Students who feel less pressure during medical school and are taught to manage stress and adversity are better off mentally and perform better academically, according to a recent study published in Academic Medicine.

According to background information provided in the paper, the problem of depression among medical school students is significant, affecting between 20 and 30 percent of medical students in the U.S.

“For many years, nobody did anything about it,” Dr. Stuart Slavin, MD, MEd, associate dean for curriculum at Saint Louis University School of Medicine wrote. “Then, the first approach to addressing the problem was to get students better access to psychiatric and mental health services. That was followed by schools adding activities that encourage wellness and teamwork, such as Olympics-style athletic competitions and optional wellness seminars. While those things are great, they’re not enough.”

The study, led by Dr. Slavin, examined the well-being of first and second year students at SLU SOM before and after changes were made to the school’s curriculum. The new curriculum was designed to prevent depression, stress, and anxiety. Dr. Slavin and his colleagues compared the performance of five classes – two before the changes and three after- measured at medical school orientation, the end of the first year and the end of the second year.

“We’ve seen dramatic improvement in the mental health of our students. Depression rates in first year medical students went from 27 percent to 11 percent and anxiety dropped from 55 percent to 31 percent. At the same time, our Step 1 board scores went up, meaning student performance improved,” Dr. Salvin explained. “Our students know more, and will be in a better situation, emotionally, to care for our patients.”

Changes to the medical school curriculum meant that rather than letter grades or honors/near honors grading, students would receive pass or fail grades for their pre-clinical courses in the first two years of medical school. With the modified curriculum, students would spend less hours in the classroom and more time to explore other electives and participate in newly established learning communities. Furthermore, the school content of some classes and the order in which they were taught was also modified.

“Physician depression and burnout are significant problems in the United States and may rightly be viewed as a substantial public health problem, particularly given the evidence of the negative impact that mental health can have on clinical care by reducing physician empathy and increasing rates of medical error,” he said. “Unfortunately strong evidence supports that the seeds of these mental health problems are planted in medical school.”