Disparities in well-being outcomes among medical students: a comparative study between medical students with and without disability.

BACKGROUND

The strenuous demands of medical education often lead to adverse mental health outcomes among students. Despite extensive research on medical student distress, the unique challenges faced by students with disabilities remain understudied. This study aims to investigate the well-being of medical students with and without disabilities, by comparing levels of distress, risk and protective factors, and modifiable variables' impact on distress.

METHODS

From September 2019 to February 2020, we implemented an exploratory observational study to survey medical students across the US, US territories, and Caribbean. Participants completed the Medical Student Wellbeing Survey (MSWS), which was used to assess well-being and capture extensive demographic data on these students. We retrospectively sorted participant data into cohorts based on disability status, then compared them using rates of well-being outcomes, logistic regression, and interaction analyses. We conducted logistic regression analyses to identify significant predictors of severe distress, burnout, and depression.

RESULTS

Of the 3162 medical student participants, 277 identified as having a disability. Respondents with disabilities reported significantly higher rates of severe distress (65%) compared to their non-disabled peers (51.3%). Additionally, burnout and depression rates were higher among disabled students, with 80.41% experiencing burnout and 54.84% experiencing depression. Logistic regression revealed that certain identities, as well as high debt and tuition costs, were significant predictors of severe distress across cohorts. Uniquely, marital status emerged as a protective factor specifically for students with disabilities.

CONCLUSION

Medical students with disabilities exhibit higher levels of severe distress, burnout, and depression than their non-disabled counterparts. Current interventions and modifiable factors are insufficient in lessening severe distress for these students. These findings highlight the necessity for tailored support strategies and structural interventions to improve the well-being of medical students with disabilities, especially for those with intersecting vulnerable identities.

TRIAL REGISTRATION

This study does not report the results of a health care intervention on human participants, so trial registration is not required.