BECOMING A PHYSICIAN: A QUALITATIVE ANALYSIS OF MEDICAL STUDENTS’ PERSPECTIVES ON THEIR ACADEMIC ENVIRONMENT, WELL-BEING AND MENTAL HEALTH

Abstract

Background: Medical students are a population at higher risk for psychological
 distress and mental health disorders when compared to the general population.
 Evidence-based interventions to promote well-being are available, but the rates of
 anxiety, burnout, depression, and suicide are not decreasing as expected. This
 scenario can lead to poor academic outcomes and lower assistance capability.
 Students are frequently targeted in interventions, but the academic environment
 itself is seldomly a target. Qualitative research is an insightful approach in deriving
 a deeper understanding of phenomena that are suitable to culture-sensitive
 interventions.
 Objective: To explore student’s perception of medical school and their understanding
 of which factors underly the path from well-being to impaired mental health.
 Methods: A qualitative exploratory study was performed. Focus groups and
 in-depth interviews were conducted, comprising students from all medical school
 years. Grounded theory was used to analyze data, and Consolidated Criteria for
 Reporting Qualitative Research were followed. Feedback from participants and
 through external supervision were conducted in ensuring saturation, reliability,
 and coherence.
 Results: Five main categories were identified: socioeconomic aspects, university
 environment (including culture, institutional functioning, and relationships),
 training issues, career demands, and mental health. Both personal and environmental
 factors were highlighted as contributors and stressors.
 Conclusion: A medical career appears to be related to a culture of omnipotence
 where excellence is frequently misconstrued as perfection. The complex relations
 between personal and environmental factors demand comprehensive strategies.
 Institutional rules could be adapted to avoid enhancing excessive competition. In
 some cases, individual assistance is needed. Inclusion of the academic community’s
 perspective and targeting the negative aspects of the medical culture seem essential
 to move forward in the field of mental health and person-centered learning.