Zoccolillo, Murphy and Wetzel, (1986) found a 12% prevalence of major depression or possible major depression during the first 2 years of medical school. The lifetime prevalence was 15%, 3 times the rate of the general population. Vitaliano’s (1989) study concluded that, for a large number of students, medical school is a highly stressful experience. The study also concluded that the distress encountered was enduring rather than transitory.
In a longitudinal study conducted by Clark, Daugherty, Zeldow, Gotterer and Hedeker (1988), the authors examined the relationship between academic performance and depressed mood over a 4-year period, with a single medical school class. Their hypotheses are clearly and briefly stated; poor grades lead to depression and depression leads to poor grades.
The Beck Depression Inventory (BDI) was used to assess the severity of depressed mood. Undergraduate, first year medical school, and second year medical school GPAs, as well as third and fourth year GPAs were calculated. Also taken into account were the MCAT scores of the students. The results suggest three different types of causal relationships between depressed mood and academic performance. The inferential statistics suggest first that a better undergraduate academic performance contributed to fewer reported depressive symptoms throughout medical school in a manner that did not diminish from one year to the next. Second, a student’s depressed mood as assessed under the considerable pressure of impending second year final examinations and Boards Part I (a major examination that is given after the first 2 years of academic coursework that covers all materials taught over the first 2 years of medical school) may have contributed to lower Boards scores. Finally, it suggests that students who performed less well on Boards tended to report more depressive symptoms in the months following receipt of their Boards scores.