Introduction Student mental health has emerged as a major challenge for health professional training worldwide, particularly among students enrolled in often demanding professional programmes such as pharmacy. Although universities increasingly recognise the importance of student wellbeing, less is known about how pharmacy students’ mental health experiences are shaped by differing institutional and socio-cultural contexts. This study examines the contextual influences shaping pharmacy students’ mental health and help-seeking behaviours across two contrasting pharmacy education contexts: Australia, a high-income country, and Pakistan, a lower-middle-income country.Methods A qualitative design was employed using semi-structured interviews with 18 pharmacy students from universities in both countries. An inductive thematic approach was adopted to identify broader thematic patterns across two different cultural and educational contexts.Results The analysis revealed several interconnected themes influencing students’ mental health including academic stressors; personal experiences and well-being; family, peer and social expectations; culture, stigma and attitudes to mental health; awareness and knowledge; coping strategies and support mechanisms; help-seeking behaviour and barriers; and institutional and system-level support. While students across both contexts reported significant academic pressure and emotional strain, notable differences emerged in the availability, accessibility, and perceived responsiveness of institutional mental health support, as well as in cultural attitudes towards help-seeking.Conclusion By examining these experiences across contrasting pharmacy education contexts, this study provides cross-national insights into how institutional environments and socio-cultural factors shape pharmacy students’ mental health experiences. The findings highlight importance of developing accessible and contextually responsive strategies to support student wellbeing within pharmacy education.
Background Empathy is a core competency in medical education and underpins patient-centered care, yet empathy-related attitudes may decline during training, particularly under sustained academic and clinical stress. Resilience may help preserve empathic functioning, but its multidimensional associations with specific empathy domains remain insufficiently examined in large, culturally heterogeneous medical student samples.Objective To examine associations between empathy dimensions and engineering, ecological, and adaptive resilience among medical students, and to evaluate the measurement properties of the study instruments across countries and gender.Methods A cross-sectional multicountry study included 7,011 medical students from 11 universities in six Latin American countries. Structural equation modeling examined latent associations between empathy and resilience dimensions. Confirmatory factor analyses evaluated the factorial structure of the Jefferson Scale of Empathy–Health Professions Students and the Resilience Trait Scale, followed by measurement invariance testing by gender. Measurement models were evaluated before structural model estimationResults Ecological resilience showed the strongest positive associations with empathy dimensions, whereas engineering and adaptive resilience showed smaller negative associations with selected empathy dimensions. In the total sample, both measurement models showed acceptable global fit, although some country-specific empathy models and the Walking in the Patient’s Shoes subscale showed psychometric limitations. Gender invariance was supported in most analyses.Conclusions The findings suggest that resilience is a multidimensional correlate of empathy-related attitudes in medical students, with ecological resilience emerging as the dimension most consistently aligned with empathic functioning. Psychometric limitations should be considered when interpreting these associations. Educational strategies that support students’ capacity to maintain psychological stability under adversity may therefore warrant further evaluation as one component of broader efforts to sustain empathy and well-being during medical training. Because the data are cross-sectional, these implications should be tested in longitudinal and intervention studies.
Background Research productivity has become an increasingly emphasised component of residency selection. However, longitudinal trends in obstetrics and gynecology (OB/GYN) applicant research output relative to other specialties remains poorly characterised, particularly in the context of evolving evaluation practices and the transition of USMLE Step 1 to pass/fail scoring.Objective To evaluate trends in research productivity among matched OB/GYN applicants and compare these patterns with other medical and surgical specialties from 2016 to 2024.Methods A retrospective analysis of the National Resident Matching Program (NRMP) Charting Outcomes data from 2016–2024 was performed. Mean research experiences and research items (abstracts, posters, and publications) reported by matched applicants were extracted for each specialty and year. Descriptive longitudinal trend analyses were performed to evaluate changes over time. Mean research experiences and research items (abstracts, posters, and publications) were summarized by specialty and year, and linear trend lines were used to illustrate directional patterns. Comparisons with other specialties (all specialties, surgical specialties, and specialties with similar match rate ± 5%) were conducted descriptively.Results From 2016 to 2024, matched OB/GYN applicants saw increased mean research items (4.2 to 9.0; +114%) and research experiences (3.2 to 3.8; +19%). Growth in research output demonstrated upward trends across OB/GYN and other specialties, with increases observed across both surgical and non-surgical fields. Although unmatched applicants showed similar relative increases, matched applicants consistently reported higher absolute research output.Conclusions/implications OB/GYN applicants have increased their research output in recent years like other surgical and similarly competitive fields. As programs increasingly rely on scholarly metrics, educators and residency leaders should consider strategies to ensure equitable access to research opportunities and maintain holistic review practices during resident selection.
Introduction Medical student feedback literacy is a crucial competency to support the learning and training of safe, competent healthcare professionals. To date, the IMPROVE-FL questionnaire has been developed as a specific instrument to measure levels of medical student feedback literacy. Although this questionnaire had established excellent content validity in our previous work, more validity and reliability evidence are required to endorse its research and practical use.Methods This study applied the 28-item IMPROVE-FL questionnaire in a national survey of 29 medical schools with quota sampling to gather evidence of construct validity (via confirmatory factor analysis and hypothesis testing) and assess its internal consistency (via construct reliability analysis). Subsequently, a smaller study was conducted in two medical schools, one public and one private, to establish evidence of test–retest reliability.Results These analyses reported that the finalised 23-item IMPROVE FL had excellent model fit and evidence of construct validity (β = .64–.87; x2/df = 3.86; RMSEA = .05; SRMR = .03; CFI = .95; TLI = .94; GFI = .93; AGFI = .91), confirmed the expected correlation with fixed mindset (r = −.116, p < .001) and growth mindset (r = .327, p < .001), good internal consistency (α = .70–.89), and moderate test–retest reliability (ICC = 0.50–0.76).Conclusion These findings provide satisfactory evidence of construct validity, test–retest, and construct reliability, comparable to existing feedback literacy instruments in other educational contexts. Therefore, these findings support the use of IMPROVE-FL for research and practice.
Introduction Professional identity formation (PIF) is increasingly understood not only as becoming a physician but as a matter of being and belonging within the profession. The development of a holistic professional identity can enhance a physician's confidence, wellbeing and performance. Assessment is a central site of the socialisation through which PIF occurs, yet how learners experience assessment when it is felt to be biassed or exclusionary, and what this means for their identity formation, is not well understood. We aimed to explore if and how medical students experience identity-related challenges, including microaggressions, through assessment and how these experiences shape their developing professional identities.Methods We conducted a constructivist qualitative study using semi-structured interviews, analysed through reflexive thematic analysis. Medical students at a single Canadian institution who self-identified in response to an emailed invitation as having had uncomfortable, unsettling or identity-related experiences with assessment were interviewed. Interpretation was guided by identity-threat and identity-safety as sensitising concepts and by an intersectional reading of participants' accounts.Results We interviewed 22 students (16 pre-clerkship and 6 clerkship), 18 of whom identified as members of underrepresented communities. Participants described assessment as an identity-laden encounter that could threaten belonging and shape professional identity formation. Students from underrepresented communities described experiencing microaggressions through assessment. However, even participants who did not report microaggressions described negative assessment experiences that eroded their sense of belonging. Participants also described how assessment could reinforce harmful biases with the potential to affect patient care.Discussion Negative experiences with assessment may be a barrier to trainees' socialisation into the medical profession and can affect patient care through reinforcing harmful stereotypes. Education about microaggressions, professional development on constructing assessment and structuring feedback, access to mentors and safe spaces to debrief may help mitigate these impacts on professional identity formation.
