title: Well-being of medical students and their awareness on substance misuse: a cross-sectional survey in Pakistan.
abstract: OBJECTIVE
  To investigate psychological well-being and substance abuse among medical students in Pakistan.
  
  
  METHODS
  A cross-sectional questionnaire-based survey was conducted in six medical colleges across Pakistan. Final-year medical students were interviewed by either a postgraduate trainee in psychiatry or a consultant psychiatrist.
  
  
  RESULTS
  A total of 540 medical students were approached; 342 participated and the response rate was 64.5%. Mean age was 23.73 years (SD 2.45 years); 52.5% were male and 90% single. Two out of every five respondents reported that work/study at medical school affected their personal health and well-being. A considerable proportion of students were aware of alcohol and smoking as coping strategies for stress in medical students. The main factors causing stress were heavy workload (47.4%), relationship with colleagues (13.5%) and staff (11.9%). A total of 30% reported a history of depression and 15% among them had used an antidepressant. More than half were aware of depression in colleagues. The majority of respondents said that teaching provided on substance misuse in the areas of alcohol and illegal drugs, management/treatment of addiction, and models of addiction was poor. There was significant association (p = 0.044) between stress and awareness about alcohol as a coping strategy for stress among medical students. A significant negative association was also found between medical colleges in public sector (p = 0.052), female gender (p = 0.003) and well-being.
  
  
  CONCLUSIONS
  The majority of the medical students reported a negative impact of heavy workload on their psychological well-being. Significant numbers of medical students think that substance misuse is a coping strategy for stress. Teaching on addiction/addictive substances is poor at undergraduate level in Pakistani medical colleges.
authors.affiliation: Department of Psychiatry, Aga Khan University, Karachi 74800, Pakistan. wahab.yousafzai@aku.edu
authors.forename: Abdul Wahab
authors.initials: AW
authors.lastname: Yousafzai
authors.forename: Syed
authors.initials: S
authors.lastname: Ahmer
authors.forename: Ehsanullah
authors.initials: E
authors.lastname: Syed
authors.forename: Naila
authors.initials: N
authors.lastname: Bhutto
authors.forename: Saman
authors.initials: S
authors.lastname: Iqbal
authors.forename: Mohammed Naim
authors.initials: MN
authors.lastname: Siddiqi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zaman