Effect of General Medical Degree Curricular Change on Mental Health of Medical Students: A Concurrent Controlled Educational Trial

Abstract

Objective: General medical degree (GMD) curriculum usually causes significant psychological distress for medical students, especially in transition periods between preclinical, clerkship, and internship periods. This study was conducted to assess the effect of curricular change in GMD program on mental health of medical students in internship period. Method: This study evaluated mental health of 2 concurrent groups of medical students under reformed and non-reformed GMD curriculum. In this study, 120 out of 180 interns in the non-reform GMD program and 60 interns in the reformed GMD program were selected and their mental health status evaluated using Symptom Checklist-90-Revised (SCL-90-R) questionnaire. The cut-off point of 0.7 was used for Global Severity Index (GSI) score. SPSS software, version 14 (SPSS Inc, Chicago, Il, USA) was used for analysis. Chi-square, Fisher’s exact test, t student, Mann–Whitney U, one-way ANOVA, and Kruskal-Wallis tests were used when appropriate. Logistic regression was used to estimate odds ratios for various determinants of students’ mental health. Results: About half of the participants in the 2 groups were male (P = 0.63), and the mean age of the students in the reformed and non-reformed programs was 24.8 (1.97) and 24.7(1.80), respectively (P = 0.9). About 20% of participants in the non-reformed and less than 2% of those in the reformed program had GSI score of more than 0.7. Medical students in the reformed program had lower scores in total GSI and 9 its dimensions (P<0.001). The results obtained from the logistic regression analysis indicated that reformed curriculum and good economic status were significant independent variables contributing to decreased psychological distress (OR = 0.016 and 0.11, respectively). Conclusion: The results revealed that curricular changes which were based on World Federation of Medical Education recommendation, could be associated with improvement in mental health status of medical students.