor ◽  
Patient Counselling ◽  
Online Behaviour ◽  
Diagnosis Therapy

Health anxiety is a disorder that can be very distressful and cause unnecessary examinations. A doctor is expected to handle health anxiety in terms of examination, diagnosis, therapy, and counselling processes. To provide optimal patient counselling, a doctor needs confidence, empathy, and good mental health. However, the process to become a medical doctor requires a student to read through a large amount of medical information, which arguably might induce “medical student's syndrome,” or health anxiety. Contradicting research findings exist about such conditions, however, most of them use traditional measures of health anxiety and do not consider students' online behaviour. The authors hypothesized that a medical student is susceptible to cyberchondria, a form of health anxiety due to excessive internet use. Some studies have shown that there may be higher cyberchondria scores among medical students compared to the general population. Cyberchondria needs to be studied further to improve the mental health condition of medical students and to provide optimal future healthcare for patients.

scholarly journals Specialty choice determinants among Mexican medical students: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carlos Gutiérrez-Cirlos ◽  
J. Jesús Naveja ◽  
Manuel García-Minjares ◽  
Adrián Martínez-González ◽  
Melchor Sánchez-Mendiola
Keyword(s):  
Medical Students ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Specialty Choice ◽  
Three Dimensions ◽  
Chi Square ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Needs ◽  
Gynecology And Obstetrics

Abstract Background The choice of medical specialty is related to multiple factors, students’ values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students. Methods Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed. Results The questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach’s alpha was 0.8. The mean age was 24 ± 1 years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics. Conclusions Specialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).

scholarly journals Exploring the relationship between medical student basic psychological need satisfaction, resilience, and well-being: a quantitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Adam Neufeld ◽  
Greg Malin
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Learning Environment ◽  
Basic Needs ◽  
Well Being ◽  
Need Satisfaction ◽  
Self Determination ◽  
Psychological Well Being ◽  
Psychological Need ◽  
Basic Psychological Need Satisfaction

Abstract Background There is increasing acknowledgment that medical training is stressful for students and can impact their well-being. An important aspect of this is self-determination and basic psychological need satisfaction. A better understanding of how medical student perceptions of the learning environment impacts their basic psychological needs for motivation, resilience, and well-being may help to create learning environments that support the needs of medical students and help them become better healthier physicians. We aim to add to the literature on this topic by examining this relationship through the lens of Self-Determination Theory. Methods A total of 400 students from all 4 years of the medical program at our institution were invited to complete an anonymous online survey, measuring basic need satisfaction/frustration (autonomy, competence, relatedness) within the learning environment, resilience, and psychological well-being. We used analysis of variance to assess the effect of gender, age, and year on all variables, with t-tests to compare subgroups. Structural equation modelling was performed to test a hypothesized model in which support of medical students’ basic needs would positively relate to their resilience and well-being. Results The response rate was 183/400 (46%). After data cleaning, 160 remained: 67 males (42%) and 93 females (58%). There were 67 first years (42%), 35 second years (22%), 30 third years (19%), and 28 fourth years (18%). The sample mean age was 25.8 years (SD = 4.1). A well-fitting model was confirmed to fit the data, χ2 = 3.15, df = 3, p = 0.369, RMSEA = 0.018, SRMR = 0.022, CFI = 0.999. Autonomy and relatedness satisfaction exerted direct effects on well-being. Competence satisfaction did so indirectly, through its direct effect on resilience. Female medical students had lower resilience scores compared to their male peers. Conclusions When medical students perceived their learning environment as supportive to their basic needs, it was associated with an increase in their psychological well-being. Satisfaction of competence, but not autonomy or relatedness, predicted an increase in their resilience. Fostering medical students’ basic needs for motivation, especially competence, is recommended to support their resilience and well-being. Further research is required to generalize these results further.

scholarly journals International medical student’s mental health: psychological distress and socio-cultural adaptation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Hachemi ◽  
M Dimitrijević ◽  
J Stojanović ◽  
S Cvjetković
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
International Students ◽  
Medical Students ◽  
Cultural Adaptation ◽  
Foreign Students ◽  
Well Being ◽  
International Medical ◽  
Depression Anxiety Stress Scale ◽  
Future Health

Abstract Background The greater academic mobility and globalization have introduced a substantial number of foreign students to more universities. The lack of recent studies about their adaptation and signs of psychological distress arose an interest about this relevant issue. Recognizing the factors involved in the adaptation process are vital for international students, especially medical, as they are considered the future health-care workforce. Ensuring their well-being is essential for consumers safety, satisfaction and raising quality at lower costs. Thus, the aim of this research was to explore the predictors of psychological distress including socio-demographic variables and socio-cultural adaptation Methods A cross-sectional study was conducted at the University of Belgrade School of Medicine, where 124 (65 males and 59 females) international students from 32 countries were interviewed using a socio-demographic questionnaire and psychometric tools such as Revised Socio-cultural Adaptation Scale (SCAS-R) and Depression, Anxiety, Stress Scale (DASS-21). Statistical analysis included prevalence data and multiple linear regression. Results The prevalence of depression, anxiety and stress was found to be 39%, 55% and 41%, respectively. Maladaptation to a new environment by lack of participation in the community and focus on own interests were significant predictors of depression (β = −.39, p&lt; .01) and stress (β = −.36, p&lt; .05), while anxiety was associated with both female gender (β = −.30, p&lt;.05), self-centration and absence of community involvement (β = −.37, p&lt; .01). Conclusions There is a high prevalence of anxiety followed by stress and depression among international medical students. The results highlighted the importance of cultural adaptation for psychological distress. This shows a requirement for developing an adequate, accessible professional counselling and peer support services for foreign students that are necessary to achieve sustainable development goals. Key messages Encouraging researchers to further investigate the needs of international medical students. The development and implementation of health policies addressing student’s mental health.

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