Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors

Ambiguous motivations in medical school applicants: a retrospective study from Japan

Aspiring to become a physician is a natural expectation for applicants to medical school. However, choosing a career in medicine is a critical decision, especially in countries where high school students can apply to medical school without an undergraduate degree. Students may select a medical career for various reasons, including parental pressure and academic performance. The question of whether there are students who enroll in medical school without clear intentions of becoming doctors has not been extensively investigated in the literature. We conducted a retrospective study at a national university in Japan. Given the scarcity of research examining medical students who did not have a clear intention to become doctors at the time of admission, we created a survey. The questionnaire asked students whether they had clear intentions to become doctors upon enrollment, and those who responded affirmatively were defined as students with clear intentions to become doctors at admission and assigned to the first group. The second group was composed of students who entered medical school without clear intentions to become doctors. We then compared the differences in sociodemographic characteristics and career determinants between these groups using statistical methods, including Chi-square tests and logistic regression. The collection rate of the questionnaire was 76.2%. We found that 28.8% of students at a national medical school in Japan entered medical school without clear intentions of becoming doctors. For these students, 'parental expectations' and 'peer influence' were identified as significant career determinants. No sociodemographic characteristics showed significant associations with the ambiguity of students' intentions to pursue a medical career at admission. This study confirmed that some students enroll in medical school without clear intentions of becoming doctors. The background factors related to this type of student were parental expectations and the influence of peers on career choice.

Stress, student burnout and study engagement - a cross-sectional comparison of university students of different academic subjects

BACKGROUND

Stress and burnout among students are health concerns in higher education systems, the prevalence of which exceeds that of the working population. Both are associated with impaired health and increased university drop-out rates. Study engagement, a positive study-related attitude characterized by energy, dedication, and absorption, counteracts stress and burnout. Person-oriented approaches can help to ensure students' health and well-being and help to deduce preventive measures and interventions. Nevertheless, most studies treat students as a homogenous group and do not differentiate between academic subjects. Students apart from medical and nursing sciences have been mostly neglected within this research field.

METHODS

In a cross-sectional study, a sample of n = 947 students from five academic subject fields (Informatics, Mechanical Engineering, Sports and Health Sciences, Medicine, Economic Sciences) at a university in Germany was analyzed using an online survey. Sociodemographic data, perceived stress, study engagement and student burnout were included.

RESULTS

A total of 73.2% of the students were moderately to highly stressed, with females displaying higher stress levels than males. Almost one-third of the students reported frequent symptoms of burnout, while 44.5% reported a high degree of study engagement, with no differences according to sex. Stress (male: F [4, 401] = 5.321; p < 0.001; female: F [4, 532] = 9.325; p < 0.001), burnout (F [4, 938] = 7.537-11.827; p < 0.001) and engagement (F [4, 938] = 14.426; p < 0.001) were significantly differentiated by faculty affiliation. Medical students had the lowest stress levels, while informatics students had the highest stress levels. The faculty of informatics also had the highest level of burnout symptoms, while medical students and students in sports and health sciences displayed the most beneficial values. Medical students were most engaged, differing significantly from those of all the other faculties.

CONCLUSIONS

Stress and burnout seem to be a problem in all students, especially among students in informatics and engineering. The previous focus on medical students concerning study demands does not seem justified according to our results. Fostering a supportive environment is key for study engagement, health and well-being of students. The inclusion of further individual factors should be a future concern in order to find and promote strategies for a healthy education system.

Risk and protective factors of student burnout among medical students: a multivariate analysis

BACKGROUND

The demanding educational environment requires sustained motivation and resilience, while the intense psychological stress among medical studies increases the risk of depression, anxiety, and burnout. Student burnout is an escalating issue among medical students worldwide, significantly affecting their career success and overall well-being. Understanding these dynamics is crucial for effective burnout prevention strategies. Therefore, this study aims to explore the role of depression, anxiety, academic motivation and resilience in student burnout in a sample of Hungarian medical students.

METHODS

An online survey was conducted among medical students at the University of Szeged, Hungary (N = 214; Mage = 21.82 years; 73.8% female). The survey first collected demographic information, after which participants completed five scales: the Maslach Burnout Inventory Student Survey, the Beck Depression Inventory Short Form, the Spielberger State-Trait Anxiety Inventory, the Academic Motivation Scale, and the Academic Resilience Scale.

RESULTS

Binary logistic regression for emotional exhaustion identified depression (OR = 0.32, p < .001), state anxiety (OR = 0.04, p < .01), and amotivation (OR = 0.19, p < .01) as significant predictors. For cynicism, the final model incorporated state anxiety (OR = 0.05, p < .001), intrinsic motivation through achievement (OR = -0.08, p < .05), external regulation (OR = 0.13 p < .01), and amotivation (OR = 0.41, p < .001). For reduced academic efficacy, depression (OR = 0.15, p < .001), alongside achievement (OR = -0.133, p < .01) and stimulation (OR = -0.10, p < .05) as intrinsic motivations were significant predictors.

CONCLUSIONS

This study reveals a significant prevalence of student burnout among medical students, particularly in clinical years, with emotional exhaustion and cynicism being more prominent. Depression and low motivation were strongly associated with higher student burnout, while intrinsic motivation appeared to protect against reduced academic efficacy. These findings underscore the importance of addressing mental health and fostering resilience to mitigate student burnout during medical training.

Effects of building resilience skills among undergraduate medical students in a multi-cultural, multi-ethnic setting in the United Arab Emirates: A convergent mixed methods study

INTRODUCTION

Although curricula teaching skills related to resilience are widely adopted, little is known about needs and attitudes regarding resilience training of undergraduate-medical-trainees in Middle-East-and-North-Africa-region. The purpose of this study is to investigate the value of an innovative curriculum developed through design-based-research to build resilience-skills among undergraduate-medical-trainees in the United-Arab-Emirates.

METHODS

Convergent-mixed-methods-study-design was utilized. Quantitative data collection was through controlled random group allocation conducted in one cohort of undergraduate medical students(n = 47). Students were randomly allocated into the respective resilience-skills-building-course(study-group) versus an unrelated curriculum(control-group). All students were tested at baseline(test-1), at end of 8-week course(test-2), and again 8 weeks after end of course(test-3). Then students crossed over to the opposite course and again tested at end of 8 weeks(test-4). Testing at four timepoints consisted of questionnaires related to burnout-Maslach-Burnout-Inventory; anxiety-General-Anxiety-Disorder-7; and resilience- Connor-Davidson-Resilience-Scale. Quantitative data were analysed descriptively and inferentially. Qualitative data, constituting of students' perception of their experience with the course, was captured using virtual-focus-group-sessions. Qualitative analysis was inductive. Generated primary inferences were merged using joint-display-analysis.

RESULTS

Significant proportion of the students, at baseline, seemed to be at risk for burnout and anxiety, and would benefit from developing their resilience. There appeared to be no statistical differences in measures of burnout, anxiety, and resilience related to course delivery. Overall risk for anxiety among students increased following the COVID-19 lockdown. Qualitative analysis generated the 'Resilience-Skills'-Building-around-Undergraduate-Medical-Education-Transitions' conceptual model of five themes: Transitions, Adaptation, Added Value of course, Sustainability of effects of course, and Opportunities for improving course. Merging of findings led to a thorough understanding of how the resilience-skills'-building-course affected students' adaptability.

CONCLUSION

This study indicates that a resilience-skills'-building-course may not instantly affect medical trainees' ratings of burnout, anxiety, and resilience. However, students likely engage with such an innovative course and its content to acquire and deploy skills to adapt to changes.

Goal Achievement and Academic Dropout Among Italian University Students: The Mediating Role of Academic Burnout

As stated by the Goal Orientation Theory, students want to achieve a goal for multiple reasons, with each having a different impact on academic performance. This framework encompasses a three-factor model of goal achievement: a mastery goal, a performance-avoidance (PAv) goal, and a performance-approach (PAp) goal. Students may experience elevated stress levels and burnout due to adopting an ineffective approach to goal achievement. This can lead to a loss of interest in studies and even physical and psychological exhaustion. In severe cases, this may result in students abandoning their studies early. This study aims to integrate these factors into a comprehensive model. A cross-sectional study comprising 1497 Italian university students examined the mediating role of academic burnout (professional efficacy, cynicism, and emotional exhaustion) in the association between achievement goals (mastery, PAv, and PAp goals) and the intention to drop out (ID). The questionnaires were administered from October 2022 to September 2023. Structural equation modeling was employed to evaluate the association between variables. The results of the mediation analysis indicate that cynicism and professional efficacy fully mediate the association between mastery and dropout. Cynicism (β = -0.28, p < 0.001) and professional efficacy (β = -0.17, p < 0.001) were both negatively associated with ID, while they partially mediate the association between PAv goals and ID (cynicism: β = 0.21, p ≤ 0.001; professional efficacy: β = 0.05, p ≤ 0.001), and between PAp goals and ID via professional efficacy (β = -0.04, p ≤ 0.001). This study contributes to the currently limited literature on the relationship between achievement goals, burnout, and ID in a sample of university students. The findings of this study may have useful implications for the application of interventions that impact students' well-being and academic success, potentially limiting their possible dropout.

