Tobacco and Alcohol Use Among 1996 Medical School Graduates

Mangus, Richard S.; Hawkins, Claire; Miller, Michael J.

doi:10.1001/jama.280.13.1192-jms1007-4-1

Cited by 38 publications

(3 citation statements)

References 19 publications

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“…literature as the main and specific sources of stress. Others include frequent investigations, worries about the future, loneliness or encounters with death [19,20]. A 2018 survey of more than 1,100 students by American authors [21] adds other factors such as faculty teaching systems, teacher attitudes, and student-hostile environments.…”

Section: Discussionmentioning

confidence: 99%

The influence of excessive stress on medical students in the Czech Republic – national sample

et al. 2023

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Purpose The Czech Republic has been dealing with a long-term shortage of doctors, which, according to demographic forecasts, will continue to worsen due to the retirement of stronger generations of doctors in contrast to the gradual aging of the population, which will require more health care over time. The country´s political set is trying to respond to this shortage and demographic forecasts by gradually increasing financial funding of medical faculties with the aim of increasing the number of graduates of the program in the field of general medicine. Methods Anonymous questionnaire survey was conducted among students and graduates of general medicine at all eight Czech medical faculties. A total of 3183 respondents participated in the survey. There were 2843 medical students, which represents approximately 28% of all medical students in the Czech Republic. The distribution of respondents within the study years was approximately even and approximately corresponded to the real distribution of students between individual faculties in country, which makes survey a national sample. The statistical processing was performed in the statistical software R. Apart from the basic comparison using percentage relative frequencies and Pearson´s chi-squared test, in this study we used Odds ratios (OR) with CI 0,95 from logistic regression model for a better interpretation of some outputs. Results The results show that the vast majority of Czech medical students experience excessive stress during their studies, which increases the risk of students´ somatic problems (OR = 4.89, CI 0.95 = (4.11;5.83), p < 0.001)., targeted alcohol use (OR = 2.29, CI 0.95 = (1.73;3.04), p < 0,001) and the use of anxiolytic or antidepressant medication to reduce it (OR = 2.99, CI 0.95 = (2.24;4.01), p < 0.001). Students experiencing higher levels of excessive stress are more likely to leave their studies based on their own decision (4.20 (CI 0.95 (3.39;5.19), p < 0.001) and not to enter clinical practice after graduation (OR = 2.62, CI 0.95 = (2.06;3.33), p < 0.001). Conclusions The survey shows the need for an open discussion at the highest level about the possibilities of reasonable reduction of unnecessary stress during medical studies. Medical students in the Czech Republic are exposed to excessive stress with all the consequences described above. All that remains is to state the existence of unnecessary components of stress, which represent an opportunity to reduce it, thereby achieving better conditions for studying, improvement in the staff situation in the Czech healthcare system and a reduction in inefficiently spent financial resources for the education of young doctors. Trial registration No registration.

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Section: Discussionmentioning

confidence: 99%

The influence of excessive stress on medical students in the Czech Republic – national sample

et al. 2023

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“…Several studies including one of 548 medical students and one of 1773 residents utilized surveys or questionnaires where it was not clear whether it was or was not anonymous. [33][34][35] A recent qualitative survey of physicians and trainees on patient bias was conducted by convenience sample focus group assessment; although clear themes emerged, that approach prevented anonymity and therein the breadth of perspective. 20 In contrast, our study methodology permitted any eligible trainee to use the anonymous hotline to describe their experience.…”

Section: Jama Network Open | Medical Educationmentioning

confidence: 99%

Assessment of Discrimination, Bias, and Inclusion in a United States Hematology and Oncology Fellowship Program

et al. 2021

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IMPORTANCEMedical trainees frequently experience discrimination. Understanding their experiences is essential to improving learning environments. OBJECTIVE To characterize trainee experiences of discrimination and inclusion to inform graduate medical education (GME) policies. DESIGN, SETTING, AND PARTICIPANTS This qualitative study used an anonymous telephone interview technique to gather data from hematology and oncology fellows. All current trainees and recent graduates were eligible. Interviews were conducted anonymously with interviewer and participant in separate locations and recorded and transcribed. Data were analyzed in an iterative process into major themes using a general inductive analysis approach. Demographic information was obtained via anonymous survey. Data collection and analysis were conducted from July 2018 to November 2019. MAIN OUTCOMES AND MEASURES Emergent themes illustrating bias and inclusion in a GME program. RESULTS Among 34 fellows and recent graduates who were approached for this study, 20 consented and 17 were interviewed. Of those interviewed, 10 were men, and the median (range) age was 32 (29-53) years. The racial and ethnic distribution included 6 Asian individuals, 2 Black individuals, 3 Hispanic individuals, 2 multiracial individuals, and 4 White individuals. All fellows reported having experienced and/or witnessed discriminatory behavior. The themes elucidated were(1) foreign fellows perceived as outsiders, (2) US citizens feeling alien at home, (3) gender roletyping, (4) perception of futility of reporting, (5) diversity and inclusion, and (6) coping strategies.The majority of reported biases were from patients. Only 1 trainee reported any incidents. Reasons for not reporting were difficulty characterizing discrimination and doubt action would occur.Participants reported that diversity of cotrainees, involvement in committees, and open discussions promoted inclusivity. CONCLUSIONS AND RELEVANCEIn this study, reports of discriminatory behavior toward trainees were common. The anonymous hotline methodology cultivated a safe environment for candid discussions. These findings suggest that GME programs should assess their learning climate regarding bias and inclusivity anonymously and develop processes to support trainees.

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“…In 1995, the Council on Graduate Medical Education concluded that “gender bias, a reflection of society’s value system, remains the single greatest deterrent to women achieving their full potential in every aspect of the medical profession and is a barrier throughout the professional life cycle.” 1 Although awareness of sexual misconduct in the field of medicine is improving with the advent of the #MeToo era, obstacles to breaking the silence persist. 2–18 Multiple previous studies investigating sexual misconduct during medical education have consistently found female students more likely to experience gender-based discrimination and harassment, 19–24 leading to deterrence from choosing surgery as a career. 22,25–27 Sexual misconduct continues throughout residency, with minimal changes in the last 30 years.…”

mentioning

confidence: 99%

A Report of Gender Bias and Sexual Harassment in Current Plastic Surgery Training: A National Survey

Chen

Schilling

Bourne

et al. 2021

Plastic &Amp; Reconstructive Surgery

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In 1995, the Council on Graduate Medical Education concluded that "gender bias, a reflection of society's value system, remains the single greatest deterrent to women achieving their full potential in every aspect of the medical profession and is a barrier throughout the professional life cycle." 1 Although awareness of sexual misconduct in the field of medicine is improving with the advent of the #MeToo era, obstacles to breaking the silence persist. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Multiple previous studies investigating sexual misconduct during medical education have consistently found female students more likely to experience

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Tobacco and Alcohol Use Among 1996 Medical School Graduates

Cited by 38 publications

References 19 publications

The influence of excessive stress on medical students in the Czech Republic – national sample

The influence of excessive stress on medical students in the Czech Republic – national sample

Assessment of Discrimination, Bias, and Inclusion in a United States Hematology and Oncology Fellowship Program

A Report of Gender Bias and Sexual Harassment in Current Plastic Surgery Training: A National Survey

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