To What Extent Is The Mental Health Issue Present?
Students at universities are reporting problems with mental health at a higher rate than before. Do medical students also have to abide by this? Compared to many other students, they follow a more comprehensive, regulated schedule and have a predetermined professional path. As a result, they interact with faculty members and fellow students more frequently and may receive higher levels of assistance. However, only a small number of UK studies have examined medical students’ particular mental discomfort levels to far.
But according to a 2018 BMA study of medical professionals and students, 40% of respondents said they had psychological issues. A comprehensive analysis conducted in the US found that 27% of medical students reported having depression symptoms while enrolled in school. The rising levels of anxiety among students prior to entering the industry would be troubling, especially considering the high rates of burnout and work stress in the medical field. Both the BMA and the General Medical Council (GMC) have issued urgent appeals to comprehend the specific problems harming the health of physicians and medical students.
What Sources Of Stress Do Medical Students Face?
Medical students may experience stress for the same reasons as their peers in other fields, such as adjusting to life away from home, deadlines, test anxiety, and interpersonal problems.
However, there are other demands placed on medical students as well, such as:
- A high workload that raises the risk of burnout and makes it harder to balance work and life
- Higher prevalence of competition, great empathy, and perfectionism as personality qualities that may cause suffering
- Reluctance to report distress due to stigma i.e. what a doctor should be able to cope with; leading to presenteeism
- Relocating frequently, which disrupts networks of support and has an influence on adjusting to new surroundings and learning methods
- Being in morally dubious or upsetting circumstances, such as being near death or experiencing discomfort
Medical students are more likely to be negatively impacted by the structure of university services, which is frequently still based on a typical 9–5 model, even though they deal with a lot of known stressors and difficult problems. In order to at least guarantee that access to services is possible, the BMA has demanded that university counselling services run an after-hours service and permit remote access for students away from campus on placement. Even while it could be difficult to get students to use support services, it still seems that it is their responsibility to disclose mental health concerns.
How May Medical Students Be Better Supported?
While the causes of mental health issues among medical students are well understood, the situation is complicated, and the UK has seen limited efforts to address this growing issue up to this point. According to the findings of a 2013 GMC-commissioned survey of eight medical schools, addressing the “domain of culture” in medicine would have the greatest positive impact on the mental health of students. Changes in culture will be difficult to achieve and take time.
Targeting interventions at the individual or programme level has been the preference of interventions thus far. An eight-week mindfulness course was found to significantly increase students’ well-being, coping skills, and professionalism during training placements in a recent study. Mindfulness has been promoted by the GMC to help support students better. On the other hand, the effectiveness of these programmes is not well-documented in the UK, and further research is required to determine the most effective means of implementing mindfulness training.
Guidelines in Australia, New Zealand, and the US are beginning to be informed by intervention studies. The medical education curriculum was changed in St. Louis, US, as part of an intervention that put wellness at its core rather than merely as an extra training opportunity. Grading adjustments, increased elective time, the creation of a new learning community, a decrease in contact hours during the pre-clinical years, and the inclusion of resilience and mindfulness courses in the curriculum were all part of the initiative. This multifactorial design demonstrated notable reductions in students’ levels of stress, anxiety, and depression as well as improved community cohesion, highlighting the importance of incorporating wellness programmes.
There is growing evidence that universities can do more to ensure the safety and well-being of their medical student population. In the last ten years, not much has been done in response to UK medical groups’ strong recommendations for immediate investigation into the effects of medical student distress and correction of systemic flaws in higher education.
In order to begin the process of changing the culture and guarantee that students entering the workforce are better prepared to provide medical care and better equipped to handle the stresses of working within the NHS, universities need to start looking for better ways to make quick wins in the wellbeing of medical students (recognising the greater stressors they often face). Additionally, more understanding of the mechanisms causing students’ psychological problems as a result of their increased discomfort is still needed, as this could help with the design of any remedies.