Coping with the challenges of training to become a medical doctor: Audio lay summary

Social Sciences: Psychology

Coping with the challenges of training to become a medical doctor.

Countless students training to become medical doctors can experience emotional distress. Medical students not only have to deal with high performance pressure and staggering workloads, but also very often difficult situations, such as helping others with serious illness and the emotional impact it has on the person and their family. Studies have shown that many student doctors can feel low or depressed and their quality of life isn’t great.

Whilst it’s natural for students to be distressed from time to time and studying to become a medic is known for having a high workload, significant responsibility and little spare personal leisure time, the authors of this 2020 article, Verena Steiner-Hofbauer and Anita Holzinger, carried out some research to find out how many medical students actually experience more critical levels of distress and depression, and how effectively they might cope with it. They also looked at possible differences in levels of distress between the genders, male and female, as well as the stages of training they were at: including early pre-clinical (year 2) Vs. late clinical (year 6) stages of study.

Verena and Anita asked around 600 students at the Medical University Vienna to fill out a survey at one point in time, which by giving them some sound questionnaires tried to put a number to their levels of stress and depression, and types of potentially helpful coping strategies they prefer to use (e.g., such as seeing friends, sleeping, exercise, optimism – ‘half glass full’ kind of thinking – to name but a few), but also potentially unhelpful coping strategies, including use of illegal and legal substances.

They carried out a particular type of calculation, called ‘regression analysis’. The purpose of this was to see if a given outcome of interest (in this case the students reports of depression and stress scores on the questionnaires completed) were influenced by a range of things (in this case, different types of coping strategies), to work out which of them may contribute to the person’s levels of distress or not, and which might be the most important. They also did the same calculation when comparing different sub-groups of the students, such as whether they were male or female, and if they were at year 2 or year 6 in their studies.

429 year 2 students and 165 year 6 students completed the survey. Around half of them in each year group were women.

They found that 92% of students experience performance pressure overload and just over half of scored very highly on low mood or depression scales. In both year groups 2 and 6, women experienced significantly more distress, but only the year 2 group had high levels of depressive symptoms. Interestingly, having social support from friends and family was the most popular coping strategy, but it didn’t have any positive effect on their levels of stress or symptoms of depression. Positive thinking (such as humour or optimism) and so called ‘active coping’ (where a person does something to manage distress before it happens, such as planning ahead rather than passively walking into stressful situations) seemed to be linked with lower levels of distress. Positive thinking also seemed to protect people from experiencing depressive symptoms. Another finding was that only a small number of students (less than 2%) said that they used substances in a risky way.

So, this study provides some initial evidence showing that medical students run into problems with critical levels of depression and distress. The worst stressor was performance pressure, and high expectations students had of themselves. Although many other studies have shown a clear link between distress and depression this current paper doesn’t really find a clear connection.

Surprisingly, positive activities, such as exercise and receiving social support, did not impact on either depression scores or levels of distress. In fact, when the study authors looked at the students’ personal activities they do in their spare time, it was difficult to get any clear sense of which activity may result in higher levels of depression. The only thing that was related to lower depression scores was positive thinking. Interestingly, turning to religion seemed to be related to greater stress and did not have any impact on low mood / depression scores. And lastly, substance use was not a common way for the medical students to cope.

It’s important to note though that this study was only a ‘snap shot in time’ and so it can’t say anything about whether one thing necessarily causes another. Plus, all the students who took part in the study came from only one medical degree programme in at one university, when it might be different elsewhere. The study also used only self-report questionnaires, which can mean that students might answer questions in a way that they think makes them look ‘better’ or worse.

From a more statistical point of view, it’s important to mention that group sizes were not the same, which can have a negative impact on how well one can rely on the statistical analyses used in this study.

Why is this an important area to research? Well, if we don’t know how common critical levels of distress are in medical students, and who might be most at risk, then we can’t do anything about it. Only if we start to understand students’ experiences, can we offer support, address any problems and try to boost their wellbeing where possible. Alongside other allied health professional students, medical students are the future of our healthcare workforce – so it makes sense that we need to provide them with all the support they need to not only succeed in completing their degrees, but also doing so in a way that does not compromise their health to the benefit of those receiving care from them.


Title of lay summary Coping with the challenges of training to become a medical doctor: Audio lay summary
Lay Summary Author(s)

Dr Anja Harrison

Vetting Professional Dr Anthony Harrison
Vetting Professional Affiliation(s) / participating organisation(s) 1
Science Area Subject
Key Search Words



Medical Students


Mental Health

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Title of the original peer-reviewed published article: How to Cope with the Challenges of Medical Education? Stress, Depression, and Coping in Undergraduate Medical Students
Journal Name: Academic Psychiatry
Page numbers (if applicable): 380–387
Year of publication: 2020

Verena Steiner-Hofbauer & Anita Holzinger

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No conflict of interest reported

Original Article language: English
Article Type: Cross-sectional study / Prevalence study
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  1. Ha. This is so interesting, thank you, Anja!
    I always considered exercising as an effective coping strategy. I wonder if its low efficiency for medical students is connected with generally high level of physical exhaustion (night shifts and so on) 🤔

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