Association of performance in medical residency selection with a psychiatric diagnosis, and depressive and anxiety symptoms

Abstract

Objective

Few studies have focused on medical students and residents’ mental health impact on medical residency selection (MRS) performance. The authors evaluated the association of performance in MRS with depressive and anxiety symptoms and with a reported psychiatric diagnosis (rPD).

Methods

The authors enrolled candidates after the second round of MRS examinations at a Brazilian Medical School. Performance was assessed by final grade. Depressive and anxiety symptoms were assessed by the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the State-Trait Anxiety Inventory (STAI). The authors performed mediation analysis and multiple linear regression analysis to investigate the impact of rPD, state and trait anxiety, and depressive symptom severity on performance.

Results

515 of the 643 MRS candidates (80.1%) participated in the study. Higher age, attending a preparatory course for MRS, rPD, and the number of MRS applications that year were associated with poorer performance. In mediation analysis, trait anxiety was associated with a direct effect on performance and an indirect effect mediated by rPD.

Conclusion

The data suggest that psychiatric diagnosis is associated with poorer performance on MRS, regardless of current symptoms of anxiety and depression. Additionally, increased levels of trait anxiety may negatively impact performance, directly and indirectly.

Keywords:

• Internship and residency
• schools
• medical
• students
• medical
• mental health
• mental disorders

Acknowledgements

The authors would like to gratefully acknowledge Mrs. Desiree Cordeiro, Mrs. Marcia Morikawa, Mrs. Katia Pienegonda, Mr. Thiago Reginatto, Mr. Henrique Ribeiro, Mrs. Simone Soares, Mrs. Priscila Toledo, and Mr. Marcio Vieira for their help collecting data. We would also like to acknowledge Prof. Iolanda Tiberio and Prof. Francisco Lotufo Neto for their support with the conception of the work.

Disclosure statement

Dr. Iosifescu did not receive any funding for this manuscript; in the last five years, he has received consulting honoraria from Alkermes, Allergan, Angelini, Axsome, Biogen, Boehringer Ingelheim, Centers for Psychiatric Excellence, Clexio, Global Medical Education, Jazz, Lundbeck, Neumora, Otsuka, Precision Neuroscience, Relmada, Sage, and Sunovion and research support (through his academic institution) from Alkermes, AstraZeneca, Brainsway, LiteCure, NeoSync, Otsuka, Roche, and Shire. On behalf of Dr. Humes, Prof. Siqueira and Prof. Fraguas, the corresponding author reports no conflicts of interest. The Institution Ethical Review Board approved this study.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Eduardo C. Humes

Eduardo C. Humes, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.

Dan V. Iosifescu

Dan V. Iosifescu, New York University School of Medicine, New York, USA.

Jose O. Siqueira

Jose O. Siqueira, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.

Renerio Fraguas

Renerio Fraguas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.