Barriers to Seeking Psychological Help among First-Year Medical Students: A Cross- Sectional Study from Turkey

Despite high rates of psychological symptoms, many medical students often avoid psychological help. Determining the mental status of medical students at an early stage is very important for developing necessary interventions. The aim of this study was to evaluate the barriers to seeking psychological help among first-year medical students. This cross-sectional study was conducted between January 2-20, 2023. Data were collected using an anonymous online questionnaire comprising students' self-reported psychological problems and treatment status, help-seeking barriers, and a validated mental health tool (Patient Health Survey 4). The response rate was 58.8% (n = 250). Of them, 34.4% had anxiety symptoms and 25.2% had depressive symptoms. The prevalence of self-reported psychological problems and serious psychological problems were 61.2% and 10.4%, respectively. Only 7.6% of students reported receiving psychological treatment. It was found that 5.6% of the students used psychiatric drugs (2% officially prescribed and 3.6% not officially prescribed). The most common barriers to help-seeking were not were not serious problems, lack of time, difficulty explaining psychological problems, fear of being recorded, and fear of stigmatization. The results indicated that a significant number of students had psychological problems, and some did not seek psychological help.

Trial by fire: The qualitative essence of interns' baptism into medical responsibility

BACKGROUND

The transition from medical student to intern represents a challenging period of professional and personal development. This study aimed to explore junior doctors' experiences navigating this critical passage.

MATERIALS AND METHODS

An exploratory qualitative study was conducted on a junior intern doctor working in a tertiary care hospital, in Gujarat. About 40 junior doctors participated in semi-structured interviews reflecting on their internship transition. Data were analyzed using thematic analysis.

RESULTS

Perceived deficits in preparedness for clinical work and emotional readiness were a major theme. Interns felt underprepared in skills like clinical reasoning and procedures. The abrupt onset of patient care responsibility provoked anxiety and eroded confidence. Difficulty adapting to workplace culture and hierarchies was another challenge. Long work hours, unfamiliar team dynamics, and new professional relationships were demanding. The intensity of workload and patient care duties provoked overwhelming stress, fatigue, and burnout risk during the junior doctor transition. Peer support and mentoring facilitated adaptation. Enhanced undergraduate training in practical skills and professional competencies was advised to improve preparedness.

CONCLUSION

Junior doctors face major challenges to their well-being, confidence, and competence as they transition into clinical practice. Support structures to ease this demanding passage of professional development are needed. Medical schools must strengthen curricula to address preparedness gaps. Improved onboarding and supervised orientation may also benefit new interns. Facilitating an optimal student-to-doctor transition has important implications for physician training, satisfaction, and retention.

Signs, Sources, Coping Strategies, and Suggested Interventions for Burnout Among Preclerkship Students at a U.S. Medical School: A Qualitative Focus Group Study

PURPOSE

Research suggests that burnout can begin early in medical school, yet burnout among preclerkship students remains underexplored. This study aimed to characterize burnout signs, sources, coping strategies, and potential interventions among preclerkship students at one U.S. medical school.

METHOD

The authors conducted a qualitative study of preclerkship students at Mayo Clinic Alix School of Medicine (MCASOM) in June 2019. Participants completed 2 Maslach Burnout Inventory (MBI) items (measuring frequency of emotional exhaustion and depersonalization) and 2 free-text questions on burnout before participating in 1 of 3 semistructured focus groups. Focus group questions were derived from a literature review on medical student burnout with input from the MCASOM Student Life and Wellness Committee. Group discussions were recorded, transcribed, coded inductively, and analyzed iteratively (along with free-text comments) using a general inductive approach from a constructivist perspective.

RESULTS

Eighteen of 111 eligible students (16%) participated, with 5/18 (28%) reporting weekly emotional exhaustion and/or depersonalization on MBI items. Analysis of focus group transcripts showed that most students had experienced burnout symptoms during their first or second year, corresponding with school-related stressors and manifesting in cognitive-emotional, physical, and verbal-behavioral ways. Students identified systemic, institutional, and individual burnout drivers and discussed how these drivers interacted (e.g., high standards of excellence at the system level interacted with anxiety and maladaptive thinking at the individual level, creating pressure to always do more). Students used various coping strategies (e.g., self-care, peer support, reframing, and compartmentalization) but emphasized limitations of these strategies and recommended interventions directed toward systemic and institutional burnout drivers.

CONCLUSIONS

This study offers insights into burnout signs and sources among preclerkship medical students that can inform future large-scale studies. Results suggest that burnout emerges from dynamic interactions among systemic, institutional, and individual factors and may benefit from multipronged interventions.

Prevalence and associated factors of cigarette smoking and substance use among university entrance test-taking students: A GIS-based study

BACKGROUND

Numerous studies have examined substance use and smoking behavior among adolescents and university students. However, little is known about these behaviors among students undergoing university entrance tests, a critical transition period from adolescence to adulthood. The entrance test can significantly affect students' mental health, potentially leading to substance use. This study aims to investigate the prevalence of cigarette smoking and substance use among students taking these exams and the associated factors.

METHODS

A cross-sectional survey was carried out on September 4th and 11th, 2022 to collect data from 1,480 university entrance test-taking students using a convenience sampling technique. Chi-square tests and logistic regression were conducted using SPSS software. Besides, GIS mapping was used to visualize the distribution of substance use and smoking behavior across districts via ArcGIS.

RESULTS

The study found a 10% prevalence of current tobacco smoking and 4% substance use. Females (OR = 1.98; 95% CI: 1.38-2.85), urban residence (OR = 2.03; 95% CI: 1.42-2.88), repeater (OR = 1.45; 95% CI: 1.02-2.06), anxiety (OR = 1.55, 95% CI: 1.10-2.19), burnout (OR = 1.51, 95% CI: 1.00-2.12), and suicidal behavior (OR = 1.57; 95% CI: 1.03-2.40) were the significant factors for cigarette use. Whereas the urban residence (OR = 1.91; 95% CI: 1.11-3.31), anxiety (OR = 2.47, 95% CI: 1.45-4.20), and suicidal behavior (OR = 2.76; 95% CI: 1.55-4.92) significantly increased the risk of substance use. GIS analysis revealed males varied in substance use and females in tobacco smoking by district. Repeat test-takers were associated with district variations in both smoking and substance use.

CONCLUSIONS

Educational institutions, public health authorities, and policymakers must implement mental health support and substance use prevention programs for students. Integrating mental health education, providing resources, and enforcing regulations can promote healthier coping strategies and reduce substance use risks among students.

Learning Mindsets and Well-Being and Ill-Being Among Osteopathic Medical Students

Importance

Given the high rates of burnout and associated negative mental health outcomes (eg, depression, suicidal ideation, substance abuse) among medical students and physicians, it is imperative to identify strategies for supporting the future health workforce, particularly when considering trends indicating a future shortage of physicians. Understanding the associations of medical school students' learning mindsets (eg, growth mindset, purpose and relevance, and sense of belonging) with indicators of well-being (eg, flourishing) and ill-being (eg, burnout) could provide a foundation for future research to consider when attempting to combat the negative mental health trends among medical students and physicians.

Objectives

To understand the associations of medical school students' learning mindsets (ie, their beliefs about themselves as learners and their learning environment) with critical student health outcomes (ie, well-being and ill-being).

Design, Setting, and Participants

This survey study used a nationally representative sample of first-year osteopathic medical school students across the US who responded to a survey of learning mindsets as well as measures of well-being and ill-being in fall 2022. Data were analyzed from January to April 2024.

Main Outcomes and Measures

Learning mindsets were categorized as growth mindset, purpose and relevance, and sense of belonging. Well-being was categorized as flourishing and resilience, and ill-being was categorized as burnout and psychological symptoms. Outcomes were regressed on learning mindset and demographics variables, and interactions of demographic variables and learning mindsets were assessed.

Results

A total of 7839 students were surveyed, and 6622 students (mean [SD] age, 25.05 [3.20]; 3678 [55.5%] women) responded and were included in analyses. The 3 learning mindsets were significantly associated with flourishing (growth mindset: b = 0.34; 95% CI, 0.23 to 0.45; P < .001; purpose and relevance: b = 2.02; 95% CI, 1.83 to 2.20; P < .001; belonging uncertainty: b = -0.98; 95% CI, -1.08 to -0.89; P < .001) and resilience (growth mindset: b = 0.28; 95% CI, 0.17 to 0.40; P < .001; purpose and relevance: b = 1.62; 95% CI, 1.43 to 1.82; P < .001; belonging uncertainty: b = -1.50; 95% CI, -1.60 to -1.40; P < .001) well-being outcomes and burnout (growth mindset: b = -0.09; 95% CI, -0.11 to -0.07; P < .001; purpose and relevance: b = -0.29; 95% CI, -0.32 to -0.25; P < .001; belonging uncertainty: b = 0.28; 95% CI, 0.26 to 0.30; P < .001) and psychological symptoms (growth mindset: b = -0.22; 95% CI, -0.30 to -0.14; P < .001; purpose and relevance: b = -0.51; 95% CI, -0.64 to -0.38; P < .001; belonging uncertainty: b = 1.33; 95% CI, 1.27 to 1.40; P < .001) ill-being outcomes, even when controlling for important demographic characteristics (eg, race and ethnicity, gender identity, age). Furthermore, several significant interactions indicated that these learning mindsets may be particularly salient for students from historically marginalized communities: there was a significant interaction between growth mindset and race and ethnicity (b = 0.58; 95% CI, 0.08 to 1.09, P = .02), such that growth mindset was more strongly associated with flourishing among American Indian or Alaska Native, Black, Latine, or Native Hawaiian students.

