An examination of the relationship between psychological factors and academic performance in undergraduate medical students

Ensuring the health and well-being of medical students as future doctors is crucial to enable them to effectively care for the health and well-being of others. Early identification of psychological distress (i.e. anxiety, depression and obsessive-compulsive symptoms) during medical training facilitates the implementation of early intervention. The prevalence of psychological distress and its relationship to academic performance amongst contemporary Australian medical students has not been adequately reported in the literature. The principal aim of this research was to determine the prevalence of psychological distress in a cohort of Australian medical students and examine the relationship between psychological distress and academic performance. Further exploration of the role of coping in this relationship may guide the development of appropriate interventions for medical students experiencing psychological distress. The sample of 169 medical students aged 17-25 years were recruited from the first four years of a Bachelor of Medicine Bachelor of Surgery (MBBS) course at a large metropolitan university in Australia. Participants completed a measure of psychological functioning that contained scales pertaining to psychological distress (depression, anxiety and obsessive-compulsive symptoms). All participants also completed a coping measure and a scale assessing attitudes towards seeking professional psychological help. All measures were completed online. Academic performance measures were medical students’ Objective Structured Clinical Examination scores, written examination scores and end of year total score. The principal findings indicate relationships among psychological distress, academic performance and coping. In general, the medical students as a group reported their psychological distress within the non-clinical range. There was a subset of students experiencing psychological distress with 24 (14.20%) having scores in the clinically significant range for at least one of the psychological distress scales. Psychological distress did not vary significantly between campus-based (years 1 and 2) or hospital-based (years 3 and 4) levels of training. Results showed that greater symptoms of depression were independently associated with lower academic performance and that higher avoidant coping was a consistent independent predictor of greater levels of psychological distress. The use of problem-focused coping was associated with reduced symptoms of depression and anxiety. Compared to men, women reported more symptoms of anxiety and greater levels of seeking support. Greater use of avoidant coping was associated with lower academic performance. The findings of the current study cannot identify causal relationships but they highlight that psychological distress is prevalent in a subgroup of medical students and that there is a relationship between depression and academic performance in medical students. These research findings also highlight the importance of addressing and monitoring symptoms of psychological distress. Interventions provided to medical students should address both depression and academic performance as well as reduce the use of avoidant coping behaviours and increase problem-focused coping skills. Further research is indicated to ascertain whether such interventions are effective in reducing symptoms of anxiety and depression and improving academic performance amongst medical students. Further research is also needed to elucidate the nature of the relationship between psychological distress, coping and academic performance.