Academic achievement, depression and anxiety during medical education predict the styles of success in a medical career: A 10-year longitudinal study

Figures & data

Figure 1. Model of success predictors (academic achievement, depression and anxiety during medical education) and markers of success four years after graduation.

Table

Practice points

We established a model of success in the medical career that includes: anxiety and academic achievement during medical school as predictors of success and markers of this success: postgraduate medical competence, satisfaction with medicine as a career, work stress and burnout and QOL. We described three different styles of success, which can be predicted during medical education based on factors of our model.

Table

Final sample (n = 54) response rate
	General response rate	Academic achievement*	Depression	Anxiety
Admission,	n = 178 of 320 (56%);	n = 45 (83%);	n = 31 (57%);	n = 29 (54%);
In year 1,	n = 178 of 320 (56%);	n = 42 (77%);	n = 32 (59%);	n = 32 (59%);
In year 2,	n = 129 of 280 (46%);	n = 41 (76%);	n = 21 (39%);	n = 22 (41%);
In year 3,	n = 127 of 302 (42%);	n = 41(76%);	n = 23 (43%);	n = 20 (37%);
In year 4,	n = 121 of 288 (42%);	n = 41 (76%);	n = 21 (39%);	n = 20 (37%);
In year 5,	n = 58 of 271 (21%);	n = 10 (19%);	n = 10 (19%);	n = 9 (17%);
In year 6,	n = 138 of 240 (57%);	n = 18 (33%);	n = 18 (33%);	n = 19 (35%).

*Academic achievement: At admission: high school final exam results and medical school admission test scores.

in year 1–6: medical school grade point average.

Table 1  Descriptions of the three styles of success in a medical career dimensions: cluster analysis (bineary Euclidean distance measure and Ward's linkage method)

	1. Committed satisfied with career n = 14	2. Clever satisfied with life n = 20	3. Bright competent n = 16	F (2; 47)	p	Tukey's post- hoc test
	M ± SD	M ± SD	M ± SD			1 vs. 2	1 vs. 3	2 vs. 3
Postgraduate medical competence	−0.62 ± 0.61	−0.50 ± 0.53	1.17 ± 0.61	48.256***	<0.001	0.53	<0.001***	0.00**
Satisfaction with medicine as a career	0.95 ± 0.68	−0.47 ± 0.47	−0.24 ± 0.85	20.180***	<0.001	<0.001***	<0.001***	0.31
Work stress and burnout	0.33 ± 0.48	−0.27 ± 0.43	0.07 ± 0.45	7.365***	<0.001	<0.001***	0.13	0.03*
QOL General well-being	−0.29 ± 0.81	0.49 ± 0.55	−0.35 ± 0.60	9.499***	<0.001	<0.001***	0.80	<0.001***
QOL Life satisfaction	−0.60 ± 0.78	0.76 ± 0.45	−0.89 ± 0.86	29.090***	<0.001	<0.001***	0.26	<0.001***
QOL Income	3.57 ± 0.51	3.80 ± 0.41	2.63 ± 0.89	16.803***	<0.001	0.31	<0.001***	<0.001***

*p < 0.05; **p < 0.01; ***p < 0.001.

Table 2  Means (±standard deviation) for groups representing the styles of success in the medical career, in terms of academic achievement, depression and anxiety at admission and during medical school

