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Depression and suicidal ideation have a higher prevalence in medical students when compared to other age-matched populations.1,2 The SARS-CoV2 pandemic has further threatened medical trainee well-being with increased stress and risk of mental illness.3,4
To compare medical student well-being at a single institution before and during the SARS-CoV2 pandemic.
Third year medical students at a single institution voluntarily completed a survey during pediatric clerkship orientation as part of an ongoing, non-pandemic longitudinal wellness study. The survey instrument includes basic demographic information, the validated World Health Organization (WHO) (FIVE) Well-Being Index (WHO-5), and questions about physical activity. Data from mid-academic year students rotating on the pediatric clerkship in the 2019-2020 (two cohorts, pre-pandemic) and 2020-21 (three cohorts, during pandemic) academic years were compared across compositive survey scores and sub-question scores.
Study participation was 81% pre-pandemic (n=34) and 59% during the pandemic (n=39) with no statistically significant differences in age or gender. Mean WHO-5 well-being scores trended up from the pre-pandemic to pandemic groups without reaching statistical significance (16.3 vs 17.5, p=0.13). The mean individual survey question on feeling fresh and rested significantly improved from pre-pandemic to pandemic groups (2.74 vs 3.23, p<0.05). Remaining question mean scores were similar or trended toward improved well-being from pre-pandemic to pandemic groups; cheerful/good spirits (3.62 vs 3.82, p=0.15), calm/relaxed (3.32 vs 3.33, p=0.48), active/vigorous (3.18 vs 3.31, p=0.28), and interest in daily life (3.41 vs 3.79, p=0.08). Based on using the composite WHO-5 survey as a validated tool to screen for depression, there was a trend towards less students screening positive for depression in the pandemic group (26.5% pre-pandemic vs 10.5% pandemic, p=0.07).
From our small sample of third year medical students at a single institution, we find that well-being is stable when comparing matched groups across academic years before and during the SARS-CoV2 pandemic. Interestingly, survey subsection data demonstrates improved subjective feelings of being rested in the pandemic group and suggests lower rates of depression based on screening cutoffs (WHO-5). We suspect this may be related to changes in the educational environment such as transitioning from the clinical environment to virtual rotations, or time away from rotations entirely which may have allowed for increased personal wellness time. Focus groups and further investigation are necessary to identify which factors are altering levels of student well-being.
- Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med J Assoc Am Med Coll. 2006;81(4):354-373. doi:10.1097/00001888-200604000-00009
- Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214-2236. doi:10.1001/jama.2016.17324
- Kannampallil TG, Goss CW, Evanoff BA, Strickland JR, McAlister RP, Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout. PLOS ONE. 2020;15(8):e0237301. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237301. Accessed Oct 5, 2020. doi: 10.1371/journal.pone.0237301.
- Wu S, Li Z, Li Z, et al. The mental state and risk factors of chinese medical staff and medical students in early stages of the COVID-19 epidemic. Compr Psychiatry. 2020;102:152202. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437442/. Accessed Oct 21, 2020. doi: 10.1016/j.comppsych.2020.152202.
Scholl, Jenna; Akinmoladun, Oladapo; Kanley, Amissabah; Gollehon, Nathan; and Burrows, Jason, "Comparison of Third Year Medical Student Wellness Before and During the SARS-CoV2 Pandemic" (2021). Child Health Research Institute Pediatric Research Forum. 15.