Developmental stresses in medical education

In attempting to understand the nature of emotional disturbances in medical student populations, one inevitably is drawn to the study of the complex interactions between the demands of the medical school environment and the adaptive capacities of students. In our work as psychiatric consultants to the University of Colorado Medical Center Student Health Service, we have found it useful to conceptualize the four-year medical curriculum as presenting the student with a series of adaptive and development tasks. The appearance of emotional disturbance is seen to relate as much to the particular developmental stress confronting the student as to his long-standing character structure and psychopathology. In this paper, we will describe and illustrate with clinical material major developmental tasks likely to elicit emotional distress in students. Indicators of potentially adaptive versus maladaptive resolutions will be outlined, and some suggestions for helpful intervention offered. Unique issues faced by women medical students will also be reviewed.