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| SHORT COMMUNICATION |
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| Year : 2021 | Volume
: 3
| Issue : 2 | Page : 114-116 |
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Stress, Well-being, and Burnout in Georgian Medical Students: A Brief Report
Ekaterine Berdzenishvili1, Murtaza Kadhum2, Andrew Molodynski2, Dinesh Bhugra3
1 Tbilisi State Medical University, Tbilisi, Georgia
2 Oxford University, Oxford, London, UK
3 King's College, London, UK
| Date of Submission | 27-Jul-2021 |
| Date of Acceptance | 04-Aug-2021 |
| Date of Web Publication | 31-Aug-2021 |
Correspondence Address:
Andrew Molodynski
Consultant Psychiatrist, Oxford Health NHS Foundation Trust; Honorary Senior Clinical Lecturer, Oxford University, Oxford
UK
 Source of Support: None, Conflict of Interest: None  | 1 |
DOI: 10.4103/wsp.wsp_33_21
Much attention has been focused on the well-being of health-care staff and more recently medical students. This small-scale study formed a part of a major international initiative and used standardized measures of health, substance misuse, and burnout. We found high levels of stress from several key sources alongside the rates of 80% and 83% for the disengagement and exhaustion subscales of the Oldenburg burnout scale. The rates of mental health problems as measured by the General Health Questionnaire-12 short version were 68%.
Keywords: Burnout, medical students, Stress, Well-being
How to cite this article:
Berdzenishvili E, Kadhum M, Molodynski A, Bhugra D. Stress, Well-being, and Burnout in Georgian Medical Students: A Brief Report. World Soc Psychiatry 2021;3:114-6 |
| Introduction | |  |
Medical education is a rigorous and prolonged process that necessarily involves some stress and personal sacrifice. It is now well established that the rates of burnout and levels of psychiatric morbidity are higher among medical students than age-matched control groups.[1] Medical students are particularly susceptible to depression and anxiety as would be expected as these are the two most common such conditions. The rates of burnout using standardized measures have been found to be extremely high in a number of studies including a large-scale international study using the same methodology as this one.[2] Despite this, there has been relatively little research involving medical students in Georgia.
This study was a part of the second wave of a large international initiative to measure stress, burnout, psychological problems, and substance misuse among thousands of students across many countries.
| Methods | | |
An exact replica of the online survey used in the other countries was translated into Georgian. Students were approached through e-mails, which are created by Tbilisi State Medical University for the small groups of students for communication and educational purposes. A short cover letter was provided alongside the survey, declaring that participation was voluntary, explaining the purpose of the survey, and providing recommendations in case the survey triggered distress.
The survey contained questions to collect demographic details and sources of stress. It also contained the General Health Questionnaire 12 (GHQ12),[3] the Oldenburg Burnout Inventory (OLBI),[4] and the CAGE questionnaire[5] to measure levels of psychiatric symptoms, burnout (disengagement and exhaustion), and problematic alcohol use, respectively. A score of 2 or greater on the GHQ was obtained to indicate caseness in line with other similar studies[6] and scores of 2.10 and 2.25 were used as the cutoffs for the disengagement and exhaustion, respectively, on the OLBI. A score of 2 or more on the CAGE questionnaire was obtained to indicate the presence of problematic alcohol use.
All replies were anonymous.
| Results | | |
About 41 students responded to the survey and all students responded to all questions in the survey. All were from the Tbilisi State Medical University. Basic demographic details and parental educational level are shown in [Table 1].
We asked students about four major domains of life and whether they were causes of stress to them. The highest rates of stress were reported for housing and study, at 92% and 82%, respectively, but money and relationships were also stress to many. This is represented in [Figure 1].
About 8% of students reached “caseness” using the GHQ12 and 80% and 83% scored as being disengaged and exhausted, respectively, using the OLBI. Rates of reported substance misuse were low with only 12% of students being positive for alcohol problems using the CAGE questionnaire and only 10% admitting the current illicit drug use. These results are shown in [Table 2]. | Table 2: Results of the CAGE, general health questionnaire 12 and Oldenburg burnout inventory scales
Click here to view |
| Discussion | | |
Our survey had limitations, principally the small sample size. It was also a convenience sample, so caution is needed when interpreting the results. Our results are, however, in line with those from the other countries involved in this program.[7],[8],[9]
The majority of medical students who responded had parents who had achieved postgraduate education (76%) compared to 37% of the overall population aged over 25. We found similar disparities in all countries, suggesting that social mobility is an issue that affects the medical workforce and those in training.
Students reported high levels of stress and many reported multiple stressors. The highest rates were reported for housing and study, suggesting that strategies to support students more in these domains would be helpful.
These high levels of stress were associated with very high levels of reported psychiatric symptoms and burnout. Again, although these rates are high, they are in keeping with the results across many countries. They suggest that the Georgian medical students are not immune in any way for the global crisis in medical student well-being. Despite high levels of stress and burnout, reported substance misuse was relatively low. This may be an artifact of the small sample size or may be a sign that respondents had found more positive ways to cope with difficult emotions.
Our study sample was small, but it does show high levels of stress, psychiatric symptoms, and burnout among medical students in Georgia. We hope these results encourage a stronger focus on student well-being and more work to ascertain the level of the problem so that strategies can be developed to help reduce the problem.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Moir F, Yielder J, Sanson J, Chen Y. Depression in medical students: Current insights. Adv Med Educ Pract 2018;9:323-33.  |
| 2. | Molodynski A, Lewis T, Kadhum M, Farrell SM, Lemtiri Chelieh M, Falcão De Almeida T, et al. Cultural variations in wellbeing, burnout and substance use amongst medical students in twelve countries. Int Rev Psychiatry 2021;33:37-42. |
| 3. | Goldberg DP, Blackwell B. Psychiatric illness in general practice. A detailed study using a new method of case identification. Br Med J 1970;1:439-43. |
| 4. | Ewing JA. Detecting alcoholism. The CAGE questionnaire. JAMA 1984;252:1905-7. |
| 5. | Demerouti E, Bakker AB. The Oldenburg burnout inventory: A good alternative to measure burnout and engagement. Handbook Stress Burnout Health Care 2008;65:78. |
| 6. | Almeida T, Kadhum M, Farrell SM, Ventriglio A, Molodynski A. A descriptive study of mental health and wellbeing among medical students in Portugal. Int Rev Psychiatry 2019;31:574-8. |
| 7. | Masri R, Kadhum M, Farrell SM, Khamees A, Al-Taiar H, Molodynski A. Wellbeing and mental health amongst medical students in Jordan: A descriptive study. Int Rev Psychiatry 2019;31:619-25. |
| 8. | Lemtiri Chelieh M, Kadhum M, Lewis T, Molodynski A, Abouqal R, Belayachi J, et al. Mental health and wellbeing among Moroccan medical students: A descriptive study. Int Rev Psychiatry 2019;31:608-12. |
| 9. | Farrell SM, Kar A, Valsraj K, Mukherjee S, Kunheri B, Molodynski A, et al. Wellbeing and burnout in medical students in India; a large scale survey. Int Rev Psychiatry 2019;31:555-62. |
[Figure 1]
[Table 1], [Table 2]
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