How neurologists are viewed by their colleagues: exploring stereotypes and social representations of neurologists.

INTRODUCTION: The choice of medical specialization is influenced by various factors, including personal, educational, and interpersonal aspects. However, stereotypes and social representations (SRs) can also play a significant role in biasing the choice of a particular medical specialty. The aim of this study is to describe and understand the social representation (SR) of French Neurologist among medical peers, and factors explaining stereotypes about neurology. METHODS: A nationwide web-based survey was sent to the French medical community (students, residents, and graduated physicians) to collect sociodemographic and professional data, status, experience, and acquaintance in Neurology as well as qualitative hierarchical evocation question to assess the SR of French Neurologists. RESULTS: Overall, 367 people participated in the survey, including 112 medical students, 170 residents, and 85 graduated physicians. Only 14.3% of students listed neurology among their top 5 specialty choices, and 63.8% disagreed with the statement "I could have chosen (or I will choose) neurology after the validation of my 6th year of medical studies." Qualitative analysis revealed that the most frequently occurring words used to describe neurologists were "stroke", "complicated", "no treatment," "clinical", and "brain" and five themes corresponded to SRs of neurologist: his/her personal and professional traits (36.4% of the corpus), his/her daily practice (18.1%), the negative aspects of the neurological practice (15.3%), and the neurological pathology and daily skills (30.2%). CONCLUSION: The perception of neurologists by other physicians is nuanced. Neurologists are described as rigorous specialists, maybe excessively so but the cliché of a contemplative specialty with no effective treatment remains. The specialty and neurological patients suffer also from a reputation of complexity. Further interventions among medical students and better information are required to increase the attractiveness of our specialty.

Medical oncologist stereotypes among medical students, residents and physicians: a national cross-sectional study.

OBJECTIVES: The perception of oncologists could impact the attractiveness of the specialty and dialogue between oncologists and other physicians. The aim of the study was to describe and understand the stereotypes and social representation (SR) associated with oncologists among medical students, residents and physicians in France. METHODS: This nationwide web-based survey conducted in 2021 was based on hierarchical evocation methods. Qualitative analyses were based on the Reinert method with factorial analyses. Each respondent's SR was graded from 1 to 5 (from 1: very positive SR to 5: very negative SR). RESULTS: Oncologists suffer from a rather negative SR. The negative representation was mostly related to difficulties in practising and the proximity with death and end of life. Oncologists were also associated with more positive notions like interdisciplinarity or intellectual complexity. Attendance to an oncology course was associated with a better SR of oncology (p=0.036), whereas having someone in the family practising oncology had a negative impact (p=0.028). CONCLUSIONS: SR of oncologists is rather contrasted. It was positively influenced by attendance to an oncology course, which could be an option to correct stereotypes and update on this rapidly evolving specialty.

How do medical students, residents and graduated physicians really perceive radiologists? A cross-national study.

BACKGROUND: Radiology has always been an attractive specialty for residents, but its attractiveness has recently decreased in France regarding the median choice rank after at the National Residency Board. AIM: To study Radiologists' perceptions and social representations (SRs) among a group of medical students, residents and graduated physicians in France, to better understand the view of Radiologists to debunk stereotypes. METHODS: The nationwide web-based survey was based on valid hierarchical evocation methods. We determined the corpus's central core and SRs' principal themes with prototypical and correspondence factor analysis (CFA), respectively. RESULTS: Overall, 419 answers were analyzed. Radiologists' SRs were divided into 3 classes: negative stereotypes of Radiologists, negative stereotypes of the Radiologists' daily practice and Radiologists' skills. After multivariate analysis, variables that seemed to have a positive influence on Radiologists' SRs were considering radiology as a potential choice of specialty (p < 0.001) and the existence of practical experience in Radiology (p = 0.008). Women seemed to have a more negative SR of Radiologists than men (p = 0.035). DISCUSSION: This was the largest qualitative study on the subject and the only one among medical students, residents and graduated physicians, allowing a global picture. SRs of Radiologists seemed to be negative, potentially caused by poor knowledge of the Radiologists' profession. CONCLUSION: SRs of Radiologists among medical students and graduated physicians appears to be negative. Promoting the specialty among medical students and encouraging their immersion in a Radiology department could help to debunk many stereotypes about the daily life and missions of Radiologists.

What do medical students and graduated physicians think about infectious disease specialists?

