Prevalence of Medical Students` Syndrome among College of Medicine Students, Majmaah University, Majmaah, KSA 2020-2021

Salah A Abdelrahim^1*, Ashraf A Deyab¹, Mohammed Abdul Lateef Junaid¹, Ahmed Hussain A Asiree², Talal Mohammed A Alonazi², Khalid Fahad K Alotaibi² and Abdulrahman Naqaa Almutairi²

^*Correspondence: Salah A Abdelrahim, Department of Pathology, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia, Email:

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Introduction

Medical students' syndrome (MSS) is characterized as medical students having health-related concern when studying a specific disease because their symptoms were incorrectly linked to the disease under study. [1] Medical students are exposed to a large amount of clinical knowledge about many diseases, which may lead to a search for symptoms that impact them, anxiety about having a major illness, or exaggeration of small symptoms, all of which can lead to a self-diagnosis of a specific somatic disease [2]. It's a type of acute hypochondriasis, a psychiatric disorder characterized by a preoccupation with worries of having, or the thought of having, a dangerous disease based on misunderstanding of body symptoms despite proper medical diagnosis and reassurance. Hypochondriasis is different from ‘Nosophobia’, which is the extreme or irrational fear of developing or having a specific disease “[3].

Medical students’ syndrome is more common among medical students compared to other college students [1], while others studies found that medical student syndrome is not more likely in medical students compared to other students [4]. Medical school is a stressful experience that has been linked to unfavorable physical and mental health outcomes as well as poor academic performance among medical students [5]. Medical student syndrome is a substantial source of stress for medical students during their undergraduate career, and it has an impact on their academic performance [6,7].

According to studies, medical schools put students under a lot of psychological stress because of the quantity of work they have to do, the stress of exams, the anxiety connected with new clinical encounters, and the competitive environment [8,9].

Stress is hypothesized to alter symptom detection by increasing physical sensations as a result of autonomic activation, making people more aware of their physical status. Knowledge is also suggested to influence symptom interpretation by encouraging medical students to realize how thin the border between health and illness can be, as well as to re-conceptualize previously ignored symptoms in the context of newly acquired knowledge [10].

Another factor unique to medical students is the intensive clinical and preclinical exposure to medical information. This knowledge is assumed to influence symptom perception through the expectations and sickness beliefs that arise as a result of it, resulting in 'selective attention' to specific physical sensations and locations [11,12].

According to some studies, the medical student syndrome has two components: the first is cognitive, which includes the suspicion that the student has the ailment under investigation, and the second is distress, which includes the fear and concerns caused by the cognitive component [13].

Few studies points out that, the distress component was most prominent in first-year medical students before becoming insignificant in senior year students. The cognitive component, on the other hand, was present in all cohorts as they progressed through medical school [13,14]. The less obvious distress component in medical school's senior years could be explained by the maturity that comes with moving through medical school and a greater understanding of medical information than in previous years [12].

There are numerous publications on MSS in the literature from all over the world, but there are just a few research on MSS in the Majmaah, KSA region, which demonstrated that the prevalence of the medical student’s syndrome varies and has an impact on student performance. The goal of this study is to determine the prevalence of medical student syndrome among students at college of medicine, Majmaah University, as well as to understand how it affects students' performance and its relationship to gender, maturity level, and level of medical expertise.

Methods

An observational, cross-sectional, institutional-based study was conducted to find out the prevalence of medical students syndrome among students of College of Medicine, Majmaah University 2020 – 2021. The study included all students from the male and female sections, registered in five consecutive years of MBBS program.

The research was carried out at Majmaah University's College of Medicine in Al-Majmaah, Saudi Arabia. This location is around 189 kilometers north of Riyadh, Saudi Arabia's capital. The College of Medicine is located on the main campus of the university in Majmaah city. Simple random sampling technique was considered with complete enumeration of all students in the college of medicine, all the students were listed in one list and were numbered according to their academic year.

