Expectations versus reality, social support, and the well-being of medical students.

This longitudinal study of medical students assessed the relationship between their mental and social well-being, the discrepancy between their expectations and the reality of the learning environment, and social support, after controlling for baseline characteristics that may affect students' perceptions. Finding, at the end of the first year, that the quality of the learning environment was better than expected was positively associated with social well-being but negatively associated with mental well-being. Finding less stress than expected was positively associated with both mental and social well-being. Social support had only a direct positive association with social well-being. There was a suggestion, although it was not statistically significant, of a negative association between social support and mental well-being and a positive interaction between social support and students' perception of the environment's quality. These findings suggest that stressors and mediators of stress may show specificity for health outcomes.