Conclusions and Relevance

These findings suggest that identifying strategies for supporting students' learning mindsets may be an effective way to support medical student well-being and reduce ill-being, particularly among students from historically marginalized backgrounds.

High risk of burnout syndrome and associated factors in medical students: A cross-sectional analytical study

INTRODUCTION

Although research on burnout syndrome in medical students has increased in recent years, results are inconsistent about which factors are associated with a high risk for burnout syndrome. The aim of this study was to assess the prevalence of high risk of burnout syndrome and to identify factors associated with burnout in medical students in preclinical and clinical training.

METHOD

A cross-sectional study was conducted at the University of Kragujevac, Serbia. The Maslach Burnout Inventory Student Survey and an epidemiological questionnaire on basic socio-demographic and academic characteristics were used. Statistical evaluation was performed through logistic regression analysis, using Odds Ratio (OR) and 95% Confidence Interval (CI).

RESULTS

Among medical students, no statistically significant differences were found in the prevalence of high risk of burnout syndrome in preclinical (14.8%) and clinical grade (15.1%), p > 0.05. High risk for burnout syndrome in preclinical study years was independently associated with the female sex (adjusted OR = 0.41, 95%CI = 0.19-0.91, p = 0.028), and cigarette smoking (adjusted OR = 2.47, 95%CI = 1.05-5.78, p = 0.038). The high risk of burnout syndrome was associated with sedatives use (adjusted OR = 4.03, 95%CI = 1.27-12.73; p = 0.018) only in clinical years medical students. The frequency of alcohol consumption was correlated with the high risk of burnout syndrome in medical students in both preclinical and clinical training, but without statistical significance (both p for trend < 0.1).

CONCLUSION

There was a significant prevalence of burnout among medical students, with some modifiable associated factors revealed.

Is There a Burnout Epidemic among Medical Students? Results from a Systematic Review

Background and Objectives: Medical students represent the ideal target group for promoting mental health and mental wellbeing, being exposed to specific risk factors, such as the content of medical training, the exposure to sickness and death, and a stressful academic routine. Medical students report high levels of cynicism and emotional exhaustion, which represent two of the essential features of burnout syndrome. In this systematic review, studies assessing the levels of burnout among medical students through validated tools worldwide were analyzed. Materials and Methods: A systematic review has been performed in order to identify studies: (1) focusing on samples of medical students; (2) evaluating burnout syndrome using validated tools; (3) providing prevalence data on burnout; and (4) written in English. Results: Out of the 5547 papers initially obtained, 64 were finally included in the analysis. The sample sizes ranged from 51 to 2682 participants. Almost all studies had a cross-sectional design; the Maslach Burnout Inventory and its related versions were the most frequently used assessment tools. The prevalence of burnout, which was stratified based on gender and academic stage, ranged from 5.6 to 88%. Burnout was mostly predicted by thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation. Conclusions: The prevalence of burnout syndrome in medical students is quite heterogeneous, reaching a peak of 88% in some countries. However, several predictors have been identified, including negative life events or poor motivation. These findings highlight the need to develop preventive interventions targeting the future generation of medical doctors, in order to improve their coping strategies and resilience styles.

The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students

Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium-high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.

The interplay between mindfulness and caring for bliss on later student burnout

Objectives: While there are good reasons to assume that mindfulness protects against burnout in students, nothing is known about the role of caring for bliss. This study examined whether caring for bliss moderated the relationship between mindfulness at baseline and aspects of burnout approximately 12 weeks later. Participants: Students (n = 92) from a university in the United States. Methods: Online surveys were administered in 2018. Results: Moderated regression analyses, controlling for depressive symptoms and burnout at baseline, revealed that caring for bliss moderated the relationship between earlier mindfulness and two aspects of later student burnout, namely emotional exhaustion and cynicism. Specifically, exhaustion and cynicism were low when students reported either low or high scores on both mindfulness and caring for bliss. No moderating effect was found for academic efficacy. Conclusions: Mindfulness and caring for bliss appear to work synergistically to reduce aspects of student burnout over time.

Stigma About Mental Health in Slovenian First-Year Medical Students

OBJECTIVE

Stigma surrounding mental health persists as a significant impediment to adequate support and help-seeking behaviors in Slovenia, despite advancements in psychiatric care and education. This study investigates stigma among first-year medical students at the University of Maribor, Slovenia and how the stigma changes after completing a course in mental health literacy.

PARTICIPANTS

Participants were first-year medical students at the University of Maribor in the academic year 2023/2024. A total of 116 students participated in the baseline study, with 66 students participating in the follow-up study.

STUDY METHOD

The intervention involved implementing the "Transitions" program, aimed at enhancing mental health literacy and reducing stigma. We conducted a baseline study and a follow-up study, then used Wilcoxon signed rank test for repeated measures to compare the differences in ranks before and after implementation of the program.

FINDINGS

There was a significant reduction in stigma after intervention (Wilcoxon Z = -3.06, P < .01), suggesting a positive impact of the educational program. This reduction aligns with findings from similar programs globally, suggesting the efficacy of educational interventions in mitigating mental health stigma.

CONCLUSIONS

The study emphasizes the importance of integrating mental health education into medical curricula to foster stigma reduction and enhance mental health literacy among future medical doctors.

Assessment of burnout syndrome and associated factors among medical students during the COVID-19 pandemic

Background: Overwhelming requirements, a high degree of work, and prolonged exposure to emotionally demanding circumstances in work and life settings can lead to burnout syndrome. The purpose of the study is to assess burnout syndrome and its associated factors among medical students during the COVID-19 pandemic. Methods: A cross-sectional, prospective, descriptive study was conducted in a Mexican medical school during the last week of the spring semester of 2021 using the Maslach Burnout Inventory-Student Survey (MBI-SS) and an associated factors survey. Results: Based on the MBI-SS definition, most students (54.2%, n = 332) had burnout symptoms and high emotional exhaustion (79.6%, n = 448), high cynicism (57.3%, n = 351), and low academic effectiveness (36.4%, n = 223). After adjusting the associated factors, a significant correlation between the school year and the presence of burnout was identified (OR 1.127, 95% CI [1.023-1.241], p<0.05). Regarding the current pandemic, the death of a family member by COVID-19 also put students at risk of developing burnout (OR 1.598*, 95% CI [1.080-2.363, p<0.05]). Limitations: The main limitation of this study was the lack of a control group (before the pandemic); therefore, the high prevalence of burnout can only be hypothesized due to the pandemic but cannot be objectively evidenced. A prospective study after the pandemic is needed to resolve this question. Conclusion: The coronavirus pandemic represents a challenge to the academic and psychological stability of students. It essential to continue assessing burnout levels in medical students and the general population to treat them in time and improve mental health.

A study on measure of resilience and impact of demanding clinical training on young medical professional's burnout in a tertiary care hospital, Andhra Pradesh

BACKGROUND

The psychological state of medical students gaining concern on the part of medical institutions in several countries. Numerous studies are being conducted to study stress, burnout, and depression in medical students in India and globally. However, little is known about medical student resilience, particularly in India. The objectives of this study were to study the resilience, self-perceptions of stress coping skills, and burnout among medical students in clinical training in a tertiary care health center, to study factors associated with resilience among medical students in clinical training in a tertiary care health center and to study the relationship between resilience and self-perceptions of stress coping skills and symptoms of burnout.

MATERIALS AND METHODS

This cross-sectional study was conducted in a tertiary healthcare hospital in district Guntur, Andhra Pradesh from November 2020 to December 2020, among 186 adult male and female medical students, aged more than 20 years, enrolled in the regular degree course and part of patient care or at least last three months. Participants were randomly selected and a structured questionnaire with Connor Davidson Resilience Scale 10 was used for interviewing. Descriptive and inferential statistics were conducted to measure associations between outcome and explanatory variables. We used multiple linear regression to examine the association between dependent and independent variables. A P value less than. 05 was considered significant.

RESULTS

In the present study, 109 (58.0%) were females. The mean age of the study participants was 25.4 years (standard deviation 2.78). The mean score resilience score of the study participants using Connor Davidson Resilience Scale 10 was 25.1 (standard deviation 7.97). Of the total 44 (23.7%) of the study, participants reported the presence of burnout. A significant positive correlation was between resilience and self-perceptions of stress-coping skills with a Pearson Correlation coefficient of 0.393. Among the study participants, the mean resilience score was higher among those not having any symptoms of burnout. In the hierarchical stepwise multiple linear regression analysis, male gender (P value = .014), financial independence (P value = .044), and absence of burnout symptoms (P value = .004) were significantly associated with higher resilience scores. Psychiatric medicine usage was significantly associated with a lower resilience score with P < .05.

CONCLUSION

Our study samples had higher resilience and lower burnout prevalence compared to the West. The stressful clinical event experienced by medical students demands training and innovative strategies to foster communication and teamwork skills among medical teams.

