title: Depression and stress amongst undergraduate medical students.
abstract: BACKGROUND
  The demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community's experience in evaluating their impact is limited.
  
  
  METHODS
  The authors designed a wellness needs assessment of all medical students at the Albert Einstein College of Medicine in order to assess students' health behaviors, stress and depressive symptoms. The online survey was administered to all medical students from the classes of 2014 and 2015 at the beginning of their first year of medical school and again at the end of their third year. Chi-square and T-tests were run comparing the survey responses of the two classes.
  
  
  RESULTS
  There was a significant increase in perceived stress from an average of 5.51 in the first year to 6.49 in the third year (p = .0001). The number of students at risk for depression, defined as a CES-D score greater than 16, was 94 (28.4%) in the first year and 131 (39.0%) in their third year (p = .004).
  
  
  CONCLUSIONS
  This study demonstrates a significant increase in the proportion of students at risk for depression in their third year as compared to the first year as well as an increase in perceived stress. In response to these findings, the authors took a multi-disciplinary approach in the development of a comprehensive program to address student wellness, including efforts to address issues specific to the clinical clerkships. This program is unique in that its design, inception and ongoing evaluation have taken the needs of an entire medical school class into account.
authors: Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. Allison.Ludwig@einstein.yu.edu.
authors: Allison B
authors: AB
authors: Ludwig
authors: Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
authors: William
authors: W
authors: Burton
authors: Montefiore Medical Center, 111 E. 210th Street, Rosenthal Pavilion, Room 4, Bronx, NY, 10467, USA. jweingar@montefiore.org.
authors: Jacqueline
authors: J
authors: Weingarten
authors: Albert Einstein College of Medicine, Clinical Skills Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. Felise.milan@einstein.yu.edu.
authors: Felise
authors: F
authors: Milan
authors: Albert Einstein College of Medicine, Clinical Skills Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. Dan.myers@einstein.yu.edu.
authors: Daniel C
authors: DC
authors: Myers
authors: Beth Israel Medical Center, Continuum Center for Health and Healing, 245 Fifth Avenue, New York, NY, 10016, USA. bkligler@chpnet.org.
authors: Benjamin
authors: B
authors: Kligler
mesh_terms: D003863:Depression / Q000453:epidemiology*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D012577:Schools, Medical / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology*; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires