Physical and psychological health of medical students involved in the COVID-19 response in Switzerland

Abstract

AIMS Involvement of medical students in the coronavirus disease 2019 (COVID-19) response remains a matter of debate. The main argument against involvement relates to potential physical and psychological health risks. Hence, we aimed to compare the physical and psychological health of Swiss medical students involved in the COVID-19 response with their non-involved peers. Among those involved, we also compared frontline (working in a dedicated COVID-19 unit) and non-frontline students. In addition, we compared frontline medical students with frontline residents. METHODS We conducted a cross-sectional anonymous online study in Switzerland between 9 and 14 May 2020. Recruitment was through hospital, faculty and student societies mailing lists using a snowball technique. Exposure to COVID-19 patients, personal protective equipment (PPE) access, support and information by employer, as well as COVID-19 symptoms and diagnosis were collected with a self-reported questionnaire. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Burnout was assessed using two single items derived from the Maslach Burnout Inventory. RESULTS 550 medical students (66.7% women, median age 23 years) and 227 residents (70.5% women, median age 30 years) were included in the analyses. Approximately half of the medical students were involved in the COVID-19 response and 30% were frontline workers. Of the residents, 61.7% were frontline workers. Both medical students and residents reported high access to PPE, support and information by employer. Students involved in the COVID-19 response reported a similar proportion of COVID-19 symptoms or confirmed diagnoses (p = 0.81), but lower levels of anxiety (p <0.001), depression (p <0.001) and burnout (p <0.001 for depersonalisation item), compared with their non-involved peers. Health outcomes of frontline students did not differ significantly compared with their non-frontline peers. Frontline students had lower levels of burnout than frontline residents (p <0.01 for emotional exhaustion item); the remaining health outcomes did not significantly differ. CONCLUSIONS In a snowball sample of Swiss medical students involved in the response to the first wave of the COVID-19 pandemic, we observed similar physical and psychological health outcomes compared with their non-involved peers. The context in which medical students are involved is certainly critical. Access to PPE, perceived support by employers and perceived passage of information by employers could explain these findings. Further research is needed to better understand the role of these contextual factors on student physical and psychological health.

Keywords

• medical student
• resident
• COVID-19
• physical health
• psychological health