Perceived Stress, Grit, and Self-Care Behaviors in First-Year Medical Students

Medical students experience more stress than the general population, which over time can cause mental and physical disease, including burnout. Identifying factors impacting stress during early medical training could inform strategies to minimize its impacts throughout training and in clinical practice. This study surveyed 238 first-year osteopathic medical students to assess stress (Perceived Stress Scale; PSS), grit, sleep quality (Pittsburgh Sleep Quality Index; PSQI), physical activity (Godin-Shephard Leisure-Time Physical Activity Score; LTPA), and nutrition habits (Rapid Eating Assessment for Participants; REAP) within the first 2 weeks of starting medical school and again 10 weeks later. Incomplete responses were removed, leaving 204 study participants. We observed statistically significant decreases in grittiness (∆grit = -2.230%, P = .002) and physical activity (∆LTPA = -22.147%, P < .0001), while perceived stress (∆PSS = 34.548%, P < .0001) and poor sleep quality (∆PSQI% = 19.853, P < .0001) increased. Correlation analyses identified the strongest relationships were between ∆PSS vs ∆PSQI (r = .47, P < .0001) and ∆PSS vs ∆LTPA (r = -.20, P < .01). Multivariable linear regression analysis isolated ∆PSQI (P < .0001) and ∆LTPA (P = .012) as statistically significant predictors of ∆PSS. These results suggest early, repeated curricular interventions focused on physical activity and sleep hygiene may help students better manage stress during medical education.

Prevalence of the medical student syndrome among health professions students and its effects on their academic performance

Medical student syndrome (MSS) is health-related anxiety while studying a specific disease that leads to stress and anxiety. The study aims to determine the prevalence of MSS among health professions students to identify its effect on the student academic performance and to recognize the awareness of MSS among health professions students. This is a descriptive cross-sectional study where 544 students from King Saud University health colleges were included and filled in a self-reported designed questionnaire. We used validated scale of short health anxiety inventory closed-ended items to measure the prevalence of MSS. All statistical analyses were performed using the statistical package for social sciences statistical software package. The results showed that 8.5% of the health colleges students were affected by MSS. The students with the medical syndrome had higher levels of anxiety (anxiety-odd ratio [OR] = 1.3, P = .35; anxiety-OR = 1.57, P = .27) and hypochondriac issues (hypochondria-OR = 2.93, P = .03; hypochondria-OR = 2.61, P = .14) than other students. Concerning to MSS negative consequences, students who experienced medical syndrome most of the time and always were 1.43 and 1.45 times more likely to experience anxiety. As a result of the medical syndrome, students with a grade point average decrease of <0.20 are 3.37 times more likely to develop a hypochondriac problem than students with no grade point average decrease (OR = 3.37; P = .04). Third-year students reported more anxiety and hypochondria symptoms than other-year students. In conclusion, MSS is a growing problem in health colleges. This study showed that, academic performance was affected for the students who have MSS. The prevention of this phenomenon may be greatly enhanced by reassurance and discussions about this syndrome.

Medical Students' Opinion of Their Learning Process

Introduction

The opinion of students is of utmost importance to identify areas of improvement in undergraduate studies. Medical schools would use this information to plan actions to ensure that the students achieve the necessary medical knowledge. The aim of this study was to analyse the opinion of medical students about their learning process and to analyse the influence of their experience according to their year of medical degree.

Methods

A questionnaire including 21 items, divided into four sections (motivation, theory lectures, hospital internships, and research) and two overall questions, was distributed among eligible 246 students. Each item was scored from 1 (strongly disagree) to 5 (strongly agree). The opinions of intermediate-year students of medical degree (3rd and 4th) were compared to late-year students (5th and 6th).

Results

A total of 148 students answered the questionnaire (60.2% response rate). The mean scores for overall student motivation and teaching quality were 6.15 and 7.10, respectively. The student-teacher interaction and new learning technological tools were considered important for student motivation. The only differences found between the two groups of students were that late-year students wished to become part of a medical team and to learn writing scientific papers more than the intermediate-year students.

Conclusions

This questionnaire revealed that the year of career had little influence on the medical students' opinion on their learning process during their undergraduate studies. Late-year students rated highest on being more interested in being part of a medical team and their knowledge on writing scientific articles. The use of new technologies and the student-teacher interaction is key to motivate students.

Burnout syndrome and depression in students of a Colombian medical school, 2018

INTRODUCTION AND OBJECTIVES

Burnout syndrome (BS) has been evaluated in few populations of medical students, and its relationship with depression is even less studied. The objective was to determine the frequency of BS in medical students of the Universidad Pedagógica y Tecnológica de Colombia (UPTC), in Tunja, Colombia, as well as its association with depression and other social, economic, demographic, and academic factors.

METHODS

An observational, analytical, cross-sectional study was carried out on 182 UPTC medical students during 2018. The Maslach Burnout Inventory-Student Survey (MBI-SS) was applied, with which 3 components were obtained to determine positive SB. This was crossed in the Stata 15 program for depression and other social, economic, demographic, and academic covariates with the Generalised Linear Model (GLM).

RESULTS

Of 182 respondents, 51.4% were women. The median age was 21 years (20-23 years). 14% had BS, of which 48% had depression. In the multiple regression, BS was significantly associated with a higher frequency of depression (RPa = 5.54; IC95%, 2.36-13.02; P < 0.001) and the feeling of insufficient money (RPa = 4.37; IC95%, 1.95-9.83; P < 0.001), in contrast to a negative association with smoking (RPa = 0.13; IC95%, 0.06-0.30; P < 0.001) and being a woman (RPa = 0.32; IC95%, 0.12-0.82; P = 0.018). The age of onset of marijuana use was not significant.

CONCLUSIONS

BS shows a high association with increased depression and a feeling that the money is not enough at the end of the month, but it showed a negative association with tobacco consumption and being a woman. Such students should be detected to provide them with adequate academic support.

Lifestyle and Sense of Coherence: A comparative analysis among university students in different areas of knowledge

BACKGROUND

The concept of health has undergone profound changes. Lifestyle Medicine consists of therapeutic approaches that focus on the prevention and treatment of diseases. It follows that the quality of life of university students directly affects their health and educational progress.

EXPERIMENTAL METHODOLOGY

Socioeconomic, lifestyle (LS), and Salutogenesis Theory/sense of coherence (SOC) questionnaires were administered to college students from three different areas. The results were analyzed for normality and homogeneity, followed by ANOVA variance analysis and Dunn and Tukey post hoc test for multiple comparisons. Spearman's correlation coefficient evaluated the correlation between lifestyle and sense of coherence; p values < 0.05 were considered statistically significant.

RESULTS

The correlation between LS and SOC was higher among males and higher among Medical and Human sciences students compared to Exact sciences. Medical students' scores were higher than Applied sciences and Human sciences students on the LS questionnaire. Exact science students' scores on the SOC questionnaire were higher than Human sciences students. In the LS areas related to alcohol intake, sleeping quality, and behavior, there were no differences between the areas. However, women scored better in the nutrition domain and alcohol intake. The SOC was also higher in men compared to women.

CONCLUSION

The results obtained demonstrate in an unprecedented way in the literature that the correlation between the LS and SOC of college students varies according to gender and areas of knowledge, reflecting the importance of actions on improving students' quality of life and enabling better academic performance.

Prevalence and factors associated with suicidal ideation among students taking university entrance tests: revisited and a study based on Geographic Information System data

BACKGROUND

A previous study identified students taking Bangladeshi university entrance tests as a vulnerable group at a higher risk of suicidal behaviours before the COVID-19 pandemic. However, the impact of the pandemic on the magnitude of these behaviours among this population remains unexplored.

AIMS

This study aimed to investigate the prevalence of suicidal ideation and associated factors among Bangladeshi university entrance test takers following the pandemic. In addition, an approach based on Geographic Information System (GIS) data was used to visualise the distribution of suicidal ideation across the country.

METHODS

A cross-sectional approach was used to collect data among participants taking the entrance test at Jahangirnagar University in September 2022. Using SPSS, data were analysed with chi-squared tests and binary regression, and ArcGIS was used to map the results across the nation.

RESULTS

The study revealed a prevalence of 14.4% for past-year suicidal ideation, with 7.4% and 7.2% reporting suicide plans and attempts, respectively. Notably, repeat test-takers exhibited a higher prevalence of suicidal behaviours. Significant risk factors for suicidal ideation included urban residence, smoking, drug use, COVID-19 infection and deaths among close relations, depression, anxiety and burnout. The GIS-based distribution indicated significant variation in the prevalence of suicidal ideation across different districts, with higher rates observed in economically and infrastructurally deprived areas.

CONCLUSIONS

Urgent measures are needed to address the high prevalence of suicidal behaviours among students taking university entrance tests students in Bangladesh, particularly in light of the COVID-19 pandemic. Enhanced mental health support, targeted prevention efforts and improved resources in economically disadvantaged regions are crucial to safeguard the well-being of these students.

Mindfulness and burnout among Chinese college students: mediation through sleep quality and perceived stress

College students often face challenges and obstacles which leads them vulnerable to burnout. Though numerous studies have supported an association between mindfulness and burnout, yet little is known about the potential mediating role of mindfulness exerts its effect in this link. This study aimed to explore the relationship between mindfulness and burnout among Chinese college students and investigated the sleep quality and perceived stress as two potential mediators of that relationship. A total of 536 college students (mean age = 21.93, 66.2% female) were investigated and completed the Five Facet of Mindfulness Questionnaire, Pittsburgh Sleep Quality Index, Perceived Stress Scale and Academic Burnout Scale of College Students. Path analyses were employed to examine the mediating effect. Results indicated that mindfulness had significant negative correlation with burnout (r=-.584, p < 0.001). Sleep quality and perceived stress were significant mediators of the observed relationship between mindfulness and burnout. These findings shed light upon the mediating role of sleep quality and perceived stress, and suggest that college students' mindfulness may facilitate their sleep quality and decrease perceived stress, which, in turn, may help prevent and reduce burnout.

