Gender differences in substance use and psychiatric distress among medical students: A comprehensive statewide evaluation

Abstract

Background: Medical student wellness has emerged as an important issue in medical education. The purpose of the present study was to obtain a comprehensive assessment of substance use, psychological distress, and help-seeking among male and female medical students in order to identify targets for continued intervention efforts.

Methods: Medical students from all 9 medical schools in the state of Florida were invited via e-mail and/or announcements to complete an anonymous online questionnaire assessing their well-being. Of 5053 matriculating medical students, 1137 (57.1% female) responded to the questionnaire. Descriptive statistics, t tests, and chi-square analyses were computed using SPSS 20.

Results: Over 70% of students acknowledged binge drinking, with men reporting higher frequency than women (χ² = 13.90, P = .003), and 22.7% (n = 201) reported marijuana use during medical school, with higher rates (χ² = 9.50, P = .02) among men (27.0%, n = 99) than women (18.9%, n = 93). A significant minority of students reported nonmedical use of prescription stimulants and prescription opioids. In addition, 3.3% of male students (n = 12) compared with 0.6% of female students (n = 3) reported problematic drug use. Further, almost 2/3 of respondents reported decreased psychological health since beginning medical school, with women noting greater reductions (χ² = 12.39, P = .05) and higher levels of stress (χ² = 16.30, P = .003). Over 10% of students (n = 102) endorsed "thoughts of committing suicide" during medical school, and 70.1% felt they would benefit from mental healthcare (79.3% of women vs. 59.6% of men; χ² = 41.94, P < .001), although only 39.8% accessed help.

Conclusions: Despite efforts to address medical student wellness, students continue to report concerning levels of psychological distress, suicidal ideation, and substance use. More work is needed to effectively address medical student mental health and well-being.

Keywords: Gender differences; medical education; medical student wellness; physician impairment; substance use disorders.