18: Student quality of life decline during third-year surgical clerkship

Abstract

Introduction: Choosing surgery as a career is declining among U.S. medical students. The 8-week third-year surgery clerkship at our institution can be an intense learning experience, and we hypothesized that participation in the clerkship may negatively impact student quality-of-life to the point of dissuading students from choosing a surgical career. We began a study in 2005 to address this hypothesis, and our quality-of-life findings are presented here. Methods: At orientation (baseline), students were asked to complete a survey that measured quality-of-life on an 84-point scale, and depression on a 40-point scale. The quality-of-life scale was composed of select questions from the Medical Outcome Study, and the depression scale was composed of a subset of questions from the Beck Depression Inventory. Students were also asked the typical number of hours they slept per night. On Week 6 of the clerkship, students were surveyed on the same quality-of -life and depression scales, and asked average hours of sleep per night for the previous week. Results: From June 2005 through June 2006, 93 of 121 students agreed to participate in the study, representing a response rate of 77%. Forty-five students were women (48.39%), and the average age was 26.09 (sd 2.85). Mean quality-of-life at baseline was 56.43 (n=93, sd=11.36) and at Week 6 was 50.79 (n=92, sd=10.35) representing a statistically significant average decline of 5.63 points (n=92, 95% CI=3.21-8.06). Mean depression at baseline was 35.31 (n=93, sd=3.94) and at Week 6 was 34.83 (n=93, sd=3.59), representing a non-significant average decline of 0.48 points (n=93, 95% CI -0.24-1.21). Mean sleep at baseline was 6.34 hrs/night (n=92, sd=0.91) and at Week 6 was 5.70 hrs/night (n=91, sd=1.30), representing a statistically significant average decline of 0.64 hrs/night (n=90, 95% CI 0.36-0.93). Conclusion: In the first year of our study, quality-of-life and sleep declined significantly in third-year medical students from orientation to week 6 of their surgery clerkship. Depression level, however, did not change significantly during this time period. We look forward to assessing whether the magnitude of this decline in quality-of-life predicts students avoiding a future career in surgery.