Patterns of distress in US medical students

Liselotte N. DyrbyeDepartment of Medicine, Mayo Clinic, USA; LISELOTTE N. DYRBYE, MD MHPE, is an associate professor of medicine, Mayo Clinic College of Medicine, Department of Medicine. Dr Dyrbye is the associate director, Research Applications, Mayo Clinic's Program on Physician Well-being. She has published extensively in the area of trainee and physician well-being.Correspondence[email protected]

William HarperUniversity of Chicago, USA; WILLIAM HARPER, MD, is an associate professor of medicine, University of Chicago Pritzker School of Medicine. Dr Harper directs the pre-clerkship clinical skills curriculum and is the medical director for the Program for Personalized Health and Prevention, University of Chicago Medical Center.

Steven J. DurningUniformed Services University of the Health Sciences, USA; STEVEN J. DURNING, MD, is a professor of medicine, Uniformed Services University of the Health Sciences.

Christine MoutierUniversity of California, USA; CHRISTINE MOUTIER, MD, is an associate professor of psychiatry and assistant dean for Student Affairs, University of California, San Diego School of Medicine. Dr Moutier's areas of interest include refractory depression and medical student/physician wellness and suicide prevention.

Matthew R. ThomasDepartment of Medicine, Mayo Clinic, USA; MATTHEW R. THOMAS, MD, is an assistant professor of medicine, Mayo Clinic, Department of Medicine. Dr Thomas directs the Internal Medicine Clerkship and is Chair of Education, Division of Primary Care Internal Medicine, Mayo Clinic.

F. Stanford Massie JrUniversity of Alabama School of Medicine, USA; F. STANFORD MASSIE Jr, MD, is an associate professor of medicine, University of Alabama, School of Medicine. Dr Massie directs the Introduction to Clinical Medicine course.

Anne EackerUniversity of Washington School of Medicine, USA; ANNE EACKER, MD, is an associate professor of medicine, University of Washington School of Medicine. Dr Eacker directs the General Internal Medicine Center at the University of Washington Medical Center.

David V. PowerUniversity of Minnesota Medical School, USA; DAVID V. POWER, MD MPH, is an associate professor of Family Medicine, University of Minnesota Medical School.

Daniel W. SzydloDepartment of Health Sciences Research, Mayo Clinic, USA;University of Washington, USA; DANIEL W. SZYDLO, BA, was a statistician, Mayo Clinic, Department of Health Sciences Research at the time of the study. He is now a graduate student at University of Washington, Seattle, Washington.

Jeff A. SloanDepartment of Health Sciences Research, Mayo Clinic, USA; JEFF A. SLOAN, PhD, is a professor of oncology, Mayo Clinic, Department of Health Sciences Research. Dr Sloan is statistician with extensive expertise in quality of life research.

Tait D. ShanafeltDepartment of Medicine, Mayo Clinic, USA; TAIT D. SHANAFELT, MD, is an associate professor of medicine, Mayo Clinic College of Medicine, Department of Medicine. Dr Shanafelt is the director of the Mayo Clinic's Program on Physician Well-being and has published extensively in the field of trainee and physician well-being.

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Abstract

Background: How multiple forms of psychological distress coexist in individual medical students has not been formally studied.

Aim: To explore the prevalence of various forms of distress in medical students and their relationship to recent suicidal ideation or serious thoughts of dropping out of school.

Methods: All medical students at seven US schools were surveyed with standardized instruments to evaluate burnout, depression, stress, mental quality of life (QOL), physical QOL, and fatigue. Additional items explored recent suicidal ideation and serious thoughts of dropping out of medical school.

Results: Nearly all (1846/2246, 82%) of medical students had at least one form of distress with 1066 (58%) having ≥3 forms of distress. A dose-response relationship was found between the number of manifestations of distress and recent suicidal ideation or serious thoughts of dropping out. For example, students with 2, 4, or 6 forms of distress were 5, 15, and 24 fold, respectively, more likely to have suicidal ideation than students with no forms of distress assessed. All forms of distress were independently associated with suicidal ideation or serious thoughts of dropping out on multivariable analysis.

Conclusions: Most medical students experience ≥1 manifestation of distress with many experiencing multiple forms of distress simultaneously. The more forms of distress experienced the greater the risk for suicidal ideation and thoughts of dropping out of medical school.

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Patterns of distress in US medical students

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Patterns of distress in US medical students

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