Burnout and resilience at work among health professionals serving in tertiary hospitals, in Ethiopia

Background

The quality of healthcare service is strongly affected by the health professionals' levels of burnout and resilience at work (RaW). Developing resilience is a key component of medical professionalism. Although burnout and resilience are indicators used to assess the level of workplace hardship, there is a dearth of information in most developing countries, including Ethiopia.

Objective

To assess the levels of burnout and 'resilience at work' among health professionals who work in the surgical care departments in teaching Ethiopian hospitals.

Methods

A cross-sectional study design was applied among health professionals employed in surgical, gynecologic, and obstetric (Gyn/Obs) departments of two acute-care hospitals (n = 388). A structured self-administered English version questionnaire, consisting of validated scales to measure RaW and burnout, was used to collect the data;22 items of Maslach's burnout inventory human service survey tool and 20 items of Win wood's resilience at work' measuring tool" was employed to assess the health professionals' burnout level and Resilience at work, respectively. Linear logistics regression was employed for inferential statistical analysis to identify factors that predict RaW and burnout.

Results

Burnout syndrome was shown among 101 (26.0%) study participants. Furthermore, 205 (52.8%), 150 (38.7%), and 125 (32.2%) participants presented high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Emotional exhaustion was predicted by the participants' profession, the hope of promotion, professional recognition, and workload. Depersonalization was predicted by age, profession, and perceived workload of the participants. The predictors for personal accomplishment were profession, relationship at work, professional recognition, and having a managerial position in addition to clinical duty. The participants' mean RaW score was 78.36 (Standard deviation ±17.78). A negative association was found between RaW and emotional exhaustion and depersonalization. In contrast, a positive association was identified between RaW and personal accomplishment. The type of profession and marital status were positive predictors of RaW.

Conclusion

A substantial amount of health professionals experience high burnout in one or more burnout dimensions. Level of RaW is more affected by burnout syndrome. Therefore, promoting activities that increase the level of professional RaW and recognition in their professional practice is needed to reduce job burnout. These findings are especially important concerning low socio-economic countries, as resilience is a vital component of the development of healthcare systems.

Prevalence of depression, anxiety and burnout in medical students at the University of Namibia

Background

There is an increased prevalence of depression, anxiety, and burnout among medical students worldwide with no information from Namibia.

Aim

This study aimed to determine the prevalence and factors associated with depression, anxiety, and burnout among medical students at the University of Namibia (UNAM).

Methods

A quantitative descriptive cross-sectional survey was conducted utilising a specially designed questionnaire for the study and standardised instruments to evaluate depression, anxiety, and burnout.

Results

Of the 229 students in this study, 71.6% were female and 28.4% were male. The prevalence of depression, anxiety, and burnout was 43.6%, 30.6%, and 36.2%, respectively. The prevalence of emotional exhaustion (EX), cynicism (CY), and professional efficacy (EF) was 68.1% (n = 156), 77.3% (n = 177) and 53.3% (n = 122), respectively. In the final regression model, participants with a current psychiatric illness were more likely to screen positive for depression (adjusted odds ratio [aOR] 4.06, confidence interval [CI] 1.28-12.91; p = 0.02) and anxiety (aOR: 3.63, CI: 1.17-11.23; p = 0.03). Emotional exhaustion and cynicism were significantly associated with female gender (EX: aOR, 0.40, CI: 0.20-0.79; p = 0.01) (CY: aOR, 0.42, CI: 0.20-0.91; p = 0.03).

Conclusion

More than one in three medical students at the UNAM were either depressed or burnt out.

Contribution

This is the first study to highlight the mental health needs of medical students at the University of Namibia.

Breaking Down Grit: Persistency and Flexibility in the Career Plans of Military Medical Students

INTRODUCTION

The field of medicine is experiencing a crisis as high levels of physician and trainee burnout threaten the pipeline of future physicians. Grit, or passion and perseverance for long-term goals, has been studied in high-performing and elite military units and found to be predictive of successful completion of training in adverse conditions. The Uniformed Services University of the Health Sciences (USU) graduates military medical leaders who make up a significant portion of the Military Health System physician workforce. Taken together, an improved understanding of the relationships between burnout, well-being, grit, and retention among USU graduates is critical to the success of the Military Health System.

MATERIALS AND METHODS

The current study was approved by the Institutional Review Board at USU and explored these relations among 519 medical students across three graduating classes. These students participated in two surveys approximately one year apart from October 2018 until November 2019. Participants completed measures on grit, burnout, and likelihood of leaving the military. These data were then merged with demographic and academic data (e.g., Medical College Admission Test scores) from the USU Long Term Career Outcome Study. These variables were then analyzed simultaneously using structural equation modeling to examine the relationships among variables in a single model.

RESULTS

Results reaffirmed the 2-factor model of grit as both passion and perseverance (or interest consistency). No significant relationships emerged between burnout and other study variables. Sustained and focused interest was predictive of less likelihood of staying in the military.

CONCLUSION

This study offers important insights into the relationship among well-being factors, grit, and long-term career planning in the military. The limitations of using a single-item measure of burnout and measuring behavioral intentions in a short time frame during undergraduate medical education highlight the importance of future longitudinal studies that can examine actual behaviors across a career lifespan. However, this study offers some key insights into potential impacts on the retention of military physicians. The findings suggest that military physicians who are most likely to stay in the military tend to embrace a more fluid and flexible medical specialty path. This is critical in expectation setting for the military to train and retain military physicians across a wide range of critical wartime specialties.

Academic burnout in nursing students: An explanatory sequential design

AIM

Despite the harmful effects of burnout among many nursing students, academic burnout is poorly understood. This study was conducted to better explain the concept of burnout in nursing students.

DESIGN

An explanatory sequential mixed-method design was used.

METHODS

In the quantitative phase, the Maslach Burnout Inventory-Student Survey was completed by 91 nursing students in eastern Iran. In the qualitative phase, individual interviews were conducted with 13 undergraduate nursing students, one nurse and one instructor. Data were analysed using the directed content analysis method.

RESULTS

Results from an ANOVA test showed differences in burnout scores in different semesters (p = .02) that were confirmed by the qualitative data. In addition to the three dimensions of the Maslach burnout model (exhaustion, cynicism and inadequacy feeling), qualitative data from the present study indicated the presence of a fourth dimension (incompatible learning style).

Burnout in Israeli medical students: a national survey

INTRODUCTION

Professional burnout is characterized by loss of enthusiasm for work, cynicism, and a low sense of personal efficacy. Burnout may adversely affect medical professionalism. Burnout is common in clinicians and varying rates have been reported in medical students. No data exist regarding the prevalence of burnout among Israeli medical students. The aims of this study were to assess the rate of burnout in Israeli medical students and to identify students who were particularly susceptible to burnout.

METHODS

A cross-sectional questionnaire design was employed, gathering data from medical students in all years of study across three medical schools. Burnout was measured using the Maslach Burnout Inventory Student Survey (MBI-SS), translated into Hebrew.

RESULTS

Of the 2160 students in the participating medical schools, 966 (44.7%) completed MBI-SS and demographic questionnaires. The overall burnout rate was 50.6%. Multivariate logistic regression analysis yielded that female gender, age under 25, advanced year of study, studying at a specific medical school and not being a parent are all significantly correlated with higher levels of burnout.

CONCLUSIONS

A high rate of burnout was found. The identification of young women who are not parents during advanced years of studies as being at-risk is important, in order to guide the development of burnout prevention interventions.

Study related factors associated with study engagement and student burnout among German university students

Introduction

Student burnout has become a health concern in higher education systems. Its prevalence rates are high due to specific demands in this life situation. It leads not only to increased academic dropout rates but is also associated with negative health outcomes both physically and mentally. Its counterpart is study engagement, which is a positive, fulfilling, study-related attitude characterized by energy, dedication, and absorption. There has not been a systematical approach covering the demands directly posed by the academic environment itself. Additionally, academic subject fields apart from medicine and nursing sciences have been mostly neglected in regards to this research field. The aim of the study is therefore to identify contributing factors for both burnout and engagement within the academic environment in a sample of different subject fields at a German university.

Methods

In a cross-sectional study, a sample of 3,451 students of all academic subjects at a technical university in Germany has been analyzed using an online survey. Sociodemographic data, study engagement, student burnout, study satisfaction, academic workload, number of semesters and occupational liabilities have been analyzed. Binary logistic regression was used to determine the associations of burnout symptoms and study engagement.

Results

Almost a third of the students showed frequent burnout symptoms, while 42.5% showed a high degree of study engagement with no differences in gender. Age was identified as a risk factor for frequent signs of cynicism (OR = 1.073). Study satisfaction (OR between 0.459 and 0.702), semester progression (OR = 0.959) and working moderately (OR between 0.605 and 0.637) was associated with fewer symptoms in different burnout-dimensions. Study satisfaction is positively associated with study engagement (OR = 2.676). Academic workload is positively related to both burnout (OR between 1.014 and 1.021) and study engagement (OR = 1.014).

