Stress in medical students is stress caused by strenuous medical programs, which may have physical and psychological effects on the well-being of medical students. Excessive stress in medical training predisposes students for difficulties in solving interpersonal conflicts as a result of previous stress. A significant percentage of medical students suffer from anxiety disorders because of the long term effects of stress on emotional and behavioral symptomatology. Dental students also suffer from excessive stress especially during the clinical years. This condition has become a focus of concern nationally and globally, therefore the first line of detection and defense from stress are the students themselves. Students need to be given the tools to recognize and cope with stress, as well as being assured that they will not suffer judgment from others for recognizing their need for help in dealing with stress. The instructors, advisers and other faculty members who notice the signs of stress in a student need to approach the student in a non-threatening, non-judgmental way, in an effort to help medical students recognize and handle their stress.
Causes
Stress is defined as an imbalance between environmental conditions necessary for survival and the ability of individuals to adapt to those conditions. Stress in medical students has been recognized for a long time. Many studies have explored the causes, consequences and solutions. There are three issues considered to be the most relevant, in terms of stress development in medical students. They are required to learn a great deal of new information in a short period of time before taking exams and evaluations. Therefore, they have little to no time to review what they have learned.
Medical students are overloaded with a tremendous amount of information. They have a limited amount of time to memorize all the information studied. The overload of information creates a feeling of disappointment because of the inability to handle all the information at once and succeed during the examination period. Many medical students struggle with their own capacity to meet the demands of medical curriculum.
Stress responses to different situations vary at different levels of consciousness, psychological stress, and physiological stress. These points of stress may be interrelated, and each may be at a different level. Many people believe that the most stressful period of a medical student's academic career is the gap between graduation from medical school and being board eligible in a medical specialty. The Resident Service Committee of the Association of Program Directors in Internal Medicine (APDIM) divided the common stressors of residency into three categories: situational, personal, and professional.
Situational stressors include inordinate hours, sleep deprivation, excessive workload, overbearing clerical and administrative responsibilities, inadequate support from allied health professionals, a large number of difficult patients, and conditions for learning that are less than optimal. Second year students experience other stress situations because they start to interact with the patients. These interactions include stressful situations, like the delivery of bad news.
Personal stressors include family, friend and relationship issues. Financial issues are common, as many residents carry heavy educational debts, and they feel compelled to hold a secondary job in order to repay their debts. Isolation is frequently exacerbated by relocation away from family and friends. Other stressors include limited free time to relax or develop new support systems, psycho-social concerns brought by the stress of residency, and inadequate coping skills. Professional stressors include responsibility for patient care, supervision of more junior residents and students, difficult patients, information overload and career planning.
Effects
Excessive amounts of stress in medical training predisposes students for difficulties in solving interpersonal conflicts, sleeping disorders, decreased attention, reduced concentration, temptation to cheat on exams, depression, loss of objectivity, increased incidence of errors, and improper behavior such as negligence. Furthermore, stress in medical students can break the stability of the student's health and result in illness. This can cause headaches, gastrointestinal disorders, coronary heart disease, impaired judgments, absenteeism, self-medication, and the consumption of drugs and alcohol. It is notable that these risks continue throughout training, also affecting resident and attending physicians in addition to medical students, particularly with regard to depressive symptoms.