Elsevier

Mayo Clinic Proceedings

Volume 81, Issue 11, November 2006, Pages 1435-1442
Mayo Clinic Proceedings

ORIGINAL ARTICLE
A Multicenter Study of Burnout, Depression, and Quality of Life in Minority and Nonminority US Medical Students

https://doi.org/10.4065/81.11.1435Get rights and content

OBJECTIVE

To determine the well-being of minority medical students in a multicenter sample of US medical students.

PARTICIPANTS AND METHODS

All 1098 medical students at 3 medical schools in Minnesota were surveyed in April 2004. Validated instruments were used to assess burnout, depression, and quality of life (QOL). Students were also asked about the prevalence of significant personal life events in the previous 12 months and strategies used to cope with stress.

RESULTS

Although symptoms of depression and overall burnout were similar among minority and nonminority students, minority students were more likely to have a low sense of personal accomplishment (P=.02) and lower QOL in a number of domains (all P≤.05). These differences persisted on multivariate analysis that controlled for demographic characteristics and recent life events. Minority students were also more likely to have a child (P=.01), originate from outside Minnesota (P<.001), and experience a major personal illness in the last 12 months (P=.03).

CONCLUSION

As a group, the minority medical students in this survey had a lower sense of personal accomplishment and QOL than nonminority students. Additional studies are needed to provide insight regarding the causes of these inequities and the unique challenges faced by minority medical students. Efforts to improve minority students' well-being, QOL, and learning experience may help prevent attrition among minority medical students and promote diversification in the physician workforce.

Section snippets

PARTICIPANTS AND METHODS

The methods of this study have been previously described.48 Briefly, all 1098 medical students in Minnesota were asked to participate in this study. Among these 1098 students, 225 (20%) were minority students. Participation was elective, and all responses were anonymous. Medical students in Minnesota attend a private medical school (Mayo Clinic College of Medicine), a traditional public university (University of Minnesota-Minneapolis campus), or a public university with a focus on primary care

RESULTS

Of the 1098 medical students in Minnesota, correct e-mail addresses could be confirmed for 1087 students, and 545 students responded (response rate, 50%). Nonresponders were more likely to be male and less likely to be first-year students (both P<.001). The demographics of all responders have been previously reported.48 Seven students did not answer the question on ethnic heritage and were accordingly excluded, yielding a total sample size for the current analysis of 538. Overall, 454

DISCUSSION

Efforts to match the racial and ethnic makeup of the nation's physician workforce and the US population require insight into the personal and professional challenges faced by minority medical students. Although minority and nonminority students in our study reported similar degrees of burnout with respect to emotional exhaustion, minority students had a lower sense of personal accomplishment (P=.02) that persisted at a trend level on multivariate analysis that controlled for demographic

CONCLUSION

To “create a diverse medical workforce capable of meeting society's needs,” the ideal medical education system needs to “successfully educate a diverse group of learners” and “support the health and well being of learners.”91 Although “pipeline” efforts to increase the number of qualified URM students,4, 78, 92, 93, 94 prematriculation programs,78, 93, 94, 95, 96, 97, 98 tutoring, test-skills instruction, and mentoring and advising programs,78, 93, 95, 98, 99, 100 and decelerated curriculum17,

REFERENCES (101)

  • DM Carlisle et al.

    The entry of underrepresented minority students into US medical schools: an evaluation of recent trends

    Am J Public Health

    (1998)
  • HW Foster

    Reaching parity for minority medical students: a possibility or a pipe dream?

    J Natl Med Assoc

    (1996)
  • HW Nickens et al.

    Project 3000 by 2000: racial and ethnic diversity in U.S. medical schools

    N Engl J Med

    (1994)
  • JJ Cohen

    The consequences of premature abandonment of affirmative action in medical school admissions

    JAMA

    (2003)
  • E Moy et al.

    Physician race and care of minority and medically indigent patients

    JAMA

    (1995)
  • G Xu et al.

    A national study of factors influencing primary care career choices among underrepresented-minority, white, and Asian American physicians

    Acad Med

    (1996)
  • DK Whitla et al.