	1. Committed satisfied with career n = 14	2. Clever satisfied with life n = 20	3. Bright competent n = 16				Tukey's post- hoc test
	M ± SD	M ± SD	M ± SD	F (2; 47)	p	η^2	1 vs. 2	1 vs. 3	2 vs. 3
High school final exam results
Biology	5.29 ± 0.47	4.80 ± 0.41	4.88 ± 0.81	3.141	0.052	0.13
Chemistry	5.00 ± 0.78	4.50 ± 0.69	4.75 ± 0.45	2.444	0.098	0.10
Physics	4.71 ± 0.47	4.50 ± 0.83	4.38 ± 0.72	0.869	0.426	0.04
Total	15.00 ± 1.11	13.80 ± 1.70	14.00 ± 1.46	2.915	0.064	0.12
Medical school admission test scores
Biology	26.43 ± 2.82	26.10 ± 3.63	28.25 ± 3.61	1.931	0.156	0.08
Chemistry	29.71 ± 3.07	29.70 ± 3.20	29.75 ± 4.31	0.001	0.999	0.00
Physics	26.86 ± 3.82	26.70 ± 4.84	28.13 ± 4.40	0.517	0.599	0.02
Total	82.86 ± 7.28	82.30 ± 7.37	85.88 ± 9.57	0.944	0.396	0.04
Medical school 1–6th grade point average
Year 1	3.61 ± 0.37	3.42 ± 0.26	3.63 ± 0.43	2.028	0.143	0.09
Year 2	3.68 ± 0.38	3.42 ± 0.29	3.81 ± 0.39	5.723**	0.006	0.24	0.09	0.09	0.01*
Year 3	3.67 ± 0.40	3.51 ± 0.20	3.76 ± 0.51	2.058	0.139	0.09
Year 4	3.89 ± 0.60	3.58 ± 0.20	3.97 ± 0.62	3.147	0.052	0.13
Year 5	4.03 ± 0.24	3.85 ± 0.24	3.98 ± 0.21	2.802	0.071	0.12
Year 6	3.99 ± 0.28	3.91 ± 0.28	4.05 ± 0.10	1.458	0.243	0.06
Depression
Year 0	42.14 ± 12.41	33.50 ± 8.73	48.25 ± 9.98	10.666***	<0.001	0.45	0.03*	0.20	0.00**
Year 1	43.57 ± 11.79	35.30 ± 8.11	53.13 ± 10.27	14.318***	<0.001	0.61	0.05	0.03*	0.00**
Year 2	41.00 ± 11.02	35.40 ± 9.64	46.63 ± 12.40	4.672*	0.014	0.20	0.32	0.35	0.01*
Year 3	45.43 ± 11.19	36.60 ± 11.44	47.00 ± 10.83	3.500*	0.038	0.15	0.13	0.94	0.05
Year 4	50.00 ± 11.65	39.50 ± 12.11	47.13 ± 11.34	3.723*	0.032	0.16	0.01*	0.01*	0.86
Year 5	52.43 ± 13.66	34.30 ± 9.68	42.13 ± 12.10	11.177***	<0.001	0.48	0.00**	0.04*	0.10
Year 6	47.57 ± 13.21	35.50 ± 10.11	40.75 ± 11.60	4.997*	0.011	0.21	0.01*	0.22	0.34
State anxiety
Year 0	17.86 ± 32.79	2.20 ± 1.01	5.00 ± 2.78	3.603*	0.035	0.15	0.03*	0.12	0.88
Year 1	4.83 ± 1.29	4.20 ± 1.77	6.75 ± 1.98	3.423*	0.041	0.15	0.04*	0.13	0.90
Year 2	4.71 ± 1.64	3.60 ± 1.31	5.88 ± 2.70	6.108**	0.004	0.26	0.24	0.24	0.00**
Year 3	5.86 ± 2.44	4.20 ± 2.33	6.13 ± 2.55	3.324*	0.045	0.14	0.14	0.95	0.06
Year 4	5.57 ± 2.28	4.10 ± 1.97	5.75 ± 2.46	3.005	0.059	0.13
Year 5	5.57 ± 2.14	3.50 ± 2.12	5.75 ± 2.46	5.647**	0.006	0.24	0.03*	0.97	0.01*
Year 6	4.71 ± 1.90	3.50 ± 2.12	5.75 ± 2.46	4.794*	0.013	0.20	0.26	0.40	0.01*
Trait anxiety
Year 0	5.57 ± 1.31	3.10 ± 1.41	5.88 ± 2.33	3.041	0.057	0.13
Year 1	18.57 ± 33.24	3.80 ± 1.36	7.63 ± 1.54	3.016	0.059	0.13
Year 2	5.43 ± 2.41	3.80 ± 1.36	6.75 ± 1.61	12.309***	<0.001	0.52	0.03*	0.12	0.00**
Year 3	5.86 ± 2.32	4.30 ± 2.43	6.50 ± 1.71	4.827*	0.012	0.21	0.11	0.70	0.01*
Year 4	5.86 ± 2.51	4.00 ± 2.25	6.63 ± 1.78	6.885**	0.002	0.29	0.05	0.61	0.00**
Year 5	6.29 ± 2.20	3.80 ± 1.51	6.88 ± 1.67	15.370***	<0.001	0.65	0.00**	0.64	0.00**
Year 6	5.57 ± 2.47	3.80 ± 1.51	6.75 ± 1.61	11.558***	<0.001	0.49	0.02*	0.20	0.00**

*p < 0.05; **p < 0.01; ***p < 0.001.

Table 3  Discriminant analysis for groups representing the styles of success in the medical career, in terms of academic achievement, depression and anxiety at admission and during medical school education

	Classification function			Effect sources
	1. Committed satisfied with career N = 14	2. Clever satisfied with life n = 20	3. Bright competent n = 16
	p = 0.28	p = 0.40	p = 0.32	Wilks’ λ	F (2; 44)	p
High school final exam results
Biology	6.00	5.16	3.58	0.831	4.482*	0.017
Medical school 1–6th grade point average
Year 2	27.36	23.43	31.66	0.742	7.654**	0.001
Year 3	−8.01	−4.43	−9.54	0.887	2.814	0.071
Year 4	13.24	11.44	14.26	0.848	3.943*	0.027
State anxiety
Year 0	466.92	387.40	332.80	0.11	110.560***	<0.001
Year 1	−6.44	−6.56	−7.11	0.636	8.001**	0.002
Year 2	−90,216.00	−97,930.00	−95,908.00	0.003	4577.420***	<0.001
Year 3	531,692.00	615,975.00	619,943.00	<0.001	41,899.700***	<0.001
Year 5	−7802.00	−11,151.00	−10,620.00	0.025	506.393***	<0.001
Year 6	−36,3711.00	−464,364.00	−452,881.00	0.003	8242.350***	<0.001
Trait anxiety
Year 0	−397.07	−330.52	−284.65	0.13	88.983***	<0.001
Year 2	90,510.00	98,251.00	96,222.00	0.003	4223.860***	<0.001
Year 3	−928,693.00	−1075941.00	−1082866.00	<0.001	29,217.800***	<0.001
Year 5	−778.00	−1176.00	−1134.00	0.487	13.689***	<0.001
Year 6	−26,739.00	−34,143.00	−33,299.00	0.066	366.340***	<0.001

*p < 0.05; **p < 0.01; ***p < 0.001.