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

摘要

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