Research suggests that medical students frequently experience mental health problems such as stress, burnout, and depression, which may, in turn, affect suicidal ideation and behaviors. Since mental health problems profoundly impact academic achievement and professionalism, it is vital to understand factors influencing students' mental health and identify strategies to provide the necessary support. Some relevant influencing factors range from the personal level, including gender, personality traits, perfectionism, and social support, to the environmental level, including the grading system, educational phases, exposure to patients' death, mistreatment, and culture of medicine. In this regard, a comprehensive mental health support system that encompasses environmental interventions, as well as personal-level support, is needed. Simultaneously, proactive approaches that address the improvement of self-care and alleviation of systemic burdens are essential, together with the predominant reactive approaches focusing on problems and deficits. Altogether, we proposed a framework for enhancing mental health constructed by four categories (personal-reactive, environmental-reactive, personal-proactive, environmental-proactive) based on the intervention level and goal of support. All four categories have important implications, and one cannot replace the other, but expanding environmental-proactive support will allow more students to learn how to pursue health independently. We expect that this comprehensive framework for enhancing mental health could expand support systems for medical students' personal and professional development.

One of the important roles of medical schools is to support medical students in deciding upon their future career path or choosing their specialty. The purpose of this study is to suggest a career advising model and strategies for medical students through a systematic approach. This study consists of three parts. The first part introduces some main career theories: super's career development theory, career decision-making theory, social cognitive career theory, and ecosystem theory. The second part proposes a systematic career advising model using the results acquired from previous studies and theories. This model considers a medical school as a social system that consists of two domains (internal and external). This social system is considered as a complex where various factors interact with each other: students' individual characteristics, institutional policies and culture, curriculum and learning experience, students' perceived specialty characteristics, and aspects of the external environment such as healthcare systems. The third part suggests some career advising strategies based on a systematic approach that medical schools can apply. These research results can be used for designing career advising courses for medical students, integrating various career advising programs and resources of medical schools, and evaluating the outcomes of career advising programs at an institutional level.

The purpose of this study was to analyze the results of a study on the psychological state, lifestyle, self-management ability, and academic adaptation of medical students, and to present examples of improvement of a student support center based on the results. A medical school in Daegu has been surveying the living conditions of students every year for 6 years since 2016. More than 60% of medical students experienced depression and more than 70% experienced stress, but these rates have significantly improved over the past 5 years. There were many cases of drinking or smoking to relieve stress, but the frequency of drinking recently decreased substantially. Some students had difficulties in emotional regulation (11.5%) and time management (16.6%), and challenges in planning and self-management increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. The satisfaction and adaptability of medical students are high, but the number of students who are not satisfied with but negative response rate is 2%-3% in every year. However, satisfaction has significantly increased in tandem with curriculum changes and COVID-19. Based on these data, the counseling system was reorganized to support psychological stability, the medical humanities curriculum was improved, and changes in actual quality of life were induced by developing and operating non-curricular programs. Furthermore, standardized questionnaires will be developed and data from many medical schools will be shared, which is expected to support medical students more effectively.

The purpose of this study was to explore the psychosocial characteristics of academically maladjusted students and the College's current status regarding academic maladjustment based on 4-year medical student cohort data collected from 2018 to 2021 and through interviews with 10 medical education experts using the integrated research method. This study included 223 students who consented to inclusion in the student cohort and participated in the emotional behavior test and college adaptability test of whom 65 students experienced academic maladjustment. Academically maladjusted students had significantly higher scores for social stress, anxiety, sense of inadequacy, attention, hyperactivity, and school maladjustment, and significantly lower scores for relationships with parents, interpersonal relationships, self-esteem, self-confidence, and self-strength. Academic and social integrity, emotional stability, university satisfaction, and university service satisfaction were all significantly lower in the academically maladjusted students than in the non-maladjusted group. The expert interviews indicated that academic maladjustment was mainly recognized as a personal problem, with causes such as lack of motivation and learning methods, vulnerability to stress, lack of social relationships and alienation, lack of support from the family, and insufficient resilience. Systematic support other than counseling for academically maladjusted students is required, and an early diagnosis and preventive intervention are important.

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

This study explored the public's response to an incident involving publicity about how physicians broke bad news to a terminal cancer patient by analyzing 1,960 comments from three online news websites that reported on this event using Braun and Clarke's theme analysis methods. Three themes and 10 subthemes emerged from the public's responses to the way the physicians broke the bad news. Theme 1 (a physician is a person who tells the facts) contained the following subthemes: physicians are responsible for delivering facts, but it is a matter of consideration for patients to deliver bad news to them, empathy and consolation should be expected from people other than physicians, and physicians who say what patients want to hear are cheaters. Theme 2 (there is a problem with physicians) included the following subthemes: the physicians' empathy or personality and problems with their communication methods. Theme 3 (there are obstacles to communication with dying patients) had the following subthemes: physicians become emotionally dull and find it very stressful to break bad news, giving hope to dying patients can lead to medical disputes, and empathy and consolation are also costly. When breaking bad news, the physicians delivered factual information, but they did so inappropriately, and emotional support for the patient was insufficient. In medical communication education, it is necessary to emphasize training in emotional support. In the medical field, an environment should be created where physicians can communicate as they have learned.

Evaluating the effectiveness of educational programs involves measuring learning processes as well as outcomes. It is essential to study cohorts of students and graduates to evaluate the long-term effects of educational programs with data generated both during education and after graduation. The purpose of this study was to establish cohorts of students and graduates to evaluate their performance, thereby providing a basis for evaluating the social accountability of medical education. In this study, student and graduate cohorts were built for both students currently enrolled and graduates at Inje University College of Medicine (IUCM). A model involving the process of cohort establishment and an evaluation indicator framework was developed. In the process of cohort establishment, the following steps were conducted: defining the goals and objectives of the student and graduate cohorts, organizing a cohort committee, developing regulations, registering cohorts, acquiring consent, and building a database. A framework of evaluation indicators according to the graduate roles of IUCM was developed by adapting Kirkpatrick's evaluation model. Next, items to be collected in student and graduate cohorts were selected, and the current status of existing data was analyzed. Moreover, a preliminary analysis was conducted, including analyses of the evaluation indicators and graduates' performance. This study suggests that it is necessary to include additional evaluation indicators considering students' learning environment and well-being in student cohorts and to develop strategies or methods for graduates to continue participating in data collection for a long-term study.