Article
How studying medicine makes prospective physicians sick – mental health of 58 individual students at the beginning and at the end of their curricular medical education
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Authors
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Kaja Schneider
- Friedrich-Alexander-Universität Erlangen, Institut für Funktionelle und Klinische Anatomie, Erlangen, Deutschland
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Georg Breuer
- REGIOMED Klinikum Coburg, Anästhesie, Coburg, Deutschland
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Michael Scholz
- Friedrich-Alexander-Universität Erlangen, Institut für Funktionelle und Klinische Anatomie, Erlangen, Deutschland
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Pascal Heinrich Burger
- Psychiatrische Universitätsklinik Zürich, Spezialambulatorium ADHD, Zürich, Schweiz
| Published: | September 15, 2021 |
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Outline
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Objective: Usually, studies about the mental health of medical students analyze large, anonymized semester cohorts. Even in a longitudinal design this approach leaves room for interpretation if those impersonal groups are truly comparable to each other. Fluctuation of individuals at the study site, changes in the curriculum and other effects might be influential and cannot be sufficiently adressed in the usual approaches.
Methods: Within the framework of our ESTRELLAS studies in Erlangen we conducted two assessments of psychological parameters with medical students in 2013 and 2018. Out of 530 participants in the initial survey, we were able to identify 58 students by their voluntary declaration of their matriculation number who had taken part in both surveys. This gave us the unique and outstanding opportunity to directly compare the mental health status of these students at the beginning of their studies and 5.5 years later. We used established, validated psychological questionnaires to quantify work-related behaviour patterns (AVEM-44), burnout symptoms (BOSS-II) and depression (BDI-II).
Results: The participants started with values that were comparable to the population average in these questionnaires. 5.5 years later the status had deteriorated massively. In 2018, a paired t-test showed significant impairment in all three burnout dimensions (physical, cognitive, emotional) and significant changes in all subscales of the AVEM-44 (all p<0.01). The distribution of dominant patterns (AVEM-44) changed dramatically from 44 participants with burnout-protective patterns in 2013 to only two people with such patterns in 2018.
Discussion: The deterioration of mental health of medical students is well known, but has been redefined in our assessment approach in a way and with a quality never before achieved. This detailed glance at work-related behaviour patterns should influence the form and content of our medical curriculum.
Take home message: The comparison of mental health parameters in 58 individual medical students over a period of 5.5 years showed a drastic and dramatic deterioration.
References
- 1.
- Burger P, Tektas OY, Paulsen F, Scholz M. From Freshmanship to the First Staatsexamen - Increase of Depression and Decline in Sense of Coherence and Mental Quality of Life in Advanced Medical Students. Psychother Psychosom Med Psychol. 2014;64(08):322-327. DOI: 10.1055/s-0034-1374593
- 2.
- Scholz M, Neumann C, Steinmann C, Hammer CM, Schröder A, Essel N,Paulsen F, Burger P. Development and correlation of work-related behavior and experience patterns, burnout and quality of life in medical students from their freshmanship to the first state examination. Psychother Psychosom Med Psychol. 2015;65(3-4):93-98. DOI: 10.1055/s-0034-1375630
