A national longitudinal cohort study of factors contributing to UK medical students' mental ill-health symptoms.

Background: The mental health of current medical students is predictive of their mental health as future doctors. The prevalence of anxiety, depression and burnout is high among medical students, but less is known about the occurrence of other mental ill-health symptoms, such as eating or personality disorders, and factors contributing to mental ill-health. Aims: (1) To explore the prevalence of various mental ill-health symptoms in medical students and (2) to investigate what medical school factors and students' attitudes contribute to these mental ill-health symptoms. Methods: Between November 2020 and May 2021, medical students from nine geographically spread medical schools in the UK participated by completing online questionnaires at two points in time, approximately 3 months apart. Results: Of the 792 participants who filled in the questionnaire at baseline, over half experienced medium to high somatic symptoms (50.8%; 402) and drank alcohol at hazardous levels (62.4%; 494). Adjusted longitudinal data analysis of 407 students who completed the follow-up questionnaire demonstrated that less supportive educational climates that were more competitive and less centralised around the students, lower feelings of belongingness, greater stigma towards mental ill-health and lower intentions to seek help for mental ill-health, all contributed to students' mental ill-health symptoms. Conclusions: Medical students experience a high prevalence of various mental ill-health symptoms. This study suggests that medical school factors and students' attitudes towards mental ill-health are significantly associated with students' mental health.