Abstract
BackgroundMedical education has a reputation for being demanding and stressful. However, longitudinal surveys across the whole course of study considering risks and resources are rare.MethodsFor the evaluation of stress and coping we administered the standard instruments Perceived Medical School Stress Scale (PMSS), Hospital Anxiety and Depression Scale (HADS), Work-Related Behavior and Experience Patterns (AVEM), Maslach Burnout Inventory (MBI), and a short form of the Coping Orientations to Problems Experienced Scale (Brief COPE) in three consecutive cohorts of medical students (N = 377) at one German university. Students were surveyed at the beginning of their studies (t0) and again during each consecutive summer semester (t1-t6).ResultsStress and symptoms of anxiety and depression increased in the first two years of medical studies but decreased again towards their end. Consistently, freshmen medical students presented with a large proportion of the healthy pattern at t0 (56 %) that decreased to 30 % at t2, and increased up to 44 % at t6. Correspondingly, the proportion with the burnout-related risk pattern B increased from 9 to 16 % at t2, again decreasing to 7 % at t6. Over the whole course of study there was an almost continuous increase of the unambitious pattern S from t0 13 to 40 % at t6. Characteristic differences especially between the healthy pattern and the risk patterns regarding stress, mental health symptoms and coping were observed. Female students showed a higher vulnerability for stress, anxiety and depression as well as lower proportions with a healthy pattern, and higher proportions with risk patterns for overexertion and burnout.ConclusionsThe development of stress, symptoms and behavior and experience patterns especially in the first two years, demonstrating increasing study-related stress in the preclinical years, as well as the high proportion with an unambitious pattern at the end of the course of study emphasize the need for prevention and health promotion at both the individual and contextual levels.
Highlights
Medical education has a reputation for being demanding and stressful
The development of stress, symptoms and behavior and experience patterns especially in the first two years, demonstrating increasing study-related stress in the preclinical years, as well as the high proportion with an unambitious pattern at the end of the course of study emphasize the need for prevention and health promotion at both the individual and contextual levels
When burnout and coping strategies were assessed at t5, 200 of those who had participated at t0 were still present in the data
Summary
Medical education has a reputation for being demanding and stressful. longitudinal surveys across the whole course of study considering risks and resources are rare. Medical education has a reputation for being one of the most stressful courses to study. Numerous crosssectional studies have proven high levels of stress, anxiety, depression, and burnout at different time points of medical education [3,4,5,6]. Surveys in US physicians compared to the general population revealed that a higher proportion of physicians were dissatisfied with their work life balance and a higher and increasing proportion presented with burnout symptoms [10]. This is a question of personal wellbeing. It has to be noted critically that medical culture is not supportive of those seeking professional help in times of personal stress [16, 18]
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