Mental health problems in medical students are far more prevalent than many people think.

Along with the academic and personal pressures placed on medical students, the global COVID-19 pandemic has intensified the challenges medical students face by adding unprecedented obstacles.

According to a report from the Council on Medical Education, stress, burnout, and depression are risk factors for medical students, with severe consequences. The council reports that medical students are three times more likely to die by suicide than the general public.

One of the most significant barriers for medical students — and why they may not seek help — is stigma, or “a fear of compromising career progression and the pressures of medical training,” according to 2020 research.

Mental health struggles come from various causes and have different signs.

“Medical students report higher levels of psychological distress than their same-age peers, despite having similar or healthier profiles than peers at the outset of medical school,” according to a 2018 study.

The study cited various stressors for medical students, such as:

  • academic stress
  • issues with work-life balance
  • relationship conflicts
  • poor student guidance or support
  • volume of information
  • finances
  • uncertainty about the future
  • lack of time to oneself
  • responsibility
  • the need to be successful

The 2018 study surveyed 1,137 medical students in Florida and stated that “stress levels increase over the course of medical school, peaking either in the second year or when students enter the medical wards.”

The sources of medical school stress can change depending on your year of study:

  • Academic workload was the biggest stressor for first-year students, while financial difficulties were the lowest stressor.
  • For second-year students, competition with peers was the highest stressor.
  • For third-year students, conflicts in work-life balance, romantic relationships, family demands, and personal medical conditions were the highest.
  • As for fourth-year med students, exposure to human suffering was the highest stressor.

Medical students’ common mental health challenges include:

How mental health challenges manifest in medical students can vary by individual.

“Some students may seem withdrawn or isolated, while others may be disruptive or aggressive,” says licensed psychotherapist Valentina Dragomir.

“Certain students might have trouble paying attention in class, while others might engage in self-harming behaviors [such as] drinking alcohol, impulsive sex,” Dragomir says.

In some cases, mental health challenges cause med students to consider dropping out of school.

Anxiety

A global meta-analysis from 2019 found that about 1 in 3 medical students has anxiety (33.8%), which is higher than the general population.

“Anxiety can guide students to overcompensate and study long hours, but it can also have a negative effect on how they remember the information during exams,” Dragomir explains.

Depression

Though not as high as anxiety, a 2016 study found that the global prevalence of depression among medical students is 28%, meaning more than 1 in every 4 med students has depression.

Burnout

“I have seen so many burned-out students I almost started to believe that it could be a norm,” says Dragomir.

She defines burnout as “a feeling of overwhelm and intense stress” that can be caused by:

  • intense workload
  • the pressure to perform well
  • a fear of not being good enough

“[Medical students] feel like they need to be perfect to succeed in school and in their careers,” Dragomir says. “This can lead to a lot of anxiety and stress, as well as feelings of self-doubt and inadequacy.”

A 2016 narrative review suggests a higher prevalence of burnout among medical trainees than the general population.

The review also states that “burnout can undermine trainees’ professional development, place patients at risk, and contribute to a variety of personal consequences, including suicidal ideation.”

Depression during medical school was already common — and then came the pandemic.

The U.S. medical education system was disrupted by the COVID-19 pandemic, which greatly affected medical students.

According to a 2021 study of multiple centers, nearly 3 in 4 (74.7%) of medical students agreed the pandemic had significantly disrupted their education.

Another 2021 study revealed that medical students reported 61% higher anxiety and 70% higher depression during the pandemic.

A 2021 study from the University of Beirut linked remote learning with additional stresses for medical students.

A 2016 study suggests that “medical schools and health authorities should offer early detection and prevention programs, and interventions for depression amongst medical students before graduation.”

Options for medical students to seek help include:

  • speaking with a private therapist
  • consulting with a primary care physician
  • seeking a counselor through the school’s student health services
  • talking with a trusted colleague or faculty member
  • confiding in a family member or friends

Some schools, including the Massachusetts Institute of Technology (MIT), offer group teletherapy for students.

Medical students can keep tabs on their mental health by exploring coping strategies to support overall well-being.

“Taking care of yourself both mentally and physically, setting realistic goals, and planning breaks into your schedule can really help,” says Dragomir.

Some of her other coping suggestions include:

  • stress-relieving activities such as yoga and meditation
  • creating boundaries from schoolwork
  • reaching out for support
  • spending more time outdoors
  • practicing self-care
  • regular exercise

The American College of Physicians also suggests improving social wellness by nurturing friendships and support systems. Spending time with people you enjoy and trust could promote your wellness and support and encourage you.

Eating a nutritious diet, getting enough sleep, and managing your financial well-being can also counter the mental health challenges you face.

For more resources, the University of Michigan offers a helpful guide for medical students.

Support for medical students is available, and the demand for support is growing.

By raising awareness, the medical community can help fight stigma around mental health and give up-and-coming doctors help.

If you’re facing mental health challenges, there are methods to help you cope. You’re not alone, and you also don’t have to do this alone.