The effectiveness of interventions designed to enhance and maintain medical student wellbeing: a systematic review

BACKGROUND: Psychological well-being is crucial for medical students, who face high levels of stress throughout their training. This systematic review examines interventions designed to enhance the well-being of medical students, addressing gaps in previous research that often focused on specific interventions or included broader health professional populations. METHODS: This systematic review was undertaken according to PRISMA guidelines and registered with PROSPERO (CRD42018097172). The review analysed 33 studies identified from a search of Medline and PsycINFO, identifying a variety of interventions and outcome measures of wellbeing. Results were narratively synthesised and primary studies assessed using the Cochrane Risk of Bias 2 (RoB-2) tool for interventional studies and the Newcastle-Ottawa Scale (NOS) tool for observational studies. RESULTS: The most effective interventions were mindfulness-based programs, particularly when combined with cognitive behavioral therapy (CBT). These approaches helped students manage stress, anxiety, and depression, which occur frequently among medical students. Notably, online mindfulness programs were as effective as in-person sessions, offering flexibility for students with demanding schedules. Voluntary participation in these interventions also led to better outcomes, highlighting the importance of student engagement. Other effective interventions included positive psychology programs, which foster resilience, coping ability and gratitude, and physical exercise which reduced stress and improved overall well-being. In contrast, voluntary mentoring programs and health education initiatives showed limited effectiveness in reducing psychological distress, possibly due to inconsistent implementation or a lack of emotional support. Interestingly, the review found that the frequency and duration of effective interventions did not significantly affect their efficacy. This suggests that simply including and delivering wellbeing interventions in curricular may be more important than their length or frequency. Participants who engaged in mindfulness and other well-being interventions also maintained improvements in mental health during follow-up assessments, indicating long-term benefits. CONCLUSION: Voluntary mindfulness interventions combined with CBT, along with positive psychology and exercise programs, were identified as the most effective strategies for enhancing the well-being of medical students. Future research should explore integrating these interventions into medical curricula to ensure lasting mental health support throughout students’ training.