Medical education and poor mental health: A quantitative-qualitative survey study

Background: Medical students’ mental health is currently an issue of concern for medical education worldwide. The aim of this study was to identify the factors affecting mental health of medical students during training.Method: A cross-sectional study was carried out in 2020 involving medical students enrolled in School of Medicine, University of Sao Paulo, Brazil, collecting sociodemographic information and associating them with scores of Quality of life (VERAS-Q), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Metacognitive Awareness Inventory (MAI) and Achievement Goals for a Work Domain (AGWD). This study also explored two open-ended questions about motivation to seek mental health service.Results: Two hundred eighty-two students completed the survey (male = 51.4%). Overall, the perception on quality of life showed significantly higher scores for the learning environment (46.6, SD: 7.4), state-anxiety (87.9%), and trait-anxiety (86.5%) followed by depressive symptoms (17.7%), same results in domains of metacognition (0.63, SD: 0.1), and mastery avoidance for motivation to learn (29.2, SD: 6.8). The present researchers obtained a model with 47% (R2 = 0.47) of variance prediction for medical students’ mental health on VERAS-Q learning environment between the quality of life domains. These students perceived curriculum evaluation associated with cognitive overload, lack of innovation in teaching methodology, irregular relation between medical practice and theory, and lack of social and diversity issues.Conclusion: The learning environment, symptoms of anxiety and depression, and the lack of seeking emotional support were factors that influenced mental health in medical education. This reinforces the need for early intervention to prevent its worsening.