It starts at university: study reveals health problems among medical students

in 2024 published in the first issue of the journal “Public Health” by lecturers Roko Šambaras and Kamilė Pociūtė, members of the Student Scientific Activity Network (SMVT) Child and Adolescent Psychiatry Group – resident doctors Gintarės Žinlinskaitė and Ieva Palačionytė – and prof. Dr. Sigitas Lesinskienės 2023 data from the study on mental health and bad habits carried out at the beginning.

The research examines the results of an anonymous voluntary online survey of the medical study programs of Vilnius University (VU) and Lithuanian University of Health Sciences (LSMU).

The questionnaire consisted of questions on demographic data, self-harm, smoking and the World Health Organization (WHO) (5) well-being questionnaire. The results of the answers of 291 respondents showed that a third of medical students fall into the risk zone of depression. Almost a fifth (24%) indicated that they had harmed themselves by scratching, cutting, burning or beating their body at some point in their life.

According to the data, one-third of students smoke and one-fifth smoke daily. Medical students who smoked had statistically significantly worse well-being and more self-harm than their non-smoking counterparts.

Every fourth student – green himself

According to one of the co-authors of the article, lect. Students of Roko Šambaras, Vilnius University Faculty of Medicine, and Lithuanian University of Health Sciences face very serious psychological challenges.

“The study revealed that almost every fourth student has intentionally harmed himself in one way or another in his life. Although the obtained data on the extent of self-harm among Lithuanian medical students are quite similar to the data of studies conducted by foreign authors, this is a clear signal that some medical students are in a very poor emotional state and are not always able to properly deal with the difficulties that arise”, said the lecturer.

According to him, studying medicine requires a lot of effort, it is stressful both physically and emotionally.

“It is very important for medical students to be able to rest, relax, and overcome the challenges that arise. Various scientific sources indicate that appropriate and timely education of students about stress management and emotional health can prevent burnout. These interventions could also be organized in our Faculty of Medicine, involving not only students, but also the academic community,” said R.Šambaras.

The lecturer told how, when assessing the well-being of students, it was noticed that the students of the 1st – 3rd year had worse estimates of the WHO (5) well-being questionnaire than the students of the 4th – 6th year.

“First-year students can go through a difficult period of adaptation, the first year of study is a big change in life: some students come from other Lithuanian cities to Vilnius or Kaunas, leave their parents’ homes, start a more independent life, encounter a different educational system than the one that was established at school, more responsibilities arise. Therefore, it is important for both academic staff and senior students to create a supportive and warm environment at the university, thus helping younger students to adapt to a new stage of life and feel happier,” said R. Šambaras.

A big problem is smoking

“The obtained research data encouraged more attention to be paid to the mental health of young people, especially to the growing problem of smoking. The supply of smoking options in society is only growing, various ways of smoking are emerging, such as heating systems, electronic cigarettes, non-nicotine disposable cigarettes and many others. Over time, among young people, smoking has become a means of “communication”, said another co-author of the article, resident doctor Gintarė Žilinskaitė.

Medical studies are really not easy: long years of study, heavy workload, encountering one of the most important things in life – human health, life – causes strong emotional experiences, raises valuable, existential questions.

“It is not surprising that various methods of relaxation are resorted to. Among students, we hear too often: “Let’s go smoke, let’s take a break,” she said.

According to G. Žilinskaitė, the study revealed that smoking medical students had a statistically significantly worse well-being than non-smokers, and although this data is important, it is only a very small part of all data related to other variable and non-variable parts of the field of mental health problems .

“It is especially important to continue to research and talk about the mental health of young people, bad habits, their connections with mental health, analyze the possible causes and look for interventions to improve mental health, which would help everyone who has faced emotional difficulties in life, to remain strong and not break down,” the confident young woman doctor

It’s not easy to talk about

“Commenting on our study, as well as similar studies conducted in other countries, we can see a trend that the mental health of doctors is significantly worse than that of the general public. Although the indicators of self-harm or such harmful habits are similar, namely depression and anxiety disorders, the tendency to suicide leads to worry” – the co-author of the article, lecturer Kamilė Pociūtė, shared her thoughts on the importance of this study and similar studies.

According to her, not only Lithuania, but also other countries are facing serious problems of the emotional health of doctors.

“It is noticed that the emotional well-being of students is much worse than that of professionals who are already working. It is not easy to talk about all this: you understand the imperfection of the health service delivery system, you hear colleagues’ stories about the emotional and physical difficulties they experience… The path of medical studies and the professional path of a doctor is difficult. And yet: I firmly believe that the doctor’s profession is extremely enriching and meaningful. We want to wish doctors not to forget themselves, to take care of themselves, not to neglect their physical, emotional and spiritual needs, to engage in stress-reducing practices, to be able to pause and allow themselves to be imperfect, to make mistakes, to empathize, and finally, in case of need, not to be afraid to ask for help,” said the lecturer. K. Pociūtė.

To help doctors who have chosen to help others

“Compared to the research results of the last decade, the prevalence of depression in Lithuania is growing rapidly. Our study revealed that as many as one-third of medical students fall into the depression risk zone, and the frequency of depressive symptoms among medical students can be 3-10 times higher than in the general population. As a student myself, I experienced what it means to be overshadowed by stress and anxiety about upcoming bills and the fatigue that comes after a heavy workload. Long-term stress inevitably affects our body and thinking: we often unconsciously look for stress coping strategies that are suitable for us, which are often unhealthy, short-term, and therefore ineffective,” said resident doctor Ieva Palačionytė.

According to her, there is a paradox: medical students have chosen to help, treat and educate people about health issues, but they themselves are not able to resist those stress coping measures that harm the body.

“We want to reduce or eliminate long-lasting and unmanageable stress as soon as possible, and care for our health decreases. This is why the topic addressed in our study is so relevant. Let me remind my colleagues: medical studies are one of the most difficult programs taught at universities, and every year those who enter them inevitably experience mental health difficulties, which they try to compensate with not necessarily healthy methods,” she said.

In addition to the prevalence of bad habits among medical students, the doctor also emphasized the vulnerability of students to high demands to achieve the best possible results.

“It is important to create and implement accessible, effective options for improving mental health, preventing burnout and healthy strategies for coping with stress for this group of society,” I.Palačionytė is convinced.

“I am grateful to the co-authors of this article for their cooperation, and to the medical students for their active participation and answers – we appreciate this very much. Since the survey was anonymous, the respondents could answer the questions online, in a comfortable and safe environment. It seems that they answered seriously and sincerely”, Professor Sigita Lesinskienė of the Faculty of Medicine expressed her gratitude to the young colleagues and students who participated in the research.

The scientist said that she hopes that this and other similar studies will help draw more attention not only to the poor mental health problems of society, but also of a specific group – medical students and young doctors who are already working.

“The research data only show that programs for improving mental health, preventing overwork, stress, and burnout are necessary for students. We have to look for suitable and attractive opportunities for implementing health-improving interventions”, said prof. S.Lesinskienė.