Disparities in well-being outcomes among medical students: a comparative study between medical students with and without disability.

Henry J Seaborne, Lara Z Chehab, Nikhil Rajapuram, Amanda Sammann
Author Information
  1. Henry J Seaborne: The Better Lab, University of California San Francisco, San Francisco, CA, USA. hjohnseaborne@berkeley.edu.
  2. Lara Z Chehab: The Better Lab, University of California San Francisco, San Francisco, CA, USA.
  3. Nikhil Rajapuram: The Better Lab, University of California San Francisco, San Francisco, CA, USA.
  4. Amanda Sammann: The Better Lab, University of California San Francisco, San Francisco, CA, USA.

Abstract

BACKGROUND: The strenuous demands of medical education often lead to adverse mental health outcomes among students. Despite extensive research on medical student distress, the unique challenges faced by students with disabilities remain understudied. This study aims to investigate the well-being of medical students with and without disabilities, by comparing levels of distress, risk and protective factors, and modifiable variables' impact on distress.
METHODS: From September 2019 to February 2020, we implemented an exploratory observational study to survey medical students across the US, US territories, and Caribbean. Participants completed the Medical Student Wellbeing Survey (MSWS), which was used to assess well-being and capture extensive demographic data on these students. We retrospectively sorted participant data into cohorts based on disability status, then compared them using rates of well-being outcomes, logistic regression, and interaction analyses. We conducted logistic regression analyses to identify significant predictors of severe distress, burnout, and depression.
RESULTS: Of the 3162 medical student participants, 277 identified as having a disability. Respondents with disabilities reported significantly higher rates of severe distress (65%) compared to their non-disabled peers (51.3%). Additionally, burnout and depression rates were higher among disabled students, with 80.41% experiencing burnout and 54.84% experiencing depression. Logistic regression revealed that certain identities, as well as high debt and tuition costs, were significant predictors of severe distress across cohorts. Uniquely, marital status emerged as a protective factor specifically for students with disabilities.
CONCLUSION: Medical students with disabilities exhibit higher levels of severe distress, burnout, and depression than their non-disabled counterparts. Current interventions and modifiable factors are insufficient in lessening severe distress for these students. These findings highlight the necessity for tailored support strategies and structural interventions to improve the well-being of medical students with disabilities, especially for those with intersecting vulnerable identities.
TRIAL REGISTRATION: This study does not report the results of a health care intervention on human participants, so trial registration is not required.

