title: Medical Student Stress, Burnout and Depression in Trinidad and Tobago.
abstract: OBJECTIVE
  Health-care workers in developed nations are well known to experience high levels of burnout and psychiatric morbidity, but little information is available from the Caribbean and other less well-developed regions. This study sought to explore the prevalence of stress, burnout, and depressive symptoms and associated risk factors among medical students in Trinidad and Tobago, the southernmost Caribbean island.
  
  
  METHODS
  A cross-sectional survey design was used to sample students. Data was collected utilizing standardized questionnaires that assess stress, burnout, and depressive symptoms. Demographic data and information pertaining to potential risk factors was also gathered. Overall, 450 questionnaires were distributed and analysis was performed upon 381 completed surveys (response rate 85%).
  
  
  RESULTS
  Students demonstrated high levels of stress and a significant prevalence of burnout (52%) and depressive symptoms (40%). Final year students demonstrated higher levels of burnout and depressive symptoms. Students who (i) felt they lacked emotional support, (ii) had little opportunity for relaxation and exercise, and (iii) did not feel they had control of their daily schedule all demonstrated higher levels of burnout and depressive symptoms. However, students who practiced from a faith base and considered their religion important demonstrated lower levels of both.
  
  
  CONCLUSIONS
  Medical students in Trinidad and Tobago are experiencing high levels of stress with a large proportion suffering from burnout and depressive symptoms. These data suggest that immediate interventions are necessary to help students cope with the challenges faced during medical school. Additionally, more research is needed to explore the potential causal links between burnout and depression during medical school and the effectiveness of tailored interventions especially within the context of developing nations.
authors.affiliation: The University of the West Indies, Saint Augustine, Trinidad and Tobago. farid.youssef@sta.uwi.edu.
authors.forename: Farid F
authors.initials: FF
authors.lastname: Youssef
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago; D055815:Young Adult
keywords: Burnout; Depression; Medical students; Positive mental health; Stress; Trinidad and Tobago