Commentary
CommentaireM edical school has long been recognized as involving numerous stressors that can affect the wellbeing of students. 1,2 In addition to coping with the normal stressors of everyday life, medical students must deal with stressors specific to medical school, which include information and input overload, financial indebtedness, lack of leisure time, and pressures of work, work relationships and career choices. [1][2][3] Comparisons between medical students and other undergraduate student groups have shown a higher level of stress and depression among medical students. 2,4 Moreover, the results of a study of 304 first-and second-year medical students revealed a 12% incidence of major depression and a lifetime prevalence of 15%; 5 the latter is 3 times higher than that of the average population. Other studies have reported incidences of depression among medical students in the range of 20% to 25%. 5,6 Predictors of depression identified in these studies included previous depression or other mental health problems, perceived medical school stress, intensity and vulnerability traits, and a family history of depression. Being married or having a stable and supportive family were found to be protective factors. [5][6][7] Reported levels of stress among medical students range anywhere from 25% to 75%. 8,9 In the United States, a survey of 9 medical schools found that 47% of student respondents had at least 1 major issue related to mental health or substance use and that stress affected 26% within this group. 9 What is equally disturbing in this study is that 70% of students indicated concerns about confidentiality and the potential impact of having stress-related issues appear on their academic record.Medical students themselves tend toward certain characteristics that place them at increased risk of stress. A study at the University of Manitoba 10 found that although medical students had high personal standards, which gave them an advantage on entry to a highly competitive profession, these standards were associated with maladaptive perfectionism leading to excessive concerns about academic performance. These characteristics were significantly correlated with baseline symptoms of neuroticism and were predictive of depression and feelings of hopelessness at follow-up.Coping strategies have also been studied in medical students. 11 Although no specific coping strategies have been identified as common to medical students, support from family and friends, exercise, recreational activities and spirituality are all reported to promote a greater sense of wellbeing. A study of 140 medical students at Hong Kong University found, not surprisingly, that optimism and a positive outlook had the strongest negative correlations with depression and anxiety. 11 One of the difficulties with stress in medical school is that students tend not to seek help from the support services available to them.The results of a survey from the University of Pennsylvania showed that although 24% of their medical students identified t...