Association of professional pre-qualifications, study success in medical school and the eligibility for becoming a physician: A scoping review

Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden

Introduction

International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden.

Methods

Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7).

Results

Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively.

Discussion

Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.

How professional and academic pre-qualifications relate to success in medical education: Results of a multicentre study in Germany

OBJECTIVE

Every year, many applicants want to study medicine. Appropriate selection procedures are needed to identify suitable candidates for the demanding curriculum. Although research on medical school admissions has shown good predictive validity for cognitive selection methods (undergraduate GPA, aptitude tests), the literature on applicants with professional and/or academic experience prior to entering medical school remains slim. In our study, we therefore aimed to examine the association between academic success in medical school and having previously completed vocational training in the medical field, voluntary service (≥11 months) or an academic degree.

METHODS

Data were collected in a multicentre, cross-sectional study at five medical schools in Germany (Baden-Wuerttemberg) from students during medical school (i.e. 3rd-, 6th-, and 10th-semester and final-year students). Academic success was assessed according to scores on the first and second state examinations, the total number of examinations repeated and the number of semesters beyond the standard period of study. For the analysis we calculated ordinal logistic regression models for each outcome variable of academic success.

RESULTS

A total of N = 2,370 participants (response rate: RR = 47%) participated in the study. Having completed vocational training was associated with a higher amount of repeated examinations (small effect), while having an academic degree was associated with worse scores on the second state examination (medium effect). No significant association emerged between voluntary service and academic success.

CONCLUSION

The results indicate that professional and academic pre-qualifications pose no advantage for academic success. Possible associations with the financing of study and living conditions of students with pre-qualifications were analysed and discussed in an exploratory manner. However, the operationalisation of academic success from objective and cognitive data should be critically discussed, as the benefits of prior experience may be captured by personal qualities rather than examination results.

Chatbots for future docs: exploring medical students' attitudes and knowledge towards artificial intelligence and medical chatbots

Artificial intelligence (AI) in medicine and digital assistance systems such as chatbots will play an increasingly important role in future doctor - patient communication. To benefit from the potential of this technical innovation and ensure optimal patient care, future physicians should be equipped with the appropriate skills. Accordingly, a suitable place for the management and adaptation of digital assistance systems must be found in the medical education curriculum. To determine the existing levels of knowledge of medical students about AI chatbots in particular in the healthcare setting, this study surveyed medical students of the University of Luebeck and the University Hospital of Tuebingen. Using standardized quantitative questionnaires and qualitative analysis of group discussions, the attitudes of medical students toward AI and chatbots in medicine were investigated. From this, relevant requirements for the future integration of AI into the medical curriculum could be identified. The aim was to establish a basic understanding of the opportunities, limitations, and risks, as well as potential areas of application of the technology. The participants (N = 12) were able to develop an understanding of how AI and chatbots will affect their future daily work. Although basic attitudes toward the use of AI were positive, the students also expressed concerns. There were high levels of agreement regarding the use of AI in administrative settings (83.3%) and research with health-related data (91.7%). However, participants expressed concerns that data protection may be insufficiently guaranteed (33.3%) and that they might be increasingly monitored at work in the future (58.3%). The evaluations indicated that future physicians want to engage more intensively with AI in medicine. In view of future developments, AI and data competencies should be taught in a structured way during the medical curriculum and integrated into curricular teaching.

Coping Styles Among High School Graduates Aiming to Study Medicine in Dealing With Depressive and Anxious Symptoms

Background: Psychological distress, its associated stressors and resilience factors, and the implications derived for the education and training of medical students and physicians have long been the subject of international studies. The study presented here investigated affective symptoms in association with coping styles in the earliest phase of University medical education: high school graduates aiming to study medicine. Materials and Methods: We conducted a self-report survey at a medical school in Germany among high school graduates who indicated being interested in studying medicine at the university's on-campus recruitment day. The questionnaire included validated instruments for the self-assessment of symptoms of depression (i.e., Patient Health Questionnaire; PHQ-9) and anxiety (i.e., Generalized Anxiety Disorder 7 (GAD-7), and participants were also asked to rate functional and dysfunctional behavior-based coping styles for symptoms of depression and anxiety. Additional variables addressed were gender, motivation, interest in studying medicine, and parental employment in medicine. Results: Of 400 high school graduates, 346 (87%) completed the survey. More than 40 (12.5%) and nearly 30 (8.4%) reported relevant symptoms of depression (PHQ-9 sum score ≥10) and anxiety (GAD-7 sum score ≥10), respectively. Among the graduates, young women had higher values for symptoms of depression than young men, and one's interested exclusively in studying human medicine tended to have marginally higher levels of symptoms of depression than ones who were also interested in other subjects. Relevant functional coping styles included seeking social support, relaxing, engaging in sports, listening to or making music, and reading books, whereas relevant dysfunctional coping styles included consuming alcohol, abusing drugs, restrictive eating, watching TV, surfing the Internet, and withdrawing and ruminating. Conclusion: The results clarify the burden and associated resilience factors of premedical high school graduates at the earliest phase of their University education. As such, they reveal ways to address educational and supportive services and support the need for further investigation into factors of success in studying human medicine.