title: Cognitive enhancement drug use among future physicians: findings from a multi-institutional census of medical students.
abstract: BACKGROUND
  Nonmedical use of prescription psychostimulants such as methylphenidate and amphetamine salts for the purpose of cognitive enhancement is a growing trend, particularly in educational environments. To our knowledge, no recent studies have evaluated the use of these psychostimulants in a medical academic setting.
  
  
  OBJECTIVE
  To conduct an online census of psychostimulant use among medical students.
  
  
  METHODS
  In 2011, we conducted a multi-institutional census using a 31-48 item online survey regarding use of prescription psychostimulants.
  
  
  METHODS
  2,732 actively enrolled medical students at four private and public medical schools in the greater Chicago area.
  
  
  METHODS
  Prevalence and correlates of psychostimulant use
  
  
  RESULTS
  1,115 (41 %) of students responded to the web-based questionnaire (range 26-47 % among schools). On average, students were 25.1 years of age (SD = 2.7, range 20-49), and single (70 %). Overall, 18 % (198/1,115) of this medical student sample had used prescription psychostimulants at least once in their lifetime, with first use most often in college. Of these, 11 % (117/1,115) of students reported use during medical school (range 7-16 % among schools). Psychostimulant use was significantly correlated with use of barbiturates, ecstasy, and tranquilizers (Pearson's correlation r > 0.5, Student's t-test p < 0.01); male gender (21 % male versus 15 % female, Chi squared p = 0.007); and training at a medical school which by student self-report determined class rank (68 % versus 51 %, Chi-squared p = 0.018). Non-users were more likely to be first year students (Chi-squared p = 0.048) or to have grown up outside of the United States (Chi-squared p = 0.013).
  
  
  CONCLUSIONS
  Use of psychostimulants, including use without a prescription, is common among medical students. Further study of the side effects, medical implications, and use during post-graduate medical training and medical practice is needed to inform evidence-based policy.
authors.affiliation: Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Robyn M
authors.initials: RM
authors.lastname: Emanuel
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Frellsen
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Kashima
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Sanguino
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Sierles
authors.forename: Cathy J
authors.initials: CJ
authors.lastname: Lazarus
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage; D010820:Physicians / Q000639:trends; D013337:Students, Medical; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D018697:Nootropic Agents