与普通人群相比，即将入学的医学生的困扰程度。

Distress among matriculating medical students relative to the general population.

作者信息

Brazeau Chantal M L R, Shanafelt Tait, Durning Steven J, Massie F Stanford, Eacker Anne, Moutier Christine, Satele Daniel V, Sloan Jeff A, Dyrbye Liselotte N

机构信息

Dr. Brazeau is professor of family medicine and psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey. Dr. Shanafelt is professor of medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. Durning is professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Dr. Massie is professor of medicine, University of Alabama School of Medicine, Birmingham, Alabama. Dr. Eacker is associate professor of medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Moutier was professor of psychiatry, University of California, San Diego, at the time of the study. She is now chief medical officer, American Foundation for Suicide Prevention, New York, New York. Mr. Satele is statistician, Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota. Dr. Sloan is professor of oncology, Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota. Dr. Dyrbye is professor of medicine and medical education, Department of Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Acad Med. 2014 Nov;89(11):1520-5. doi: 10.1097/ACM.0000000000000482.

DOI:10.1097/ACM.0000000000000482

PMID:25250752

Abstract

PURPOSE

Many medical students experience distress during medical school. If matriculating medical students (MMSs) begin training with similar or better mental health than age-similar controls, this would support existing concerns about the negative impact of training on student well-being. The authors compared mental health indicators of MMSs versus those of a probability-based sample of the general U.S. population.

METHOD

In 2012 all MMSs at six U.S. medical schools were invited to participate in a survey during orientation. The research team surveyed a probability-based sample of U.S. individuals using the same questions in 2011. Individuals from the population sample who completed a four-year college degree and matched within the appropriate age strata (< 30, 31-35, 36-40, > 40) were compared with MMSs. Surveys included demographics and validated instruments to measure burnout; depression symptoms; and mental, emotional, physical, and overall of quality of life (QOL).

RESULTS

Demographic characteristics of the 582/938 (62%) responding MMSs were similar to U.S. MMSs. Relative to 546 age-similar college graduates, MMSs had lower rates of burnout (27.3% versus 37.3%, P < .001) and depression symptoms (26.2% versus 42.4%, P < .0001) and higher scores across the four QOL domains assessed relative to controls (all P < .0001). These findings persisted on multivariate analysis after adjusting for age, sex, relationship status, and race/ethnicity.

CONCLUSIONS

These findings, along with high rates of distress reported in medical students and residents, support concerns that the training process and environment contribute to the deterioration of mental health in developing physicians.

摘要

目的

许多医学生在医学院学习期间会经历困扰。如果入学的医学生（MMSs）开始培训时的心理健康状况与年龄相仿的对照组相似或更好，这将支持现有的关于培训对学生幸福感产生负面影响的担忧。作者比较了MMSs与美国普通人群基于概率抽样样本的心理健康指标。

方法

2012年，美国六所医学院的所有MMSs在迎新期间被邀请参加一项调查。研究团队在2011年使用相同问题对美国个人进行了基于概率的抽样调查。将完成四年制大学学位且在适当年龄层（<30岁、31 - 35岁、36 - 40岁、>40岁）内匹配的人群样本个体与MMSs进行比较。调查包括人口统计学信息以及用于测量职业倦怠、抑郁症状、心理、情感、身体和总体生活质量（QOL）的经过验证的工具。

结果

582/938（62%）名做出回应的MMSs的人口统计学特征与美国MMSs相似。相对于546名年龄相仿的大学毕业生，MMSs的职业倦怠率（27.3%对37.3%，P <.001）和抑郁症状发生率（26.2%对42.4%，P <.0001）较低，并且相对于对照组，在评估的四个QOL领域中的得分更高（所有P <.0001）。在对年龄、性别、恋爱状况和种族/民族进行调整后的多变量分析中，这些发现仍然存在。