    Educational benefits of diversity in medical school: a survey of students

    Acad Med

    (2003)
  • US Census Bureau

    Fact Sheet: 2005 American Community Survey Data Profile Highlights

  • M Rainey

    How do we retain minority health professions students?

  • Association of American Medical Colleges

    Minority Students in Medical Education: Facts and Figures XII

    (2002)
  • A Tekian

    Cognitive factors, attrition rates, and underrepresented minority students: the problem of predicting future performance

    Acad Med

    (1998)
  • JE Stetto et al.

    Variables associated with attrition from Uniformed Services University of the Health Sciences Medical School

    Mil Med

    (2004)
  • A Tekian et al.

    Baseline longitudinal data of undergraduate medical students at risk

    Acad Med

    (1996)
  • Association of American Medical Colleges

    Underrepresented in medicine definition

  • DG Kassebaum et al.

    The longer road to medical school graduation

    Acad Med

    (1994)
  • BY Fogleman et al.

    Demographic, situational, and scholastic factors in medical school attrition

    South Med J

    (1981)
  • AE Crowley et al.

    Undergraduate medical education

    JAMA

    (1987)
  • HS Jonas et al.

    Undergraduate medical education [published correction appears in JAMA. 1988;260:3008]

    JAMA

    (1988)
  • HT Frierson

    Black medical students' perceptions of the academic environment and of faculty and peer interactions

    J Natl Med Assoc

    (1987)
  • CE Pyskoty et al.

    Psychosocial assets and mental health of minority medical students

    Acad Med

    (1990)
  • DL Camp et al.

    Does a problem-based learning curriculum affect depression in medical students?

    Acad Med

    (1994)
  • J Tjia et al.

    Factors associated with undertreatment of medical student depression

    J Am Coll Health

    (2005)
  • K Henning et al.

    Perfectionism, the imposter phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students

    Med Educ

    (1998)
  • G Strayhorn et al.

    Assessing correlations between black and white students' perceptions of the medical school learning environment, their academic performances, and their well-being

    Acad Med

    (1989)
  • CM Bright et al.

    Perceived barriers and biases in the medical education experience by gender and race

    J Natl Med Assoc

    (1998)
  • SS Bergen

    Underrepresented minorities in medicine

    JAMA

    (2000)
  • V Taylor et al.

    The needs of students from diverse cultures

    Acad Med

    (1999)
  • G Strayhorn

    Perceived stress and social supports of black and white medical students

    J Med Educ

    (1980)
  • Association of American Medical Colleges

    2004 Medical School Graduation Questionnaire All Schools Report

  • KH Sheehan et al.

    A pilot study of medical student ‘abuse’: student perceptions of mistreatment and misconduct in medical school

    JAMA

    (1990)
  • DG Kassebaum et al.

    On the culture of student abuse in medical school

    Acad Med

    (1998)
  • EA Guthrie et al.

    Embarking upon a medical career: psychological morbidity in first year medical students

    Med Educ

    (1995)
  • KJ Moffat et al.

    First year medical student stress and coping in a problem-based learning medical curriculum

    Med Educ

    (2004)
  • M Aktekin et al.

    Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey

    Med Educ

    (2001)
  • E Guthrie et al.

    Psychological stress and burnout in medical students: a five-year prospective longitudinal study

    J R Soc Med

    (1998)
  • JL Givens et al.

    Depressed medical students' use of mental health services and barriers to use

    Acad Med

    (2002)
  • DC Clark et al.

    Vicissitudes of depressed mood during four years of medical school

    JAMA

    (1988)
  • MC Rosal et al.

    A longitudinal study of students' depression at one medical school

    Acad Med

    (1997)
  • TH Mosley et al.

    Stress, coping, and well-being among third-year medical students

    Acad Med

    (1994)
  • S Ball et al.

    Self-care in medical education: effectiveness of health-habits interventions for first-year medical students

    Acad Med

    (2002)
  • Cited by (0)

    This study was funded through an Academic Primary Care Grant from the Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine.

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