Medical student distress: Causes, consequences, and proposed solutions

被引:615
作者
Dyrbye, LN
Thomas, MR
Shanafelt, TD
机构
[1] Mayo Clin, Coll Med, Div Primary Care Internal Med, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Coll Med, Dept Internal Med, Rochester, MN 55905 USA
[3] Mayo Clin & Mayo Fdn, Coll Med, Div Hematol, Rochester, MN 55905 USA
[4] Mayo Clin & Mayo Fdn, Coll Med, Dept Internal Med, Rochester, MN 55905 USA
关键词
D O I
10.4065/80.12.1613
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The goal of medical education Is to graduate knowledgeable, skillful, and professional physicians. The medical school curriculum has been developed to accomplish these ambitions; however, some aspects of training may have unintended negative effects on medical students' mental and emotional health that can undermine these values. Studies suggest that mental health worsens after students begin medical school and remains poor throughout training. On a personal level, this distress can contribute to substance abuse, broken relationships, suicide, and attrition from the profession. On a professional level, studies suggest that student distress contributes to cynicism and subsequently may affect students' care of patients, relationship with faculty, and ultimately the culture of the medical profession. In this article, we review the manifestations and causes of student distress, its potential adverse personal and professional consequences, and proposed institutional approaches to decrease student distress.
引用
收藏
页码:1613 / 1622
页数:10
相关论文
共 171 条
[61]   The national depressive and manic-depressive association consensus statement on the undertreatment of depression [J].
Hirschfield, RMA ;
Keller, MB ;
Panico, S ;
Arons, BS ;
Barlow, D ;
Davidoff, F ;
Endicott, J ;
Froom, J ;
Goldstein, M ;
Horman, JM ;
Guthrie, D ;
Marek, RG ;
Maurer, TA ;
Meyer, R ;
Phillips, K ;
Ross, J ;
Schwenk, TL ;
Sharfstein, SS ;
Thase, ME ;
Wyatt, RJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (04) :333-340
[62]   PERSONALITY-FACTORS AS PREDICTORS OF MEDICAL-STUDENT PERFORMANCE [J].
HOBFOLL, SE ;
ANSON, O ;
ANTONOVSKY, A .
MEDICAL EDUCATION, 1982, 16 (05) :251-258
[63]   An empirical study of decline in empathy in medical school [J].
Hojat, M ;
Mangione, S ;
Nasca, TJ ;
Rattner, S ;
Erdmann, JB ;
Gonnella, JS ;
Magee, M .
MEDICAL EDUCATION, 2004, 38 (09) :934-941
[64]   Empathy in medical students as related to academic performance, clinical competence and gender [J].
Hojat, M ;
Gonnella, JS ;
Mangione, S ;
Nasca, TJ ;
Veloski, JJ ;
Erdmann, JB ;
Callahan, CA ;
Magee, M .
MEDICAL EDUCATION, 2002, 36 (06) :522-527
[65]   Empathy in medical education and patient care [J].
Hojat, M ;
Mangione, S ;
Gonnella, JS ;
Nasca, T ;
Veloski, JJ ;
Kane, G .
ACADEMIC MEDICINE, 2001, 76 (07) :669-669
[66]   Gender comparisons of medical students' psychosocial profiles [J].
Hojat, M ;
Glaser, K ;
Xu, G ;
Veloski, JJ ;
Christian, EB .
MEDICAL EDUCATION, 1999, 33 (05) :342-349
[67]   STUDENTS PSYCHOSOCIAL CHARACTERISTICS AS PREDICTORS OF ACADEMIC-PERFORMANCE IN MEDICAL-SCHOOL [J].
HOJAT, M ;
ROBESON, M ;
DAMJANOV, I ;
VELOSKI, JJ ;
GLASER, K ;
GONNELLA, JS .
ACADEMIC MEDICINE, 1993, 68 (08) :635-637
[68]  
HOLTZWORTHMUNROE A, 1985, J MED EDUC, V60, P417
[69]   FEAR OF DEATH AND DYING IN MEDICAL-STUDENTS - EFFECTS OF CLINICAL-EXPERIENCE [J].
HOWELLS, K ;
GOULD, M ;
FIELDS, D .
MEDICAL EDUCATION, 1986, 20 (06) :502-506
[70]   Characteristics of the informal curriculum and trainees' ethical choices [J].
Hundert, EM ;
Hafferty, F ;
Christakis, D .
ACADEMIC MEDICINE, 1996, 71 (06) :624-633