The influence of excessive stress on the quality of life of medical students in the Czech Republic – National sample
Authors: Palička Martin , Rybář Marian , Mechúrová Barbora , Paličková Natália , Sobelová Tereza , Pokorná Kateřina , Cvek Jakub 
Published: January 2023

Abstract
Purpose

The Czech Republic has been dealing with a long-term shortage of doctors, which, according to demographic forecasts, will continue to worsen due to the retirement of stronger generations of doctors in contrast to the gradual aging of the population, which will require more health care over time. The country´s political set is trying to respond to this shortage and demographic forecasts by gradually increasing financial funding of medical faculties with the aim of increasing the production of graduates of the program in the field of general medicine. The proportion of medical students in the Czech Republic who do not complete their studies for various reasons varies between 7.7% and 21.6% depending on the faculty.

Methods

We conducted anonymous questionnaire survey among students and graduates of general medicine at all eight Czech medical faculties. A total of 3183 respondents participated in our survey. There were 2843 medical students, which represents approximately 28% of all medical students in the Czech Republic. The distribution of respondents within the study years was approximately even. The distribution of respondents in our survey approximately corresponded to the real distribution of students between individual faculties in the Czech Republic, which makes our survey a national sample. The statistical processing was performed in the statistical software R. Apart from the basic comparison using percentage relative frequencies and Person’s chi-squared test, in this study we used Odds ratio (OR) for a better interpretations of some outputs.

Results

Our results show that the vast majority of Czech medical students experience excessive stress during their studies, which increases the risk of students´ somatic problems (OR = 7.97, p < 0.001), targeted alcohol use (OR = 2.69, p < 0.001) and the use of anxiolytic or antidepressant medication to reduce it (OR = 9.16, p < 0.001), which reduces the students´ quality of life. Students experiencing higher levels of excessive stress are more likely to leave their studies based on their own decision (OR = 3.91, p < 0.001) and not to enter clinical practice after graduation (OR = 1.27, p = 0.18).

Conclusions

Our work shows the need for an open discussion at the highest level about the possibilities of reasonable reduction of unnecessary stress during medical studies. Medical students in the Czech Republic are exposed to excessive stress with all the consequences described above. All that remains is to state the existence of unnecessary components of stress, which represent an opportunity to reduce it, thereby achieving a higher quality of life for medical students, a higher quality of health care provided in the future, an improvement in the staff situation in the Czech healthcare system and a reduction in inefficiently spent financial resources for the education of young doctors.
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