Context: Medical schools seek for measures to improve their students' study progress and are responsible for a diverse student population. Objectives:The effect of a stricter academic dismissal (AD) policy in medical school on short-term and long-term study progress was investigated in a longitudinal cohort study. In addition, differential effects for subgroups were assessed by intersecting gender, ethnicity and prior education (intersectional framework).Methods: Participants were first-year Bachelor students enrolled in 2011 to 2016 in a Dutch medical school. For cohorts 2011-2013, the AD policy consisted of a minimum of 67% of Year-1 credits required to remain enrolled (67%-policy, n = 1189), and for cohorts 2014-2016, this bar was raised to 100% of Year-1 credits (100%-policy, n = 1233). Outcome measures on study progress were Year-1 completion and dropout (short term) and Bachelor completion in three and four years (long term).Results: Overall, Year-1 completion rates increased under the 100%-policy compared to the 67%-policy (OR = 2.50, 95%-CI:2.06-3.03, P < .001). Yet, this increase was not present for students with non-standard prior education -except for males with a migration background (OR = 7.19, 95%-CI:2.33-25.73, P < .01). The dropout rate doubled under the 100%-policy (OR = 2.41, 95%-CI:1.68-3.53, P < .001). Mainly students with standard prior education dropped out more often (OR = 3.68, 95%-CI:2.37-5.89, P < .001), except for males with a migration background. Bachelor completion rates after three and four years were not positively affected by the 100%-policy. Notably, females without a migration background and with non-standard prior education suffered from the 100%-policy regarding Bachelor completion after three years (OR = 0.29, 95%-CI:0.11-0.76, P < .05).Conclusions: Despite increased dropout rates, the stricter AD policy improved Year-1 completion rates -especially for under-represented subgroups, thereby improving study progress without harming student diversity on the short term. However, these positive effects did not hold regarding Bachelor completion rates indicating that long-term effects require higher performance standards throughout the Bachelor, which in turn may harm other subgroups and thereby student diversity.

Background Medical schools are challenged to guard student wellbeing given the potential negative impact of the COVID-19 outbreak combined with an already high prevalence of mental distress. Although social support is generally associated with less crisis-induced stress, it is unknown whether this applies to medical students during the COVID-19 outbreak. Objectives The impact of the COVID-19 outbreak on perceived stress of medical students was assessed by comparing their perceived stress levels during the outbreak to both their own baseline and the previous cohort’s pre-COVID-19 stress levels. Then, the association between social support and stress during the COVID-19 outbreak was assessed. Methods Dutch Year-1 medical students of cohort 2019 (n = 99) completed the 14-item Perceived Stress Scale (PSS-14) at two time points: baseline (pre-COVID-19) and final measurement (COVID-19). Social support—emotional-informational support and club membership—was assessed during the final measurement. PSS and social support scores were compared to similar measurements of cohort 2018 (n = 196). Students’ baseline stress levels, gender, and study performance were controlled for when comparing final stress levels. Results In cohort 2018 (pre-COVID-19), students’ perceived stress levels did not differ significantly between the baseline and final measurements. Additionally, baseline stress levels of the two cohorts (2018 and 2019) were not found to be significantly different. Cohort 2019’s final stress levels (COVID-19) were significantly higher compared to their baseline stress levels (paired t-test: t = 6.07, p < .001) and cohort 2018’s final stress levels (linear regression: B = 4.186, p < .001). Only during the COVID-19 outbreak higher social support levels—i.e., emotional-informational support (B = -0.75, p < .001) and club membership (B = -3.68, p < .01)—were associated with lower stress levels. Conclusions During the COVID-19 outbreak, medical students’ perceived stress levels were higher—especially for students with lower social support levels. Our results suggest that medical schools should optimize social support to minimize crisis-induced stress.

