BMC Medical Education (Jun 2023)

The association between how medical students were selected and their perceived stress levels in Year-1 of medical school

  • Vera M.A. Broks,
  • Karen M. Stegers-Jager,
  • Suzanne Fikrat-Wevers,
  • Walter. W. Van den Broek,
  • Andrea M. Woltman

DOI
https://doi.org/10.1186/s12909-023-04411-0
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 9

Abstract

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Abstract Background The prevalence of medical students’ mental distress is high. While schools apply various methods to select a well-performing and diverse student population, little is known about the association between different selection methods and the well-being of these students during medical school. The present retrospective multi-cohort study assessed whether students selected by high grades, assessment, or weighted lottery showed different stress perception levels in Year-1 of medical school. Methods Of 1144 Dutch Year-1 medical students, 650 (57%) of the cohorts 2013, 2014, and 2018 who were selected by high grades, assessment, or weighted lottery completed a stress perception questionnaire (PSS-14). A multilevel regression analysis assessed the association between selection method (independent variable) and stress perception levels (dependent variable) while controlling for gender and cohort. In a post-hoc analysis, academic performance (optimal vs. non-optimal) was included in the multilevel model. Results Students selected by assessment (B = 2.25, p < .01, effect size (ES) = small) or weighted lottery (B = 3.95, p < .01, ES = medium) had higher stress perception levels than students selected by high grades. Extending the regression model with optimal academic performance (B=-4.38, p < .001, ES = medium), eliminated the statistically significant difference in stress perception between assessment and high grades and reduced the difference between weighted lottery and high grades from 3.95 to 2.45 (B = 2.45, p < .05, ES = small). Conclusions Selection methods intended to create a diverse student population – assessment and lottery - are associated with higher stress perception levels in Year-1 of medical school. These findings offer medical schools insights into fulfilling their responsibility to take care of their students’ well-being.

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