Understanding mental health among US medical students during the COVID-19 pandemic: Role of primary care providers

Context: The SARS-CoV-2 pandemic disrupted education, contributing to poor mental health among medical students. Primary care providers provide critical roles for maintaining wellness and good mental health and may be one key to address mental health issues among medical students during periods of crises.

Objective: Examine depressive symptoms and medical school communication among US medical students during the COVID-19 pandemic.

Study Design: Online convenience sample.

Setting: National population-based survey.

Population studied: Participants enrolled in a US medical school during the 2019-2020 academic year and who completed the survey were included. A total of 212 surveys were included.

Instrument: Online survey included the Center for Epidemiologic Studies Depression (CESD-10) 10-item scale. We also included items to examine communication between medical schools and students.

Outcome Measures: Primary outcome was a dichotomized measure of the risk of developing depression, with a CESD-10 score of <10 at average risk and a score ≥10 at risk of developing depression. Multivariable logistic regression was used to examine associations between communication methods during the pandemic and risk of depression after controlling for potential confounders.

Results: We found 48.6% of medical students were at risk of developing depression. Of students reporting that their depressive symptoms became worse between Spring 2020 and Fall 2020, 75.7% were at risk of depression in December 2020 when the survey was administered. Most students reported communication with their medical schools during the pandemic occurred via e-mail, but more interpersonal communication, such as through remote townhall meetings, was desired. Students who agreed that faculty and administration were readily available for questions had lower odds for risk of developing depression.

Conclusions: Primary care practitioners play an important role in medical school education and prevention of mental health problems in patients. As medical students are at high risk of developing depression, primary care practitioners and educators could play an important role in reaching out to medical students using interactive communication strategies to provide them with resources to improve mental health, particularly during stressful situations such as the pandemic.