Objective: Medical students are vulnerable to poor mental well-being. The recent COVID-19 pandemic has disrupted student life and had significant effects on curricula delivery at medical schools around Australia. The study aimed to assess the impact of COVID-19 on medical student mental well-being, assess concerns and determine activities used by students to help with the situation. Method: An online cross-sectional survey was designed. Questions focused on concerns and impact of COVID-19. The Kessler-10 (K10) measured psychological distress. Results: Two hundred and ninety-seven students participated with a 37.5% response rate. Mean K10 score was 20.6 indicating moderate psychological distress. There were no significant differences in K10 mean score or distress level (low, moderate, high, very high) between students in different years of the medical course. Deterioration in mental well-being since COVID-19 onset was reported by 68% students. Main negative impacts were on social connectedness, studies and stress levels. Concerns related to uncertainty about returning to normal and graduation. Common activities were using video chats, social media, exercise and hobbies. Conclusions: The impact of COVID-19 on mental well-being has led to legitimate concerns by students regarding their studies and progress through the medical course. We hope to minimise these disruptions, and reassure and support students to ensure that academic goals are achieved.

BackgroundMental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students’ attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness.MethodYear 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career.ResultsAttitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students’ interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students ‘definitely considering’ psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up.ConclusionThe clerkship made a modest impact on students’ attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.

The studies undertaken to-date have identified and raised awareness of a wide range of negative and positive factors toward psychiatry. In order to encourage more students to consider psychiatry as a career, attention needs to focus more closely on the psychiatry curriculum and the development of innovative teaching strategies. This may overcome the negativity that students express toward psychiatry, improve recruitment rates to training programs, and put psychiatry on a more positive foundation for the future.

Overall, the psychiatry clerkship has a positive impact on students' attitudes towards psychiatry, but does not improve interest in psychiatry as a career option. For those students particularly interested in psychiatry, the challenge is to maintain their enthusiasm post-clerkship. Charismatic teachers, mentorship and stigma reduction may be effective strategies. Future research needs to more clearly identify specific components of the clerkship that are viewed favorably by students.

The HANAA is a culturally appropriate and useful tool for the screening of SEWB among Aboriginal adults. It can also be used for teaching and training purposes of mental health and other professionals working with Aboriginal people.