Discussion

A substantial number of students show frequent symptoms of burnout and the majority is not highly engaged. The included factors contribute to the model to various degrees and show that university-bound factors play a major role. Fostering a supportive environment is key for study engagement, health and well-being. The inclusion of further, individual factors should be a future concern in order to find and promote strategies for a healthy education system.

Mental health in medical, dental and pharmacy students: A cross-sectional study

Background

The mental health of health students is considered a public health issue which increased dramatically with the COVID 19’s pandemic. Few studies have assessed the prevalence of depression in medical, pharmacy, and dental students. Our goal was to assess mental health in health students from the same university and identify the associated factors.

Methods

An online survey was sent to the health students of the University of Paris in 3 specialties (medicine, pharmacy, and dentistry). We used the Hospitalization Anxiety and Depression scale, the Composite International Diagnostic Interview-Short Form and the Maslach Burnout Inventory (with 2 versions: the Human Services Survey for clinical students and residents and the Student survey for the others). The presence of suicidal ideation, humiliation, sexual harassment, and sexual aggression over twelve-months was also measured. We performed multivariable logistic regression analyses to identify the associated factors of Major Depressive Episodes (MDE).

Findings

1925 students answered the survey. The overall prevalence of 7-day anxiety and depressive symptoms, MDE, suicidal ideation, humiliation, sexual harassment, and sexual aggression were 55%, 23%, 26%, 19%, 19%, 22%, and 5.5%, respectively. Burnout was present in 42% of nonclinical students and 65% of clinical students and residents. Multivariable logistic regression identified several associated factors of MDE: moderate (OR = 1.49,CI95[1.17-1.90]) or major (OR = 2.32,CI95[1.68-3.20]) subjective financial difficulties, humiliation (OR = 1.71,CI95[1.28-2.28]), sexual abuse (OR = 1.65,CI95[1.04-2.60]), and sexual harassment (OR = 1.60,CI95[1.19-2.16]).

Interpretation

This is one of the largest studies comparing dental, pharmacy and medical students from the same university. We found elevated prevalences of psychiatric symptoms with variation depending on specialty.

-Barriers faced by medical students in seeking mental healthcare: A scoping review

Background: Medical students commonly exhibit mental health issues. Despite the availability of professionals on medical campuses, seeking help continues to be a challenge for some students. Our review aimed to identify the barriers medical students face when seeking professional mental healthcare. Methods: A Medical Subject Headings (MeSH) search was created for articles using PubMed, Embase, and PsychINFO databases to identify articles specifically about medical students and their barriers to professional mental healthcare. Inclusion criteria included articles in which barriers to mental healthcare were either the primary variable or one of multiple study results. No date limits were imposed. Reviews, pilot projects, or articles that did not address barriers to mental healthcare faced by medical students or focused on veterinary or dental students were excluded. A total of 454 articles were identified and screened by title/abstract and then full text. Data were extracted from 33 articles using an independent framework. Barriers identified were compiled and reported.  Results: From a total of 33 articles, the most identified barriers were fear of negative effect on residency/career opportunities, fear of confidentiality breach, stigma and fear of shaming from peers, lack of perceived seriousness/normalization of symptoms, lack of time, and fear of documentation on academic record. Students also preferred to seek care outside of their institution from fear of their provider being an academic preceptor.  Conclusions: Many of the barriers to mental healthcare faced by medical students relate to a fear of academic and career reprisal, and fear of confidentiality breach. It appears that despite recent efforts to decrease stigma surrounding mental illness, many medical students struggle to seek appropriate support. Access to mental healthcare can be improved by increasing transparency regarding what information will be displayed on academic records, dispelling common myths about mental healthcare, and increasing awareness about resources available for medical students.

Burnout and Resilience among Respiratory Therapy (RT) Students during Clinical Training in Saudi Arabia: A Nationwide Cross-Sectional Study

BACKGROUND

The epidemic of burnout has been widely documented among health discipline students. However, there is limited information available on the prevalence of burnout and its association with resilience among clinical-level respiratory therapy (RT) students.

METHODS

Between March 2022 and May 2022, a descriptive, cross-sectional study using a convenience sample of RT students and interns was conducted. A total of 559 RT students and interns from 15 RT programs responded to socio-demographic questions and the Maslach Burnout Inventory (MBI) and the Brief Resilience Scale (BRS) questionnaires. The data were analyzed using descriptive, inferential, and correlation tests.

RESULTS

Of the 559 respondents, 78% reported a high level of burnout. Within the three subscales of burnout, 52% reported emotional exhaustion (EE), 59% reported depersonalization (DP), and 55% reported low personal achievement (PA). The prevalence of burnout increased as students proceeded to senior years (p = 0.006). In addition, participants with higher grade point averages (GPA) reported a higher level of burnout. Only 2% of the respondents reported a high level of resiliency. Further, there were negative correlations between resilience and EE (r = -41, p < 0.001) and DP (r = -32, p = 0.03), and a positive correlation with low PA (r = 0.56, p = 0.002).

CONCLUSION

The findings showed a high prevalence of burnout among RT students and interns during clinical training in Saudi Arabia. Resilience was associated with all domains of burnout and is likely to play a protective role. Therefore, there is a need for collaborative interventions to promote resiliency during clinical training to alleviate and overcome burnout symptoms.

The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students

The purpose of the study was to evaluate the relationship between school burnout, sense of school belonging, and academic achievement in medical students. This cross-sectional study was performed with students at the Ondokuz Mayıs University Medical Faculty (Samsun, Turkey) between 1 and 31 May 2019. Six hundred one (71.0%) first, second, and third-year students were included in the study. A questionnaire was employed as the data collection method. The questionnaire consisted of two parts. The first part consisted of questions investigating sociodemographic information produced by the authors by scanning the literature. The second part consisted of the School Burnout Inventory and the Psychological Sense of School Membership Scale. The relationship between the sense of school belonging, school burnout, and academic achievement was evaluated using structural equation modeling. The structural equation modeling analysis determined that school burnout played a mediating role in the relationship between the sense of school belonging and academic achievement in preclinical medical students. As the sense of belonging to the school increases in preclinical medical students, academic achievement increases. School burnout in preclinical medical students increases as a sense of school belonging decreases. Academic achievement among preclinical medical students decreases as school burnout levels increase. Increasing the sense of school belonging can be effective in preventing school burnout and increasing academic achievement.

Stress, anxiety, and depression among students at the Faculty of Medicine of Sousse (Tunisia)

OBJECTIVE

To evaluate the frequency of anxious and depressive symptoms and to determine their associated factors in a population of students enrolled at the Faculty of Medicine of Sousse (Tunisia).

METHODS

this is a descriptive cross-sectional study that took place at the Faculty of Medicine of Sousse over the period from 09/15/2017 to 03/15/2018. An anonymous questionnaire was administered to the students in the guided teaching rooms. The assessment of anxiety and depressive symptoms was based on the Anxiety and Depression Scale (HADS) and the quality of sleep was assessed by the PSQI questionnaire.

RESULTS

A total of 202 medical students participated in the study. The average PSQI score was 5.62±2.87 and 47% of students had poor sleep quality (PSQI ≥ 6). Symptoms of anxiety and depression were observed in 73 (36.1%) and 45 (22.3%) students respectively. The mean HADS-A score was 9.21±4.17 and that of the HADS-D score was 7.37±4.06. In univariate analysis, the factors found to predict a high level of perceived stress were the study cycle (p=0.022) and poor quality of sleep (p 11) were the use of sleeping pills (p=0.004), the quality of sleep (p<0.001), and a high level of perceived stress (p<0.001). The high level of perceived stress was found to predict depression (p=0.006).In the multivariate analysis of variables in the present study, poor sleep quality was a factor independently related to high perceived stress in medical students (ORa=9.062 [4.247-19.334]) while being a medical student of the 1st cycle proved to be a protective factor (ORa=0.101 [0.025-0.406]). Use of sleeping pills (ORa=4.481 [1.135-17.682]), poor sleep quality (ORa=2.131 [1.081-4.203]) and high level of perceived stress (ORa=5.790 [2.444-13.716]) were factors independently related to anxiety symptoms. Female sex was a protective factor for depressive symptoms (ORa=0.440 [0.205-0.945]) while a high level of perceived stress was a factor independently related to depressive symptoms (ORa=3.429 [1.469-8.005]). HAD-A and HAD-D scores were correlated (r=0.631 ; p<0.001).

CONCLUSION

sleep disturbances, perceived stress, anxious and depressive symptoms are common among Tunisian medical students. Prevention strategies targeting the improvement of sleep quality and student stress management should be developed at the faculty and ministerial level.

Wellbeing and mental health among medical students in Indonesia: A descriptive study

BACKGROUND

Medical students face high pressures to perform academically, which may lead to poor psychological well-being, burnout, and even mental illness.

AIMS

This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors.

METHODS

In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire).

RESULTS/CONCLUSION

A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students.

