Wellbeing and support-seeking in undergraduate medical students

Abstract

Background: The traditionally demanding medical curriculum is known to cause stress and impair student wellbeing. Despite their high risk of psychological distress, medical students tend to avoid seeking help due to stigma and fear of academic repercussions or adverse impact on career prospects. The aim of this study was to determine the relationship between wellbeing status and support-seeking thoughts and behaviors among undergraduate medical students in Hong Kong. Summary of Work: The data were collected from a 6-year longitudinal cohort study of medical students followed from admission (2014) to graduation. Students completed annual questionnaires during face-toface mandatory teaching sessions or online if necessary. Instruments used included Perceived Stress Scale (PSS-10) to measure stress and World Health Organization Quality of Life Instruments (WHOQOL-BREF), to measure quality of life (QOL) in terms of physical, psychological, social and environmental domains. Students indicated if they had felt the need to seek support for non-academic reasons, and if they actually sought support. Data were analyzed in aggregate with descriptive statistics, chi-square, independent t-test, and ANOVA. Summary of Results: The aggregated response rate was 71.3% (895/1255). 34.6% students felt the need for support and 19.8% sought support. More female students sought support compared with male (23.0% vs 14.6%). Compared with when they were in pre-clerkship studies, a larger proportion of students in the clerkship years perceived the need for support (43.1% vs 28.7%) and sought support (24.9% vs 16.3%). Perceived need for support and active support-seeking were both significantly related to higher stress and poorer QOL. However, perceived need for support combined with inaction was associated with the highest stress and poorest QOL across all domains. Discussion and Conclusions: It is concerning that students who felt the need to seek support but did not do so had the worst perceived stress and QOL. Accessible, confidential mental health resources are as important as concerted efforts to create a culture that enables those who recognize they need help to feel safe in doing so. Take-home Messages: Over half of students who felt the need for support did not seek support. Wellbeing was poorest in the subgroup of students who felt the need for support but did not take action.