Change in subjective well-being over 20 years at two Norwegian medical schools and factors linked to well-being today: a survey

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BACKGROUND: There is a lack of studies on factors in the curriculum, study environment and individual differences that can promote well-being among medical students as a response to the frequent reports on the negative health effects of study demands among medical students worldwide. OBJECTIVE: This study investigates differences in well-being among today's Norwegian medical students compared with students 20 years ago, the most important predictors of well-being today, and whether there have been any changes in the levels of some of these factors since the period analysed. METHODS: We analysed cross-sectional survey data among all medical students (63.9%, N = 1044/1635) at two medical faculties with different curriculums (traditional and integrated) in Norway in 2015 (STUDMED 2015). We used comparison data from a longitudinal survey among medical students from the same medical faculties in 1993 to 1999: the NORDOC project (T1 = 89%, T2 = 72% and T3 = 68%). Differences in subjective well-being and correlates by demographic, curriculum, and study environment factors among the present students were tested by t-tests and stepwise linear regression analysis. RESULTS: Students today scored lower on their levels of subjective well-being than students 20 years ago. The difference was found among female and males in different study stages. The final model showed that subjective well-being today was associated with self-esteem (β = .98, p < .001) and social support from medical school friends (β = .22, p < .001), a partner (β = .08, p = .020) or other family members (β = .04, p = .041), as well as perception of medical curriculum and environment (β = -.38, p < .001), personal competence (β = -.40, p < .001), finance/accommodation (β = -.22, p < .001) and perceived exam stress (β = -.26, p < .001). CONCLUSIONS: The results show a decrease in subjective well-being among medical students and, in particular, among female students. The faculties should pay attention to the factors identified in the study environment and curriculum associated with subjective well-being in order to promote their student's well-being and stimulate health and academic performance.