Experiences of academic and professional burn-out in medical students and residents during first COVID-19 lockdown in Belgium: a mixed-method survey

COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to: 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students and residents. We hypothesized burnout levels to be high; those involved in COVID-19 care to experience higher impact of COVID-19 on studies and work, and to experience higher levels of academic and professional burnout than those not involved in COVID-19 care; academic and professional burnout to be higher when perceived burden due to COVID-19 was higher. During first lockdown in Belgium, a mixed-method cross-sectional survey assessed academic burnout (MBI-SS) and professional burnout in relation to internships and residency (MBI-HSS). Correlations and t-tests tested associations of burnout with involvement in COVID-19-related care and perceived impact of COVID-19 on studies and work (SPSS). Participants provided open-ended comments which were thematically analysed (NVivo). In total, 194 medical students and residents participated (79.5% female, M age = 24.9 ± 2.5). Emotional exhaustion and depersonalisation were high in professional burnout, but moderate in academic burnout. Those involved in COVID-19 related care perceived a higher impact of COVID-19 on their studies and internship/residency and have higher professional burnout, but do not show a higher academic burnout. Those who have a higher perceived impact of COVID-19 on their studies scored higher on academic burnout. Participants mentioned an increased workload (e.g., having to be constantly available and constantly adapt), distress (e.g., uncertainty, fatigue, fear for impact on significant others), fewer learning opportunities (e.g., cancelled internships, changing learning methods), lack of relatedness with patients and supervisors (e.g., lack of respect and understanding from supervisors, distance created by phone consultations with patients) and cynicism towards remote care or non-medical tasks (e.g., considering what they do is not useful or not what they trained for). Students and residents showed indications of professional and academic burnout in relation to the COVID-19 situation. Interventions are needed that can meet the needs of achieving learning outcomes, managing extreme situations and relatedness.

Development of Team Behavior Skills and Clinical Lactation Competence Among Medical Students Engaging in Telesimulations with Standardized Patients

Objective: The aims of this pilot feasibility study were to determine if telesimulations with standardized patients (SPs) wearing high-fidelity breast models impact students' team behavior and clinical competence in lactation support. Materials and Methods: Medical students (N = 19) completed five telesimulations: Cases 1, 2, 5 in a team, 3 as individual, and 4 randomized. SPs used the Formative Assessment Rubric (FAR) to evaluate interpersonal and clinical competence. Collaboration skills within team-based telesimulations (Cases 2 and 4) were rated using the Interprofessional Collaborator Assessment Rubric (ICAR). Satisfaction data were collected from a focus group and written evaluation. Descriptive statistics were calculated for FAR, ICAR, and written evaluations. Appropriate nonparametric tests were used to measure FAR and ICAR differences over time or between team and individual telesimulations and the relationship between FAR and ICAR scores. Content analysis was used to generate themes from focus group data. Results: Learners' interpersonal and lactation-specific competence improved over time (p = 0.003 and 0.009, respectively). Learners were able "to accept responsibility for their actions" more but spent less time "seeking perspectives from peers" in Case 4 compared with Case 2 (p = 0.01 and p < 0.001, respectively). Themes from the focus group related to the value of team telesimulations to learn clinical lactation skills and learn about one's role in a team. Learners agreed they developed clinical lactation skills (>4.5/5-pt). Conclusions: Opportunities to work collaboratively in telesimulations with a SP prepare learners for professional collaborations to effectively care for breast/chestfeeding dyads.

Psychological Distress, Burnout, and Academic Performance in First Year College Students

Background: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. Methods: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students’ grades for the first semester were collected. Results: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. Conclusions: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.

Responsibility with a Safety Net: Exploring the Medical Student to Junior Doctor Transition During COVID-19

INTRODUCTION

The Foundation Interim Year-one (FiY1) Programme was part of a UK strategy to increase the medical workforce in response to the COVID-19 pandemic. However, the strategy was introduced urgently without evidence. We sought to explore the transition experience of medical student to FiY1 to foundation doctor, with a view to inform future undergraduate education.

METHODS

In this hermeneutic phenomenology study, semi-structured individual interviews were completed with nine foundation doctors who had experience of an FiY1 placement. A template analysis approach was taken, and themes reported.

RESULTS

Participants reported that FiY1 tended to offer a positive experience of transition as a stepping stone to becoming a foundation doctor. Having a degree of clinical responsibility including the right to prescribe medication with supervision was highly valued, as was feeling a core member of the healthcare team. Participants perceived that FiY1 made them more prepared for the foundation transition, and more resilient to the challenges they faced during their first foundation job.

DISCUSSION

The FiY1 fostered many opportunities for junior doctors to bridge the transition to foundation doctor. Aspects of the FiY1 programme, such as early licencing and increased team membership, should be considered for final-year students in the future.

Suicidal behaviors and university entrance test-related factors: A Bangladeshi exploratory study

PURPOSE

The present study is the first investigating unexplored psychological issues of university entrance test-taking students in Bangladesh.

DESIGN AND METHODS

This cross-sectional study investigates suicidal behaviors and their socio-demographic, admission test-related, and psychopathological risk factors among a total of 911-Bangladeshi university entrance test-takers.

FINDINGS

About 17.7% of the participants report suicidal thoughts, whereas it is 8.0% and 2.5% for suicide plans and suicide attempts, respectively. Significantly higher suicidal thought is observed in the repeat test-taking students compared to the first-time test-takers (20.7% vs. 14.6%, χ ²  = 5.669, p = 0.017), though the suicide plan and suicide attempt are not associated with student status. The suicidal thought risk factors include female gender, urban residence, satisfaction with the mock test, mental disorders etc. PRACTICAL IMPLICATIONS: The present findings warrant implementing initiatives for this suicide-prone cohort, especially for the test-failing students.

Reliability and validity study of the Thai adaptation of the Copenhagen Burnout Inventory-Student Survey (CBI-SS) among preclinical medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

Burnout syndrome is a syndrome of emotional exhaustion, professional efficacy and cynicism. A significant proportion of medical students reported having burnout syndrome during their training in medical education. Several tools including the Copenhagen Burnout Inventory-Student Survey (CBI-SS) are considered to be a valid measurement of burnout syndrome in medical students. This study aimed to translate, culturally adapt, and validate the CBI-SS for assessing burnout syndrome among preclinical medical students in Thailand. This study was conducted during February to March 2019 at the Faculty of Medicine Siriraj Hospital, Mahidol University (Bangkok, Thailand), which is Thailand’s largest and oldest medical school, and Thailand’s largest national tertiary referral center. After receiving formal permission to do so from the copyright owner, the original English language version of the CBI-SS was translated to Thai language using an internationally recommended and accepted forward-backward translation protocol. The Thai version of the CBI-SS (Thai CBI-SS) comprises 25 items, including 6 items for personal burnout, 7 items for study-related burnout, 6 items for colleague-related burnout, and 6 items for teacher-related burnout. Standardized Cronbach’s alpha coefficient was calculated to evaluate internal consistency reliability, and correlation coefficient was computed to determine test-retest reliability. A total of 414 preclinical medical students participated in this study. Due to sub-optimal factor weights (<0.50), items 6, 10 and 17 were excluded. The Cronbach’s alpha coefficients of the 22-item Thai CBI-SS for personal, study-related, colleague-related, and teacher-related burnout were 0.898, 0.896, 0.910 and 0.900 respectively. The correlation coefficients for test-retest reliability after three weeks were 0.820, 0.870, 0.821, and 0.787 for personal, study-related, colleague-related, and teacher-related burnout, respectively. Maximum likelihood analysis with oblimin rotation indicated four main components, and confirmatory factor analysis revealed good fit indices of the Thai CBI-SS. Confirmatory factor analysis showed good fit indices of CBI-SS domains (χ2/df = 2.39; CFI = 0.957; GFI = 0.909; RMSEA = 0.058; TLI = 0.949; and NFI = 0.928). The convergent validity analysis using the Average Variance Extracted (AVE) and the Composite Reliability (CR) was adequate for all dimensions (personal: AVE = 0.626, CR = 0.893; study-related: AVE = 0.601, CR = 0.899; colleague-related: AVE = 0.677, CR = 0.913; teacher-related: AVE = 0.606, CR = 0.900). The HTMT values for all variables are in the range from 0.315 to 0.833, confirming the discriminant validity. The Thai CBI-SS was found to be a valid and reliable tool for evaluating burnout syndrome in preclinical medical students in Thailand.

The Influence of Religiosity and Spirituality on the Happiness, Optimism, and Pessimism of Brazilian Medical Students

BACKGROUND

Mental health problems are very common among medical students, becoming a concern for health care professionals and educators. Despite the fact that there is a growing body of literature supporting the role of religiosity and spirituality (RS) on mental health and on positive psychology outcomes, little evidence is available among medical students, a population subjected to important distress.

AIMS

This study aimed to investigate the role of RS on the levels of optimism, pessimism, and happiness among Brazilian medical students.

METHODS

This is a cross-sectional study including medical students from the first to the eighth semester of a private medical school. The instruments used were: TOT-R for optimism and pessimism, Lyubomirsk and Lepper subjective happiness scale, and sociodemographic profile. The independent variables were Brazilian Portuguese Duke University Religiosity Scale for religiosity, Brief Spiritual Religious Coping (SRC) for negative and positive SRC; and Facit-Sp for spiritual well-being.

RESULTS

A total of 353 medical students were included (response rate 97.51%). Higher levels of intrinsic religiosity and peace were associated with greater happiness and optimism. However, negative SRC was associated with lower levels of happiness and optimism and higher levels of pessimism.

CONCLUSION

Medical students tend to use their RS as a resource for dealing with the challenges of medical school, influencing their happiness and optimism. In this context, it seems that religiousness acts in two different ways, not only have positive but also negative outcomes among the participants.

