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LETTERS TO THE EDITOR| Volume 82, ISSUE 2, P252, February 2007

Burnout, Depression, and Quality of Life in Medical Students–Reply–I

      Response bias is a concern with survey studies. We do not know if depressed students are more apathetic and less likely to fill out surveys on QOL and depression or if, on the other hand, they are more likely to complete such surveys because the survey content is more relevant to their circumstances. As pointed out by Drs Khoo and Tan, there may be other factors as well that impede minority students from filling out survey forms. As we pointed out in the discussion, minority students may feel that their anonymity is threatened because there are few minority students like them. Specifically, survey forms that seek information on age, sex, and ethnic groups may be perceived as being unduly revealing. Further research is needed to explore these issues and other possible barriers to participating in survey research.
      Although not reported, the survey did ask students if they were currently being treated for depression or anxiety. There was no difference by minority group in response to this question (6% minority vs 11% nonminority; P=.17). We agree that this question is sensitive and vulnerable to reporting bias.
      The survey instrument did include questions about the use of illicit substances (marijuana, methylenedioxymethamphetamine [XTC, ecstasy], amphetamines, and other substances). As expected, the prevalence of students using such illicit substances was exceedingly low, and thus we did not analyze the data by minority status.

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      • Burnout, Depression, and Quality of Life in Medical Students
        Mayo Clinic ProceedingsVol. 82Issue 2
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          To the Editor: The article on burnout, depression, and quality of life (QOL) in US medical students by Dyrbye et al1 certainly brings attention to issues often dismissed by many students and some teachers of medicine. Many have considered a poor QOL during the early phases of medical training to be a norm, almost an expectation, or even the acid test required to prepare them for the grueling years ahead. Previous surveys have quantified the prevalence of depression at up to a quarter of first- and second-year medical students, only a fraction of whom seek mental health counseling.
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