Table 2.
Results of Multivariable Logistic Regression of Professional Attitudes and Behaviours Associated with Substance Use
| Dependent variable | Independent variable | OR (95% CI) a | P-value |
|---|---|---|---|
| Career Satisfaction b | Excessive alcohol used c | 1.24 (1.04, 1.49) | 0.02 |
| Current cigarette smoking d | 0.80 (0.44, 1.46) | 0.47 | |
| Cannabis use in the past 12 months | 1.16 (0.89, 1.39) | 0.33 | |
| NPS in past 12 months e | 0.63 (0.42, 0.93) | 0.02 | |
| Ability to handle workload due to physical health | Excessive alcohol used | 1.26 (0.91, 1.75) | 0.16 |
| Current cigarette smoking | 0.97 (0.36, 2.61) | 0.95 | |
| Cannabis use in past 12 months | 0.90 (0.60, 1.34) | 0.59 | |
| NPS in past 12 months | 0.31 (0.18, 0.54) | <0.01 | |
| Ability to handle workload due to mental health | Excessive alcohol used | 1.16 (0.96, 1.43) | 0.17 |
| Current cigarette smoking | 0.84 (0.43, 1.62) | 0.60 | |
| Cannabis use in the past 12 months | 1.18 (0.89, 1.55) | 0.24 | |
| NPS in past 12 months | 0.46 (0.30, 0.71) | <0.01 | |
| How often do you talk about smoking cessation with a typical patient? | Excessive alcohol used | 0.97 (0.84, 1.13) | 0.73 |
| Current cigarette smoking | 1.32 (0.80, 2.17) | 0.28 | |
| Cannabis use in the past 12 months | 1.12 (0.93, 1.35) | 0.22 | |
| NPS in past 12 months | 0.86 (0.59, 1.24) | 0.41 | |
| How relevant do you think talking to patients about smoking cessation will be? | Excessive alcohol used | 0.98 (0.83,1.16) | 0.84 |
| Current cigarette smoking | 0.48 (0.29, 0.80) | <0.01 | |
| Cannabis use in the past 12 months | 1.08 (0.88, 1.32) | 0.46 | |
| NPS in past 12 months | 0.71 (0.49, 1.03) | 0.07 | |
| How often do you talk about alcohol use with a typical patient? | Excessive alcohol used | 1.10 (0.93, 1.30) | 0.27 |
| Current cigarette smoking | 1.77 (1.05, 2.99) | 0.03 | |
| Cannabis use in the past 12 months | 1.06 (0.86, 1.31) | 0.56 | |
| NPS in past 12 months | 0.85 (0.56, 1.28) | 0.44 | |
| How relevant do you think talking to patients about alcohol use will be? | Excessive alcohol used | 1.00 (0.84, 1.19) | 0.98 |
| Current cigarette smoking | 0.42 (0.25, 0.70) | <0.01 | |
| Cannabis use in the past 12 months | 1.26 (1.01, 1.56) | 0.04 | |
| NPS in past 12 months | 0.90 (0.60, 1.35) | 0.60 |
Abbreviation: OR, odds ratio; CI, confidence interval; NPS, non-medical use of prescription stimulants. Bold values indicate significant effects (P<.05). Proportional odds logistic regression was performed for the respective dependent variables. Regression analyses were conducted using weighted data based only on male and female respondents in years 1-4 (n = 4,438), as national enrollment demographic data were only available for these subgroups.79 Data were weighted for nonresponse using the raking ratio method78 to match students’ gender, year of study, medical school, and site of study with national enrollment data.79
Higher OR is more desirable. A higher OR represents increased odds of having higher career satisfaction, better ability to handle workload due to mental and physical health, and better patient counselling practices and attitudes.
Respondents were asked, “If you re-lived your life, would you still want to become a physician?” Responses were scored according to a Likert scale, from ‘definitely not’ (0) to ‘definitely’ (4) and subsequently dichotomized at the Likert score of 3 or higher.
Scoring of alcohol consumption was based on criteria from the National Institute on Alcohol Abuse and Alcoholism.1,2 Alcohol consumption was classified as ‘excessive’ in the previous month if respondents met at least one of the following criteria: 1) reported at least one occasion on which they consumed five or more drinks (i.e., reported one or more episodes of binge drinking); or 2) men who drank more than two drinks per day on average or women who drank more than one drink per day on average. Alcohol consumption was classified as ‘non-excessive’ for respondents who consumed alcohol in the past month but did not meet the “excessive” alcohol use criteria. Alcohol consumption was classified as ‘none’ for respondents that reported zero alcohol consumption in the past month.
Smoking history is defined as having smoked at least 100 cigarettes during one’s entire life, based on CDC Behavioural Risk Factor Surveillance Survey definition.6,7 Cigarette use is presented as a dichotomous categorical variable, with all those categorized as having a ‘current’ smoking history scored as ‘1’ and those with a “past” or “never” history scored as ‘0’.
Non-medical use of prescription stimulants is the use of pharmaceutical stimulant medicines (e.g., Ritalin, Dexedrine or Adderall) that are used outside of a doctor’s orders.3