The present study examined whether disagreement between self-, other-, and meta-perceptions of personality was related to burnout symptoms and eudaimonic workplace well-being. We expected disagreement in personality perceptions to explain incremental variance in burnout symptoms and eudaimonic workplace well-being beyond the main effects of the different personality ratings. Participants were 459 Dutch employees and their 906 colleagues (who provided other ratings of personality). The results, based on polynomial regression with response surface analyses, highlighted strong main effects of self-rated personality traits in relation to burnout symptoms and eudaimonic workplace well-being. This study provides, as far as we know, the first empirical evidence that self-rated Honesty-Humility negatively predicts burnout symptoms. Results showed little evidence on incremental effects of disagreement between personality perceptions, with one clear exception: when respondents misjudged how their colleagues would rate them on Honesty-Humility (i.e., discrepancy between meta- and other-perceptions), respondents experienced more feelings of burnout and less eudaimonic workplace well-being. Our study contributes to the literature by providing evidence that discrepancies between meta- and other-perceptions of Honesty-Humility affect employee well-being (i.e., burnout symptoms and eudaimonic workplace well-being).

Background: Medical schools are challenged to guard student wellbeing due to the potential negative impact of the COVID-19 outbreak on top of the already high prevalence of mental distress. Whereas social support is generally associated with less crisis-induced stress, it is unknown whether this applies to medical students during the COVID-19 outbreak. Objectives: The impact of the COVID-19 outbreak on perceived stress of medical students was assessed by comparing their perceived stress levels during the outbreak to both their own baseline and the previous cohort's pre-COVID-19 stress levels. Then, the association between social support and COVID-19 induced stress was assessed. Methods: Dutch Year-1 medical students of cohort 2019 (n=99) completed the 14-item Perceived Stress Scale (PSS-14) at two time points: baseline (pre-COVID-19) and final measurement (COVID-19). Social support - emotional-informational support and club membership - was assessed during the final measurement. PSS and social support scores were compared to similar measurements of cohort 2018 (n=196). Students' baseline stress levels, gender and study performance were controlled for when comparing two cohorts. Results: Stress levels did not differ statistically significant between both pre-COVID-19 measurements of cohort 2018 and baseline cohort 2019. During the COVID-19 outbreak, cohort 2019 showed significantly higher stress levels compared to baseline (paired t-test: t=6.07, p<.001) and compared to cohort 2018 (linear regression: B=4.186, p<.001). Only during the COVID-19 outbreak, higher levels of social support - i.e. emotional-informational support (B=-0.75, p<.001) and club membership (B=-3.68, p<.01) - were associated with lower levels of stress. Conclusions: During the COVID-19 outbreak, the perceived stress of medical students was higher - especially for students with lower levels of social support. Our results suggest that medical schools should optimize social support to minimize crisis-induced stress.

Background The prevalence of medical students’ mental distress is high. While schools apply various methods to select a well-performing and diverse student population, little is known about the association between different selection methods and the well-being of these students during medical school. The present retrospective multi-cohort study assessed whether students selected by high grades, assessment, or weighted lottery showed different stress perception levels in Year-1 of medical school. Methods Of 1144 Dutch Year-1 medical students, 650 (57%) of the cohorts 2013, 2014, and 2018 who were selected by high grades, assessment, or weighted lottery completed a stress perception questionnaire (PSS-14). A multilevel regression analysis assessed the association between selection method (independent variable) and stress perception levels (dependent variable) while controlling for gender and cohort. In a post-hoc analysis, academic performance (optimal vs. non-optimal) was included in the multilevel model. Results Students selected by assessment (B = 2.25, p < .01, effect size (ES) = small) or weighted lottery (B = 3.95, p < .01, ES = medium) had higher stress perception levels than students selected by high grades. Extending the regression model with optimal academic performance (B=-4.38, p < .001, ES = medium), eliminated the statistically significant difference in stress perception between assessment and high grades and reduced the difference between weighted lottery and high grades from 3.95 to 2.45 (B = 2.45, p < .05, ES = small). Conclusions Selection methods intended to create a diverse student population – assessment and lottery - are associated with higher stress perception levels in Year-1 of medical school. These findings offer medical schools insights into fulfilling their responsibility to take care of their students’ well-being.