Keywords

References

  1. JAMA Netw Open. 2022 Feb 1;5(2):e220115 [PMID: 35195698]
  2. Clin Teach. 2018 Apr;15(2):109-113 [PMID: 28436204]
  3. Fam Med. 2019 May;51(5):399-404 [PMID: 31081911]
  4. MedEdPORTAL. 2023 Jun 20;19:11317 [PMID: 37346470]
  5. Acad Med. 2009 Feb;84(2):258-68 [PMID: 19174682]
  6. Med Sci Educ. 2019 Aug 07;29(4):1003-1011 [PMID: 34457577]
  7. BMC Med Educ. 2018 May 8;18(1):98 [PMID: 29739376]
  8. Ann Intern Med. 2008 Sep 2;149(5):334-41 [PMID: 18765703]
  9. PLoS One. 2020 Dec 3;15(12):e0243250 [PMID: 33270759]
  10. J Crit Care. 2009 Sep;24(3):e1-7 [PMID: 19664516]
  11. J Am Coll Surg. 2016 Jan;222(1):52-8 [PMID: 26616033]
  12. Rehabil Psychol. 2020 May;65(2):101-112 [PMID: 32105109]
  13. Acad Psychiatry. 2016 Feb;40(1):89-91 [PMID: 25749920]
  14. Acad Med. 2020 Apr;95(4):492 [PMID: 32209850]
  15. JAMA Netw Open. 2024 Jan 2;7(1):e2351046 [PMID: 38198142]
  16. BMC Med Educ. 2023 May 11;23(1):329 [PMID: 37170246]
  17. JAMA. 2019 Nov 26;322(20):2022-2024 [PMID: 31769816]
  18. BMJ Open. 2019 Jul 2;9(7):e029980 [PMID: 31270123]
  19. Educ Health (Abingdon). 2015 Sep-Dec;28(3):209-12 [PMID: 26996647]
  20. Med Educ. 2020 Feb;54(2):138-149 [PMID: 31868262]
  21. BMJ. 2022 Mar 22;376:e065984 [PMID: 35318190]
  22. Acad Med. 2006 Apr;81(4):354-73 [PMID: 16565188]
  23. Med Educ. 2007 Mar;41(3):258-64 [PMID: 17316210]
  24. J Health Soc Behav. 1983 Dec;24(4):385-96 [PMID: 6668417]
  25. Arch Phys Med Rehabil. 2009 Sep;90(9):1532-40 [PMID: 19735781]
  26. Acad Med. 2020 Sep;95(9):1350-1353 [PMID: 32134774]
  27. Disabil Health J. 2017 Oct;10(4):475-484 [PMID: 28501322]
  28. BMC Med Educ. 2010 Jan 27;10:8 [PMID: 20105312]
  29. BMJ Open. 2016 Jul 07;6(7):e010641 [PMID: 27388349]
  30. JAMA. 2016 Dec 6;316(21):2214-2236 [PMID: 27923088]
  31. Soc Sci Med. 2013 Aug;91:94-100 [PMID: 23849243]
  32. JAMA Netw Open. 2021 Oct 1;4(10):e2130358 [PMID: 34673966]
  33. Med Teach. 2011;33(10):834-9 [PMID: 21942482]
  34. BMC Med Educ. 2024 Aug 30;24(1):947 [PMID: 39215314]
  35. Med Teach. 2009 Jun;31(6):e272-7 [PMID: 19811160]
  36. BMC Med Educ. 2019 Jul 1;19(1):241 [PMID: 31262294]
  37. Med Educ Online. 2023 Dec;28(1):2189558 [PMID: 36966504]
  38. Med Educ Online. 2022 Dec;27(1):2082909 [PMID: 35642839]
  39. Med Educ Online. 2023 Dec;28(1):2271224 [PMID: 37859424]
  40. JAMA. 2019 Jan 15;321(2):143-144 [PMID: 30535168]
  41. Mayo Clin Proc. 2021 Oct;96(10):2682-2693 [PMID: 34607637]
  42. JAMA. 2016 Dec 6;316(21):2237-2252 [PMID: 27923091]
  43. Acad Psychiatry. 2008 Jan-Feb;32(1):44-53 [PMID: 18270280]
  44. Am J Surg. 2016 Feb;211(2):343-9 [PMID: 26723836]
  45. J Gen Intern Med. 2017 Dec;32(12):1309-1314 [PMID: 28861707]
  46. Acad Med. 2019 Nov;94(11):1781-1791 [PMID: 31436626]
  47. Acad Med. 2016 Jul;91(7):954-7 [PMID: 26422593]
  48. Acad Med. 2011 Jul;86(7):907-14 [PMID: 21642810]
  49. Med Educ. 2023 Jun;57(6):523-534 [PMID: 36456473]
  50. Med Educ Online. 2018 Dec;23(1):1530558 [PMID: 30286698]
  51. Ann Surg. 2018 Aug;268(2):204-211 [PMID: 29462009]
  52. Acad Med. 2020 Mar;95(3):351-356 [PMID: 31425184]
  53. J Grad Med Educ. 2020 Feb;12(1):74-79 [PMID: 32064062]
  54. Med Teach. 2022 Mar;44(3):294-299 [PMID: 34618650]
  55. J Marital Fam Ther. 2000 Jul;26(3):341-51 [PMID: 10934680]
  56. Subst Abus. 2017 Oct-Dec;38(4):401-406 [PMID: 28832279]
  57. J Surg Educ. 2019 Nov - Dec;76(6):e1-e14 [PMID: 31601487]
  58. Med Educ Online. 2015 Feb 03;20:25923 [PMID: 25652117]
  59. Acad Med. 2003 May;78(5):500-8 [PMID: 12742788]

MeSH Term

Humans
Students, Medical
Female
Male
Persons with Disabilities
Depression
Adult
United States
Young Adult
Retrospective Studies
Burnout, Professional
Caribbean Region
Stress, Psychological
Surveys and Questionnaires

Word Cloud

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