Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians

Background: Different stages of a physician's career may be associated with different types of mental health impairment. Aims: This study aimed to compare symptoms of anxiety, depression, and stress and their associated factors among medical students, medical residents, and physicians. Methods: A cross-sectional study was conducted. Data collection included sociodemographic data, religiosity (Duke University Religion Index), and mental health (21-item Depression, Anxiety and Stress Scale - DASS-21) data. The comparison between the groups was performed using ANOVA, and the associated factors were evaluated via linear regression models. Results: The sample consisted of 1,417 participants: 778 medical students, 190 medical residents, and 468 established physicians. Medical students had significantly higher depression, anxiety, and stress scores as compared to medical residents and established physicians. However, regarding DASS 21 scores, no significant differences were found between established physicians and medical residents. The factors associated with mental health in the different groups showed that being married and male were associated with better mental health among physicians and medical residents, while the factors of male gender, being in later years of the course, and lower religious attendance were associated with better mental health in students. Conclusion: Medical students had worse mental health outcomes when compared to residents and established physicians. Interventions are needed to minimize suffering during medical education and career.