Medical students’ perspective on common stressors experienced at medical school and how to address them

We read with great interest the study titled “Identifying the major sources of stress in Brazilian medical students,” as it proved an informative read on an extremely important issue that resonates with us.1 As a group of graduate medical students from Warwick Medical School (WMS) in the United Kingdom, we are no strangers to experiencing stress throughout our degree. We were very intrigued by your Medical Student Stress Factor (MSSF) instrument, and its potential to be implemented across medical schools globally.

During this unprecedented time of coronavirus disease 2019 (COVID-19), there has been a significant increase in mental health concerns and stress factors, particularly among medical students. After reading the results of your study, we thought it would be pertinent to discuss how medical schools worldwide could create a better understanding of their student populations and adapt to their common stressors. We would like to share our experiences of the coping mechanisms and strategies implemented by WMS to combat some of the consistent “stressors” identified.

1. Extensive content – Similar to other graduate programs, much of our theoretical content is condensed into the first year. At WMS, we have in place excellent facilities to tackle this stressor, namely through “peer support” groups. These groups are a student-led initiative which aim to help students meet their learning objectives through optional evening/weekend student seminars taught by students in older-year groups. From our own experience of attending such sessions and ultimately teaching in them, peer support has provided stress relief through offering a chance to enhance our knowledge on difficult topics in a more supportive, lower-pressure environment. Studies have also shown that peer teaching benefits both the teachers and the students, allowing the educators to consolidate their learning as they teach others.2

2. Lack of time to study and lack of leisure time – Research continues to show that conflicts in work-life balance are correlated with a decline in mental health.3 WMS recently introduced a “4-day” week for year 1 students, giving them an additional working day to enjoy extracurricular activities, personal leisure, and/or study time. Moreover, in later years of the degree, student-directed learning is the centre of the program, encouraging students to organize their time and acknowledge their limitations – a key skill as a doctor.

3. Sleep deprivation – A recent meta-analysis described sleep deprivation among medical students as a pandemic, with results showing that sleep deprivation is significantly associated with decreased academic performance, creating a vicious cycle with the aforementioned stressors.4 At WMS, mindfulness practice is incorporated regularly into the program – empowering students to adopt their own stress-relief techniques ranging from sleep hygiene to talking therapy, meditation, yoga and more.

With an alarming increase in mental health concerns among medical students, it is of utmost importance for medical schools to adopt a tool like the MSSF to identify current stressors within their different cohorts of students, address these “self-pressures” that students face, and avoid further negative impact on mental health.

Disclosure

The authors report no conflicts of interest.