Depression and stress amongst undergraduate medical students

TLDR

Medical training threatens wellbeing, leading to burnout and empathy loss, yet the onset of this decline during education remains unclear and few schools evaluate wellness program impact. The study aimed to assess medical students’ health behaviors, stress, and depressive symptoms through a wellness needs assessment at Albert Einstein College of Medicine. The authors conducted an online wellness needs assessment survey of 2014–2015 medical students at the start of first year and end of third year, analyzed responses with chi‑square and t‑tests, and used the results to develop a multidisciplinary wellness program targeting clinical clerkship issues. Students experienced a significant rise in perceived stress (from 5.51 to 6.49) and in depression risk (from 28.4% to 39.0%) between first and third years, prompting the creation of a comprehensive wellness program tailored to the entire class.

Abstract

The demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community's experience in evaluating their impact is limited.The authors designed a wellness needs assessment of all medical students at the Albert Einstein College of Medicine in order to assess students' health behaviors, stress and depressive symptoms. The online survey was administered to all medical students from the classes of 2014 and 2015 at the beginning of their first year of medical school and again at the end of their third year. Chi-square and T-tests were run comparing the survey responses of the two classes.There was a significant increase in perceived stress from an average of 5.51 in the first year to 6.49 in the third year (p = .0001). The number of students at risk for depression, defined as a CES-D score greater than 16, was 94 (28.4%) in the first year and 131 (39.0%) in their third year (p = .004).This study demonstrates a significant increase in the proportion of students at risk for depression in their third year as compared to the first year as well as an increase in perceived stress. In response to these findings, the authors took a multi-disciplinary approach in the development of a comprehensive program to address student wellness, including efforts to address issues specific to the clinical clerkships. This program is unique in that its design, inception and ongoing evaluation have taken the needs of an entire medical school class into account.