New Findings out of JAMA says that almost 1/3 of medical students are depressed or have depression symptoms :(. Doesn’t break it down into BS/MD vs. traditional MD students but still nevertheless very significant food for thought for those wanting to go into medicine.
https://www.apetest.org/us/latest-news/almost-13-of-med-students-depressed/
When 20-25% of the general population is, frankly 1/3 isn’t that much of an increase over baseline.
It will get worse in residency. The good news is that it is only 7-11 years.
^FWIW, I’ve had a lot of residents tell me MS3 is the worst year of the whole process - even worse than intern year. Don’t know if they’re being honest (with me and/or themselves), but they’re definitely saying it.
@iwannabe_Brown
That (MS3 is worse than intern year) is exactly what my PGY2 told her MS3 sister last month when D1 visited for her BFF’s thesis defense.
N=1 an all that, but another data point for you.
@iwannabe_Brown I think it is significant. The study stated that “medical school students are between two and five times more likely to experience depression than the general United States population”.
It’s unfortunate the system has to be that way and even more unfortunate that students, trainees believe it has to continue to be that way. If only more were willing to speak up for the silent majority who feel and think the same!
If you read the actual JAMA article (and not the summarization at the link you gave), you’ll notice the methodology used in the study is suspect. (The authors admit as much.) The authors used self-reporting inventories to obtain their data-- which introduces a whole multitude of sampling errors and reporting biases. So there data may not be accurate.
Other studies and meta-analyses report a lower incidence of depression or depressive symptoms than this one does. (But still higher than their age peers.)
I’m sure there is an increase in depression among medical students. I don’t think it’s 2-5x. ~1.5x (20% vs. 33%) does sound in line with what I’ve seen.
In terms of the actual study, some thoughts:
Medical school, residency training, and the practice of mental health in 1983 (the oldest data in the study) is quite different from 2015.
As WOWMom points out: of the 54 studies, only 3 featured clinical interviews to diagnose people. The other 51 used self administered questionnaires that are not designed as clinical diagnostic tools but as research/screening tools since a 9 question questionnaire is much faster than a true psych eval. For example the PHQ-9 has a sensitivity and specificity of 88% each for depression if you score 10 or above (out of 27). That means 12% of people with depression are missed and 12% of people without depression are erroneously labeled as such. It’s better than dealing with the potential variability of different clinicians diagnosing but personally I think the interview is better.
Only 35 of the studies were of North American medical students and residents. The number involving american medical students is even smaller. I think that pooling countries with completely different training systems and mental health systems is an odd choice here.
I’m not really sure what the definition or significance is of having “depressive symptoms” without meeting the criteria for either major depressive disorder or persistent depressive disorder (FKA dysthymia). Additionally “depressive symptoms” are experienced by people with many other psych disorders. Unclear
I have no idea what the significance of this is, but it’s interesting that among the 54 studies, there was an association between higher quality studies and lower incidence of depression - in other words, the better studies found lower rates than the poorer studies.
I also can’t find any claim within the actual paper that the 1/3 being depressed represents a 2-5 fold increase over controls. In fact the word “control” doesn’t appear anywhere in the manuscript. That may be an assertion in the article you linked (which I didn’t read), but the actual JAMA publication makes no such claim. They only claim to establish the rate of depression and depressive symptoms in medical students and residents.
These studies are like the federal government spending $1 billion to study to determine why crap stinks.
For just $50, I could confirm that at least 20% of medical students are miserable for 2-3 years. Whether they are “depressed” is less the point.
Depends on what you mean by worse. I certaimly enjoyed intern year far more than ms3 or my subinternships because there was real and active participation but the hours on average were worse and negative experience like being yelled at or getting into squabbles with other hospital staff more frequent.