Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden

Rebecca Erschens; Isabelle Skrypski; Teresa Festl-Wietek; Anne Herrmann-Werner; Sophia Helen Adam; Carla Schröpel; Christoph Nikendei; Stephan Zipfel; Florian Junne

doi:10.3389/fpsyt.2024.1358173

Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden

Front Psychiatry. 2024 May 2:15:1358173. doi: 10.3389/fpsyt.2024.1358173. eCollection 2024.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany.
² Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany.
³ Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
⁴ Deanery of Students' Affairs, University's Faculty of Medicine, Tuebingen, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, Magdeburg, Germany.

Abstract

Introduction: International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden.

Methods: Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7).

Results: Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively.

Discussion: Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.

Keywords: anxiety; depression; medical students; professional identity; professional role model; psychosomatic medicine.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Ministry of Science, Research and Arts Baden-Württemberg through the Competence Centre for the Prevention of Mental and Psychosomatic Disorders in Work and Educational Settings Baden-Württemberg [AZ42-04HV.MED(13)/3/1]. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.