Abstract
Addressing the mental health and well-being of pre-health students is critically important to ensuring their success through college and entry into advanced training or the workforce. Pre-health students represent some of the most motivated, involved, and engaged students on campus. Retaining these students and ensuring a positive undergraduate experience may help improve the development of a robust and diverse healthcare workforce. This chapter considers academic stress points and common mental health concerns among pre-health and graduate-level clinical students and discusses the implications of poor mental health outcomes among these student populations. This chapter is the first in a two-part series designed to understand the experiences of health science students and potential adverse health outcomes they may experience. The second chapter in this series considers practical approaches for pre-health advisors to foster and encourage well-being among students.
TopCareer Satisfaction And Well-Being Trends In The Health Professions
The pre-health advisor's relationship with their student is critical to ensuring student persistence through their undergraduate training and into advanced health professions education or the workforce. Pre-health advisors provide critical guidance to students as they navigate complex coursework, consider appropriate careers, engage in extracurricular activities, and complete rigorous application processes for graduate training programs (Arnold & Schneider, 2010; Barr et al., 2008). For pre-health advisors to best support their students and guide them toward a career in healthcare, they should understand the well-being trends among health professionals. Having a broad understanding of career satisfaction and general well-being among clinicians can help pre-health advisors in setting expectations with their undergraduate students (Bridgeman et al., 2018; Hall et al., 2016). This knowledge can help inform students of the types of careers they may want to pursue. As advisors encourage students to explore all the pre-health professions, it is important to understand key characteristics in each profession that will contribute to the individual’s overall satisfaction and well-being throughout their career.
While no direct comparisons between health professions can be made, we can rely on key data obtained for several health professions. For the purposes of this chapter, we focus on physicians, physician assistants, physical therapists, dentists, and veterinarians. Within the health professions there are drastic disparities between overall job satisfaction, levels of burnout, and suicidal ideation. Research suggests that Physician Assistants (83%) and Physical Therapists (78%) report the highest job satisfaction rates throughout their career (Halasy et al., 2021; Smith, 2007). These data are in stark contrast to job satisfaction experienced by physicians (44%), dentists (48%), and veterinarians (65%) (Dyrbye et al., 2013; Merck Animal Health, 2020; Starkel et al., 2015).
Key Terms in this Chapter
Substance Use Disorder: A mental disorder that impacts an individual’s behavior and results in an inability to control the use of legal or illegal substances such as alcohol, medications, or illegal drugs (National Institutes on Mental Health, 2021).
Imposter syndrome: Feelings that cause students to experience demoralization, shame, and a perception that they are less intelligent or capable than their peers which is commonly known as imposter syndrome, imposterism, or the imposter phenomenon (Houseknecht et al., 2019; Morgenstern & Beck Dallaghan, 2020).
Major Depressive Disorder: More commonly referred to as depression, major depressive disorder is a mood disorder that “causes a persistent feeling of sadness and loss of interest… it affects how you feel, think, and behave and can lead to a variety of emotional and physical problems'' (Mayo Clinic Staff, 2018, pp. 1). Depression may result in difficulties carrying out activities of daily living and can be experienced along a spectrum of emotions, from sadness to anger or emptiness. Often, depression requires specific therapeutic care from mental health practitioners.
Distress: The negative form of stress. This is the type of stress that the body views as a threat and reacts with a fight-flight-or-fright response. Too much stress, lasting for too long becomes chronic stress. This type of ongoing, unrelenting, dis-stress can have a significant, detrimental impact on our health and well-being, affecting the mind, body, and spirit (National Institutes of Health, n.d.; Russell & Lightman, 2019).
Burnout: A psychological syndrome characterized by emotional exhaustions, feelings of cynicism, and reduction in personal accomplishment (Koutsimani et al., 2019, p. 1).
Anxiety: An emotional response that includes feelings of tension, worry, and which may include physical changes in the body such as elevated blood pressure, digestive trouble, difficulty sleepy, shortness of breath, etc. (American Psychological Association, 2019a).
Eustress: The beneficial or positive form of stress. This is the type of stress that elicits an excite-and-delight or challenge response (Cowell & Millard, 2016). With the challenge response the body is energized in anticipation of an upcoming situation that tests one’s abilities. The stress hormones that get released help access mental resources to increase focus and access physical reserves to improve performance (Davis, 2018).
Subjective Well-Being: Overall psychological well-being accepting mental health as a complete state considering positive and negative experiences, self-perceptions, and clinical diagnoses (Wang et al., 2011).
Life Transition: The specific phenomenon of transitional stress refers to the negative emotions that present in response to changes in their lives (i.e., life transition) that people have no automatic adaptive response (Corr, 2021; Lazarus & Cohen, 1977; Sykes & Eden, 1985).
Suicidal Ideation: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defined suicidal ideation as “thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one’s own death” (American Psychiatric Association, 2013).