Stress in junior medical students

The purpose of the authors in the study reported here was to compare perceived stress in junior medical students (n = 169) before and after a clinical clerkship and to determine the relationship of unfavorable and favorable stress to personality and performance. Degree of stress and whether the stress was considered favorable or unfavorable were determined by the students' ratings on a stress scale administered before and after their surgical clerkship. Locus of control and self-esteem scales were used as measures of personality. It was determined that students likely to experience more unfavorable stress were more external in control and lower in self-esteem as compared with the other students. The students' cognitive performance was evaluated by two written and two oral examinations; their attitudes and skills were assessed by a behavioral scale completed by faculty members and residents. The major finding was that unfavorable stress was associated with poor performance. Since stress predictably will increase in the residency and in the practice years, students should be exposed to stress management techniques to help prevent the known high consequences of stress, such as substance abuse and suicide, among practicing physicians.