Sense of Community, Academic Performance, and Psychological Distress among Medical Students at One Northeastern School

Background: Physicians are counted among the most stressful professions and have higher rates of depression/suicide than the general population. Given research showing that poor mental health may begin during medical school, we assessed sense of community (SOC), academic performance, and psychological distress (using the Medical Student Well-Being Index, MSWBI) among New England medical students.

Methods: We administered cross-sectional surveys to 475 students and conducted 9 structured interviews between April-August 2014, assessing demographics, mental health/learning disability history, support utilization, SOC, academic performance, and PD (defined as MSWBI score above 2). We conducted bivariate analyses using chi-square and linear regression. Multivariable and template analyses are pending.

Results: Among 256 participants (response rate=53.9%), mean SOC was 3.35 +/-3.32, 33 (12.9%) reported academic failures (AF), and 163 (63.9%) reported PD (MSWBI Cronbach alpha=.75). AF was significantly associated with having learning disability before (p=0.24) and after (p=.00) matriculation. SOC was negatively associated with mood disorder diagnosis after matriculation (p=.01) and difficulty coping with an adverse life event (p=.02). The MSWBI score was significantly higher (more PD) for students reporting the following: AF (p=.01), mood disorder before (p=.01) or after (p=.00) matriculation, learning disability before (p=.04) or after (p=.00) matriculation, and difficulty coping with an adverse life event (p=.00).

Conclusion: Greater support and community building may be needed among students with learning disabilities, mood disorders, and adverse life events. The MSWBI may be a useful tool for identifying medical students with PD before AF, but further psychometric analysis is necessary. Future research should assess causality of AF among medical students.