G.W. Gengoux is clinical associate professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0002-6942-9513. L.W. Roberts is chairman and Katharine Dexter McCormick and Stanley McCormick Memorial Professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0003-4270-253X.
Acad Med. 2019 Feb;94(2):162-165. doi: 10.1097/ACM.0000000000002436.
Research investigations have repeatedly shown that medical school can be a period of high stress and deteriorating mental health for many students. There is a critical need for systematic guidance on how to personalize prevention and treatment programming to help those students at highest risk. The authors of this Invited Commentary respond to the report by Dyrbye and colleagues, published in this issue of Academic Medicine, that proposes a prognostic index to predict risk of developing depression symptoms in medical students. The commentary authors applaud Dyrbye and her coauthors for their innovative approach; their findings provide substantial insights relevant to the critical goal of enhancing medical student well-being. However, evidence indicates that students who identify as members of racial, ethnic, sexual, and/or gender minority groups are at heightened risk of depression, so any program that profiles students in relation to their mental health symptoms must be proactive in ensuring that its efforts do not perpetuate stigma, marginalization, and discrimination for these underrepresented and potentially vulnerable groups. The commentary authors suggest practices for ethically implementing recommended wellness programs while maintaining an inclusive learning environment that respects personal privacy and incorporates transparent consent practices.
研究调查反复表明，对许多医学生来说，医学院时期可能是压力很大、心理健康恶化的时期。非常有必要系统地指导如何针对个人制定预防和治疗方案，以帮助那些处于高风险的学生。本文的特邀评论作者回应了 Dyrbye 及其同事在本期《学术医学》上发表的报告，该报告提出了一种预后指数，以预测医学生出现抑郁症状的风险。评论作者赞赏 Dyrbye 及其合著者的创新方法；他们的研究结果为增强医学生福祉这一关键目标提供了重要的见解。然而，有证据表明，自认为属于种族、民族、性和/或性别少数群体的学生患抑郁症的风险更高，因此，任何与学生心理健康症状相关的项目都必须积极确保其努力不会对这些代表性不足和潜在脆弱的群体造成污名化、边缘化和歧视。评论作者建议实施推荐的健康计划的实践方法，同时保持一个包容的学习环境，尊重个人隐私并纳入透明的同意实践。