Data was collected using a pre-tested questionnaire. The data was input and processed using SPSS version 24 software, and statistical analysis was used to determine the prevalence of medical students' syndrome among students. The data was analyzed using descriptive statistics (frequency and standard deviation). For qualitative data, the chi-square test was used to determine group comparisons, with a p value of less than 0.05 was considered significant.

Results

This study included 216 male and female medical students, with male students accounting for 70.4% of the total (Table 1). 66.2% of those who took part were in their third year or higher (Table 1). Only 48.6% of participants in our study were aware of medical student's syndrome (Figure 1).

Table 1: Participation according to gender and year of study.

Figure 1: Knowledge of participants about MSS.

78.2% of individuals reported feeling symptoms or signs of an illness after reading about it, 31.9% of participants who felt symptoms and signs were explored further, and just 12% of people who experienced symptoms or signs consulted a doctor or psychiatrist and only 2.8% of the individuals took medicine for their symptoms and signs (Table 2).

Table 2: Determinants of medical student syndrome.

It was also observed that male students experience symptoms or signs of an illness after reading about it (65.6%) more than female students, and that 70.4% of those who experienced symptoms or signs were in their third year and above (Table 3).

Table 3: Feeling of signs and symptoms when reading about a disease and year of study and gender.

Furthermore, the majority of those who sought a doctor or psychiatrist after experiencing symptoms or signs of an illness after reading about it were in their higher years of study (Table 4). Figure 1 shows that 48.6% of participants were aware of medical student's syndrome, while the remainder was unaware.

Table 4: Visit a doctor (psychiatrist) and year of study.

Discussion

A total of 216 medical students took part in the research. 70.4% of them were male pupils. The majority of participants were in their third and subsequent years, which could be because they learned more about the patients' conditions and management, these finding were in accordance with previous researches]. Only 48.6% of the medical students who took part in this study were aware of medical student's syndrome, a finding that has previously been reported in the literature [2]. However, majority of participants (78.2%) reported feeling symptoms or signs of a disease when reading about it. Other research in the literature supported our findings, reporting that MMS was found to be prevalent in 70% to 80% of medical students. In contrast to these findings, prior research of medical students in Saudi Arabia found that the overall prevalence of MSS was just 3.4%. Our research highlighted that most of the participated medical students (68.1%) with feeling of symptoms or signs of a disease when reading about it ignored their condition and only 31.9% underwent further investigation. Only 12% of those who had these feelings consulted general practitioner or psychiatrist, and the majority of them were senior level students. The reason for this is that students in these years are more clinically oriented, learning more about disease pathology and patient examinations, whereas students in their first two years have little clinical exposure. Similar findings were observed in previous studies, while few other studies were contradictory to our findings whose observation showed higher percentage in students of initial two years of medical education.

Another significant finding observed in our study was the association between feeling of MSS and gender. We found that male medical students have a greater degree of MSS than female medical students. This finding could be explained by the fact that a larger number of male students participated in this study. Other studies that revealed female predominance contradicted our findings. The feeling of symptoms or signs of an illness when reading about it was found to have a strong relationship with the year of study in our research. We observed that the majority of medical students with these attitudes were in their third and subsequent years of study, and that most research conducted in Saudi Arabia and other countries supported our findings [23, 25]. However, some researchers found a larger percentage of students with MSS in the first two years of medical school and that the percentage decreases as the students get older, these observation were contradicting our findings [14-25].

Conclusion

Medical Student Syndrome was prevalent among students at college of medicine, Majmaah University, particularly among male students in their third and fourth years.

Recommendations

Counselling and supporting of medical students through the mentorship program is highly recommended in order to decrease the prevalence rate of Medical Student Syndrome.

We also recommend that future research be carried out which should include a larger study population by allowing students from other universities from other parts of Saudi Arabia to participate. This will aid our understanding of regional disparities and also will provide a more in-depth look at the Medical Student Syndrome across students at various levels of study.

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