ArticleBMC medical education2024
Medical students in distress: a mixed methods approach to understanding the impact of debt on well-being.
Article in BMC medical education, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Generative AI's Impact on the Mental Health of Medical Students: Scenario Analysis.JMIR medical education · 2026Article
- Examining the multidimensional structure of stress among international medical students: a construct-based approach.BMC medical education · 2026Article
- Emotional vulnerability and research capacity in medical postgraduates: toward understanding the reciprocal relationship and proposing targeted interventions.Frontiers in public health · 2026Article
- Identifying predictors of student depression through validated machine learning pipelines.Frontiers in medicine · 2026Article
- Academic Stressors and Sociodemographic Vulnerabilities Among Medical Students at the University of Ottawa.MedEdPublish (2016) · 2026Article
- Article
- Disparities in well-being outcomes among medical students: a comparative study between medical students with and without disability.BMC medical education · 2025Observational
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Authors and funding
6 authors.
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Abstract
backgroundNearly three in four U.S. medical students graduate with debt in six-figure dollar amounts which impairs students emotionally and academically and impacts their career choices and lives long after graduation. Schools have yet to develop systems-level solutions to address the impact of debt on students' well-being. The objectives of this study were to identify students at highest risk for debt-related stress, define the impact on medical students' well-being, and to identify opportunities for intervention.
methodsThis was a mixed methods, cross-sectional study that used quantitative survey analysis and human-centered design (HCD). We performed a secondary analysis on a national multi-institutional survey on medical student wellbeing, including univariate and multivariate logistic regression, a comparison of logistic regression models with interaction terms, and analysis of free text responses. We also conducted semi-structured interviews with a sample of medical student respondents and non-student stakeholders to develop insights and design opportunities.
resultsIndependent risk factors for high debt-related stress included pre-clinical year (OR 1.75), underrepresented minority (OR 1.40), debt $20-100 K (OR 4.85), debt >$100K (OR 13.22), private school (OR 1.45), West Coast region (OR 1.57), and consideration of a leave of absence for wellbeing (OR 1.48). Mental health resource utilization (p = 0.968) and counselors (p = 0.640) were not protective factors against debt-related stress. HCD analysis produced 6 key insights providing additional context to the quantitative findings, and associated opportunities for intervention.
conclusionsWe used an innovative combination of quantitative survey analysis and in-depth HCD exploration to develop a multi-dimensional understanding of debt-related stress among medical students. This approach allowed us to identify significant risk factors impacting medical students experiencing debt-related stress, while providing context through stakeholder voices to identify opportunities for system-level solutions.
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