Wellness Activities, Stress, and Academic Performance in Medical Students

Medical student wellness has a range of effects from academic performance to tragic mortality. Many factors correlate with academic performance, including study environments, faculty support, research participation, and student attitude. Its relationship with student stress and wellness demonstrates mixed results. This study hopes to help clarify these results and will also assess the interplay of these factors in relation to the pre-clerkship and clerkship phases of medical school.

This retrospective descriptive study was conducted using a de-identified database from 2017 to 2023, provided per an Institutional Review Board (IRB) protocol. The subjects were the students of the classes of 2021-2027 at the Kirk Kerkorian School of Medicine at UNLV. The database included performance data including semester, clinical subject, and USMLE Step 1 and Step 2 exam scores. Other data included variables relating to self-perceived stress and time spent in wellness activities before medical school and at the end of the pre-clerkship and clerkship phases of medical school. The effects of these variables were calculated with bivariate correlations and independent samples T-tests using cut-off points calculated from the class means of those variables. A total of 361 medical students were included in the study.

Students with high wellness time had lower stress levels in both the pre-clerkship and clerkship phases of medical school (5.83 vs. 7.3 p < 0.001^* and 5.74 vs. 8.49 p < 0.001^*, respectively). Students with low stress levels in the pre-clerkship phase scored 5.81 points higher on the Step 1 exam (p = 0.013^*). Clerkship phase stress levels were significantly negatively correlated with all clinical subject exams except for pediatrics. Stress levels in the pre-clerkship and clerkship phases had similar relationships with the second and third semester and Step 2 exams, respectively, although not statistically significant. Wellness activity time did not have a significant relationship with academic performance.

Stress levels had significant negative relationships with many medical school exams. Although wellness activity time did not have a direct relationship with academic performance, its relationship with stress levels can allude to an indirect effect on academic performance. This, along with fending off burnout and stress, are reasons why medical student wellness should be a priority for medical schools, faculty, and their students.