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SPECIAL ARTICLE
MEDICAL STUDENT DISTRESS
Medical Student Distress:
Causes, Consequences, and Proposed Solutions
LISELOTTE N. DYRBYE, MD; MATTHEW R. THOMAS, MD; AND TAIT D. SHANAFELT, MD
The goal of medical education is to graduate knowledgeable, tween 1966 and 2004 with use of the search terms medical
skillful, and professional physicians. The medical school curricu-
lum has been developed to accomplish these ambitions; however, student AND depression, suicide, stress, burnout, distress,
some aspects of training may have unintended negative effects on abuse, alcohol drinking, illicit drug usage, street drugs,
medical students’ mental and emotional health that can under- substance-related disorders, ethics, professionalism , cyni-
mine these values. Studies suggest that mental health worsens
after students begin medical school and remains poor throughout cism, cheating, debt, or academic performance. Additional
training. On a personal level, this distress can contribute to sub- studies were identified from the reference lists of these
stance abuse, broken relationships, suicide, and attrition from the articles. Articles were reviewed critically by authors and
profession. On a professional level, studies suggest that student
distress contributes to cynicism and subsequently may affect included as appropriate to provide readers an overview of
students’ care of patients, relationship with faculty, and ulti- the research on medi
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