Digital mental health literacy -program for the first-year medical students' wellbeing: a one group quasi-experimental study

BACKGROUND

Medical students are prone to mental disorders, such as depression and anxiety, and their psychological burden is mainly related to their highly demanding studies. Interventions are needed to improve medical students' mental health literacy (MHL) and wellbeing. This study assessed the digital Transitions, a MHL program for medical students that covered blended life skills and mindfulness activities.

METHODOLOGY

This was a one group, quasi-experimental pretest-posttest study. The study population was 374 first-year students who started attending the medical faculty at the University of Turku, Finland, in 2018-2019. Transitions was provided as an elective course and 220 students chose to attend and 182 agreed to participate in our research. Transitions included two 60-minute lectures, four weeks apart, with online self-learning material in between. The content focused on life and academic skills, stress management, positive mental health, mental health problems and disorders. It included mindfulness audiotapes. Mental health knowledge, stigma and help-seeking questionnaires were used to measure MHL. The Perceived Stress Scale and General Health Questionnaire measured the students' stress and health, respectively. A single group design, with repeated measurements of analysis of variance, was used to analyze the differences in the mean outcome scores for the 158 students who completed all three stages: the pre-test (before the first lecture), the post-test (after the second lecture) and the two-month follow-up evaluation.

RESULTS

The students' mean scores for mental health knowledge improved (-1.6, 95% Cl -1.9 to -1.3, P<.001) and their emotional symptoms were alleviated immediately after the program (0.5, 95% Cl 0.0 to 1.1, P=.040). The changes were maintained at the two-month follow up (-1.7, 95% Cl -2.0 to -1.4, P<.001 and 1.0, 95% Cl 0.2 to 1.8, P=.019, respectively). The students' stress levels reduced (P=.022) and their attitudes towards help-seeking improved after the program (P<.001), but these changes were not maintained at the two-month follow up. The stigma of mental illness did not change during the study (P=.13).

CONCLUSIONS

The digital Transitions program was easily integrated into the university curriculum and it improved the students' mental health literacy and wellbeing. The program may respond to the increasing global need for universal digital services, especially during the lockdowns due to the COVID-19 pandemic.

TRIAL REGISTRATION

The trial was registered at the ISRCTN registry (26 May 2021), registration number 10.1186/ ISRCTN10565335 ).

Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review

BACKGROUND: The mental health of medical students has long been a topic of concern in many countries. Much research in Europe reported that around 30% of medical students suffered from anxiety. Anxiety disorders have significant physical and emotional consequences. Various studies show that excessive, unmanaged stress related to poor academic performance in medical students leads to cynical personalities, lack of empathy, and suicidal ideas. AIM: This study aimed to identify studies for psychotherapy interventions carried out in medical students and analyze each impact on anxiety level in medical students. METHODS: This systematic review was conducted with evidence sourced from 2000 to 2020. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered with the Prospective Registering of Systematic Reviews database (Protocol ID: CRD42020180650). RESULTS: Twenty-three studies meet the inclusion criteria, and there are various psychotherapy interventions to deal with anxiety. Most studies reported that students who received mindfulness-based interventions reported lower anxiety, depression, and stress. CONCLUSION: There are various interventions carried out to decrease stress levels, depression, and anxiety in medical students. The most effective psychotherapy was found in cognitive and behavior intervention and mindfulness intervention.

Burnout, does the university entrance test failing attribute? A Bangladeshi exploratory study

Getting admission into a university is highly competitive globally and can be regarded as a mental stressor for some individuals. In Bangladesh, most of the universities allow students to repeat the test, whereas repeat test-taking students are supposed to suffer from psychological issues like burnout because of academic non-achievement in their first attempt. But there is no prior study assessing burnout to the population, which was investigated herein. A cross-sectional study was carried out among a total of 911 Bangladeshi university entrance test-taking students (i.e., 49.5% first-time test-takers). The survey measures included socio-demographics, admission-related issues, and mental health problems (depression, anxiety, and burnout). Of the mental health problems, depression, anxiety, and burnout were assessed by the Patient Health Questionnaire (PHQ-9), Generalized anxiety disorder (GAD-7), and Maslach Burnout Inventory-Student Survey (MBI-SS), respectively. In light of two-dimensional and three-dimensional cutoff schemes of the MBI-SS, about 43.7% and 17.3% of the test-taking students, respectively, were classified to be burnout in the total sample. Additionally, 48.1%, 71.4%, and 49.1% of the students in the total sample reported higher emotional exhaustion, higher cynicism, and lower academic efficacy, respectively. In respect to the student status, two-dimensional burnout (48.0% vs. 39.2%; χ2 = 7.164, p = 0.007), and emotional exhaustion (52.2% vs. 43.9%, χ2 = 6.789, p = 0.034) were significantly higher among the repeat test-taking students. Satisfaction with previous mock tests, depression, and anxiety were the associated factors of burnout in all three samples. Based on the present study, it can be concluded that the university entrance test appearing students are highly prevalent to burnout, and the rate increases with academic non-achievement. As the first study assessing burnout to the population, the findings are anticipated to be helpful for policymaking and further studies both inside and outside Bangladesh.

Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis

BACKGROUND

Burnout is common among university students and may adversely affect academic performance. Little is known about the true burden of this preventable malady among university students in low-and-middle-income countries (LMICs).

OBJECTIVES

This study aimed to systematically estimate the prevalence of burnout among university students in LMICs.

METHODS

We searched PubMed, Google Scholar, CINAHL, Web of Science, African Journals Online, and Embase from the inception of each database until February 2021. Original studies were included. No study design or language restrictions were applied. A random-effects meta-analysis was performed using STATA version 16.0. Heterogeneity and publication bias were assessed using Q-statistics and funnel plots, respectively.

RESULTS

Fifty-five unique articles, including a total of 27,940 (Female: 16,215, 58.0%) university students from 24 LMICs were included. The Maslach Burnout Inventory (MBI) was used in 43 studies (78.2%). The pooled prevalence of burnout was 12.1% (95% Confidence Interval (CI) 11.9-12.3; I2 = 99.7%, Q = 21,464.1, p = < 0.001). The pooled prevalence of emotional exhaustion (feelings of energy depletion), cynicism (negativism), and reduced professional efficacy were, 27.8% (95% CI 27.4-28.3; I2 = 98.17%. p = <0.001), 32.6 (95% CI: 32.0-33.1; I2: 99.5%; p = < 0.001), and 29.9% (95% CI: 28.8-30.9; I2: 98.1%; p = < 0.001), respectively.

CONCLUSION

Nearly one-third of university students in LMICs experience burnout. More studies are needed to understand the causes of burnout in this key population. There is a need to validate freely available tools for use in these countries.

High risk of burnout in medical students in Serbia, by gender: A cross-sectional study

INTRODUCTION

Burnout syndrome is common among medical students, but findings about the gender differences in burnout are not consistent. The aim of this study was to assess high risk of burnout syndrome among medical students at one University in Serbia, by gender.

METHOD

A cross-sectional study was conducted at the Faculty of Medical Sciences, University of Kragujevac in 2014. The Maslach Burnout Inventory-Student Survey was used for assessment of burnout level. A questionnaire on basic socio-demographic characteristics (age, gender, marital status, habits, etc.) and academic performance (year of study, cumulative total average grade, length of study, housing, study financing, etc.) was used. The study included a total of 760 medical students (760/836 medical students; participation rate: 90.9%). Logistic regression analysis was used to determine odds ratios (OR) with 95% confidence intervals (95% CI).

RESULTS

Significant gender differences were detected in prevalence of high risk of burnout syndrome (male students- 19.0% vs. female students- 12.8%, p = 0.024). A significant independent predictor of high risk for burnout syndrome in male medical students was study year (p for trend = 0.011), while in female medical students-study year (p for trend = 0.002) and use of sedatives (adjusted OR = 5.74, 95% CI = 1.96-16.77, p = 0.001).

CONCLUSION

Our results indicate the need to assess the risk of burnout syndrome at the very beginning of medical studies, in order to more effectively control the modifiable risk factors.

A Scoping Review of Research into the Origins of Cynicism Among Medical Trainees

There is a perception that medical trainees begin their training idealistic and full of excitement. Yet, there is growing recognition in scholarly literature that this idealism is replaced by cynicism as a result of the training process itself. The ultimate goal of this study was to review the current literature on cynicism during medical training in order to identify factors that engendered its development. Equipped with this information, medical education can expand data collection regarding cynicism in order to further inform the development of solutions to combat it. This scoping review was conducted with a broad search for published articles across three medical education databases using search terms "cynicism in medical students." Additional relevant articles were added from reference lists of included articles. Articles on cynicism in practicing professionals were excluded as were articles that focused on burnout. The search identified 161 unique articles; 30 articles merited full reading and 19 ultimately met inclusion criteria. Emergent themes comprised three categories: causes of cynicism, variations of cynicism among populations, and outcomes of cynicism. Within these 3 categories, 9 sub-categories were also extracted. From Kopelman's perspective (Kopelman in JAMA 250(15):2006-10, [11]), the presence of cynicism verifies that students' ideals are still alive because they recognize that things could be better and are disappointed that they are not; cynicism may be preferable to despair. This review revealed that trainees have not suffered a death of their ideals, but a burial. Corrective action may be able to excavate what was lost-an idealistic approach to medical training.