Mental health and burnout during medical school: Longitudinal evolution and covariates

Valerie Carrard; Sylvie Berney; Céline Bourquin; Setareh Ranjbar; Enrique Castelao; Katja Schlegel; Jacques Gaume; Pierre-Alexandre Bart; Marianne Schmid Mast; Martin Preisig; Alexandre Berney

doi:10.1371/journal.pone.0295100

Mental health and burnout during medical school: Longitudinal evolution and covariates

PLoS One. 2024 Apr 16;19(4):e0295100. doi: 10.1371/journal.pone.0295100. eCollection 2024.

Affiliations

¹ Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
² Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
³ Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
⁴ Institute of Psychology, University of Bern, Bern, Switzerland.
⁵ Department of Psychiatry, Addiction Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
⁶ Department of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
⁷ Faculty of Business and Economics (HEC Lausanne), Department of Organizational Behavior, University of Lausanne, Lausanne, Switzerland.

Abstract

Background: Medical students' rate of depression, suicidal ideation, anxiety, and burnout have been shown to be higher than those of the same-age general population. However, longitudinal studies spanning the whole course of medical school are scarce and present contradictory findings. This study aims to analyze the longitudinal evolution of mental health and burnout from the first to the last year of medical school using a wide range of indicators. Moreover, biopsychosocial covariates that can influence this evolution are explored.

Method: In an open cohort study design, 3066 annual questionnaires were filled in by 1595 different students from the first to the sixth year of the Lausanne Medical School (Switzerland). Depression symptoms, suicidal ideation, anxiety symptoms, stress, and burnout were measured along with biopsychosocial covariates. The longitudinal evolution of mental health and burnout and the impact of covariates were modelled with linear mixed models.

Results: Comparison to a same-aged general population sample shows that medical students reported significantly more depression symptoms and anxiety symptoms. Medical students' mental health improved during the course of the studies in terms of depression symptoms, suicidal ideation, and stress, although suicidal ideation increased again in the last year and anxiety symptoms remained stable. Conversely, the results regarding burnout globally showed a significant worsening from beginning to end of medical school. The covariates most strongly related to better mental health and less burnout were less emotion-focused coping, more social support, and more satisfaction with health.

Conclusion: Both improvement of mental health and worsening of burnout were observed during the course of medical school. This underlines that the beginning and the end of medical school bring specific challenges with the first years' stressors negatively impacting mental health and the last year's difficulties negatively impacting burnout.

Copyright: © 2024 Carrard et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Burnout, Professional* / epidemiology
Burnout, Professional* / psychology
Cohort Studies
Depression / epidemiology
Depression / psychology
Humans
Mental Health
Schools, Medical
Students, Medical* / psychology
Suicidal Ideation

Grants and funding

This work was supported by the Swiss National Science Foundation (grant number 10001C_197442). The CoLaus|PsyCoLaus offspring study was supported by unrestricted research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation (grants 3200B0–105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535, 3247730_204523, 324730_189130) and the Swiss Personalized Health Network (grant 2018DRI01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.