Medical students, mental health and the role of resilience – A cross-sectional study

Abstract

Background

Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias.

Methods

Participants were n = 521 medical students from RCSI University of Medicine and Health Sciences. Outcomes were measured using validated scales. We report descriptive statistics, and risk factors for the difficulties were investigated using generalized linear modelling.

Results

One-in-three students reported incidence of depression or anxiety (24.5% co-morbidity). 8.9% of students reported all four difficulties. Difficulties were more common in female students and those in middle years of the programme. Resilience was negatively correlated with all outcomes and stable across demographic and educational variables. Weighting the data for sampling bias did not affect these results.

Conclusions

Our results emphasise the high incidence of depression, anxiety, burnout, and comorbidity in students. We advocate for further investigation into the role of resilience as a modifiable factor that may ameliorate the incidence of depression, anxiety, and burnout in medical students.

Keywords:

• Medical students
• depression
• anxiety
• burnout
• resilience

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Mental Health: A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

World Health Organization. Promoting mental health: concepts, emerging evidence, practice (Summary Report) Geneva: World Health Organization; 2004.

Burnout: Is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) a sense of ineffectiveness and lack of accomplishment. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

World Health Organization. (2019). ICD-11: International classification of diseases (11th revision). Retrieved from https://icd.who.int/

Resilience: The ability to overcome adversity from negative experiences.

Rutter M. 1999. Resilience concepts and findings: implications for family therapy. J Fam Ther. 21:119–44.

Additional information

Notes on contributors

Colm Healy

Dr Colm Healy, BSc, MSc, PhD, is a Lecture in the Department of Health Psychology and a Senior Post-Doctoral Research Fellow in the Department of Psychiatry at the Royal College of Surgeons in Ireland. His interests include Youth Mental Health and the Prediction and Prevention of Severe Psychiatric Disorder.

Áine Ryan

Dr Áine Ryan, BSc (Physio), MSc, PhD, PGDip HPE, MISCP, is a Postdoctoral Fellow in Professionalism in Healthcare and Honorary Lecturer in the RCSI. Áine is a Chartered Physiotherapist and has a PhD in Population Health and Health Services Research. Her research interests are in Professionalism, Health Professions Education and Lifestyle Medicine.

Catherine N. Moran

Dr Catherine N. Moran, B.A., M.Psych.Sci., P.Grad.Cert.Stats, PhD, is a postdoctoral researcher in the Department of Health Psychology at RCSI University of Medicine and Health Sciences, Dublin. Her research interests include medical education, stroke quality of care, interventions for complex chronic conditions, and cognitive ageing.

Denis W. Harkin

Professor Denis W. Harkin, MB, MD, FRCSI, FEBVS, is Chair of Medical Professionalism at RCSI and leads the Centre for Professionalism in Medicine and Health Sciences at RCSI. A Consultant Vascular Surgeon, he has a special interest in vascular trauma, complex aortic and venous disease. His research interests include Medical Education, Professionalism and Vascular Surgery.

Frank Doyle

Professor Frank Doyle, BA(Hon), MLitt, PhD, is Associate Professor in Psychology in RCSI and a Fellow of the European Health Psychology Society. His research interests include health and education and he has led the development of three new research methods, including a novel metric for the assessment of medication adherence and a ‘hybrid’ systematic review approach.

Anne Hickey

Professor Anne Hickey, PhD, AFPsSI, Reg.Psychol.PsSI, is Professor of Health Psychology and Deputy Dean for Positive Education at RCSI University of Medicine and Health Sciences. She is involved in coordinating and teaching health psychology and resilience skills to health professional students. Her research interests include stroke and stroke rehabilitation, development of complex interventions for clinical settings, and medical education.