title: Student quality-of-life declines during third year surgical clerkship.
abstract: BACKGROUND
  Choosing surgery as a career is declining among U.S. medical students. The 8-wk third year surgery clerkship at our institution can be an intense learning experience, and we hypothesized that during this clerkship medical student quality-of-life would drop significantly from baseline, and that this drop would be greater among certain subgroups, such as women students not interested in pursuing a surgical career, and those who place a high value on a controllable lifestyle.
  
  
  METHODS
  At clerkship orientation (baseline), students were asked to complete a survey that measured quality-of-life on an 84-point scale, and depression on a 40-point scale. The quality-of-life scale was composed of select questions from the Medical Outcomes Study, and the Harvard Department of Psychiatry/NDSD brief screening instrument was used to measure depression. Students were also asked the typical number of hours they slept per night. Demographics, attitude toward a controllable lifestyle, and top three specialties of interest were also gathered at baseline. On week 6 of the clerkship, students were surveyed on the same quality-of -life and depression scales, and asked average hours of sleep per night for the previous week.
  
  
  RESULTS
  From June 2005 through December 2006, 143 of 177 (81%) students agreed to participate, and after exclusions for missing data, 137 students were included in the analysis. Sixty-nine students were women (51%), and the average age was 25.8 (sd 2.6). Mean quality-of-life at baseline was 57.0 (sd 11.3) and at week 6 was 50.4 (sd 10.1) representing a statistically significant average decline of 6.6 points (P < 0.0001). Mean depression at baseline was 14.4 (sd 3.8) and at week 6 was 15.1 (sd 3.6), representing a small but significant average decline of 0.7 points (P = 0.0155). Mean sleep at baseline was 6.3 h/night (sd 0.9) and at week 6 was 5.7 h/night (sd 1.2), representing a statistically significant average decline of 0.6 h/night (P < 0.0001). Declines were similar on all outcomes between men versus women, those who ranked surgery in their top three career choices versus those who did not, and those who ranked controllable lifestyle as "very important" versus all other categories.
  
  
  CONCLUSIONS
  Quality-of-life and sleep declines and depression increases significantly in third-year medical students from orientation to week 6 of their surgery clerkship at our institution. We look forward to studying quality-of-life on other clerkships for comparison, assessing whether the magnitude of this decline in quality-of-life predicts students avoiding a future career in surgery, and testing interventions to prevent this decline in quality-of-life during the clerkship.
authors.affiliation: Department of Surgery, University of South Florida College of Medicine, Tampa, Florida 33647, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Goldin
authors.forename: Monika M
authors.initials: MM
authors.lastname: Wahi
authors.forename: Osman S
authors.initials: OS
authors.lastname: Farooq
authors.forename: Heather A
authors.initials: HA
authors.lastname: Borgman
authors.forename: Heather L
authors.initials: HL
authors.lastname: Carpenter
authors.forename: Lucas R
authors.initials: LR
authors.lastname: Wiegand
authors.forename: Lois L
authors.initials: LL
authors.lastname: Nixon
authors.forename: Charles
authors.initials: C
authors.lastname: Paidas
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Rosemurgy
authors.forename: Richard C
authors.initials: RC
authors.lastname: Karl
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D002982:Clinical Clerkship; D003625:Data Collection; D003863:Depression / Q000523:psychology; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008019:Life Style; D008297:Male; D011788:Quality of Life; D012890:Sleep; D013337:Students, Medical / Q000523:psychology*