OBJECTIVES: This study evaluated the social representation and stereotypes on infectious disease (ID) specialists among medical students and physicians in France after the COVID-19 pandemic. METHODS: A survey applying the hierarchical evocation model assessed the social representations (SRs) of ID specialists. RESULTS: All in all, 372 answers were analyzed. The positive elements related to the personal and professional qualities of ID specialists ('intellectual prestige", "open-mindedness"), in contrast with negative stereotypes related to their perceived daily life and practice characteristics ("hospital-based", "intense", "overspecialized"). Variables such as "I would not have chosen (or I won't choose) ID after the national ranking exam" and "I know someone who is an ID specialist" were associated with worse SR scores (p < 0.001 and p = 0.022 respectively). CONCLUSIONS: These findings provide insights into the attractiveness of ID as a specialty. Rounds in ID departments may enhance the interest of the specialty as a possible residency choice.

[Distress and resilience of Paris-Saclay medical students during the first wave of the COVID-19 pandemic]. / Détresse et résilience des étudiants en médecine de Paris-Saclay lors de la première vague de la pandémie de COVID-19.

Objectives: In France, during the first wave of the COVID-19 pandemic, all care workers have been mobilized. Despite this, the strong demand for care has put the health system under great strain. To overcome this overload of world, 86 medical students of Paris-Saclay University came to help some hospital services. They replaced caregivers, nurses or stretcher bearers under "degraded care" conditions. At the university level, the closure of the faculty due to generalized lockdown disrupted the training of these future doctors who were in second, third or fourth year of training (pre-clinical). This exploratory study proposes to collect the impact of the experience of these students during the first wave of the pandemic in order to better understand the difficulties they encountered, as well as the resources they exploited during this period. Materials and methods: Using a mixed approach, both quantitative on the one hand and qualitative on the other hand, medical students from Paris-Saclay were interviewed through a retrospective questionnaire distributed in December 2020. The quantitative part of the questionnaire assessed their psychological distress (6-item Kessler scale) and their resilience (Brief Resilience Scale). The qualitative part of the questionnaire included various open questions concerning the motivations to participate, the difficulties encountered, the impact of the situation on their interpersonal relationships or their university course. Results: A total of 46 responses from medical students from the University of Paris-Saclay were collected. This constitutes a response rate of 55%. Half of them were second or third year medical students. They were assigned to emergency departments, resuscitation or units dedicated to the care of patients with COVID-19. The average psychological distress score is 7.13. The average resilience score is 3.14. From these results, several categories of students were analyzed according to the elements found in their answers to the open questions. Almost all the students reported wanting to contribute to the collective effort and help hospital services. For some students, it was also a way of making themselves useful while escaping lockdown. The students were exposed to difficult working conditions, the distress of families and the deaths of numerous patients. Their involvement also had an impact on their relationships with their families: they could feel more isolated, or be afraid of infecting them. Their university work was very disrupted by their investment in the hospital: fatigue, concentration problems, lack of motivation could lead them to a form of dropping out of university. Conclusions: The results of this study are part of the context of a particular health crisis. They show medical students exposed to significant psychosocial risks in a period of stress. It seems important to identify what leads some students to develop good resilience capacities. The COVID-19 pandemic acts as an indicator of difficulties that were already present but that it is exacerbating: the link between the faculty, the student and the hospital, mentoring, supervision, support, university workload, hospital working conditions, psycho-pedagogical support for students and support for most struggling students… These results invite us to rethink the educational engineering of medical studies so that they make it possible, even in a health crisis, to ensure the quality of training and the quality of life of medical students.

COVID-19 pandemic's impact on French Health Students: A cross-sectional study during the third wave.

BACKGROUND: COVID19 pandemic had a huge impact on global mental health. Health students, because of their age and status, are a more at-risk population. National survey during the first wave already found high levels of psychological distress. OBJECTIVE: This nationwide study aimed to assess health's student mental health during the third wave in France. METHODS: We did an online national cross-sectional study, which addressed all health students from April 4th to May 11th 2021. The questionnaire included sociodemographic and work conditions questions, Kessler 6 scale, and numeric scales. RESULTS: 16,937 students answered, including 54% nurse and 16% medical students. Regarding K6 scale, 14% have moderate (8-12) and 83% high (≥13) level of psychological distress. In multivariate analysis, being a man (OR = 0.54, 95% CI [0.48; 0.60], p < 0.001) and not living alone (OR = 0.71, 95% CI [0.62; 0.82], p < 0.001), are associated with a reduced risk of psychological distress. Not having the ability to isolate themselves (OR = 1.58, 95% CI [1.39; 1.81], p < 0.001), and having low (OR = 2.31, 95% CI [2.08; 2.56], p < 0.001) or important (OR = 4.58, 95% CI [3.98; 5.29], p < 0.001) financial difficulties are associated with an increased risk of psychological distress. LIMITATIONS: The response rate was low regarding the target population (300,000 health students). CONCLUSION: Compared to the first national survey, we noticed mental health deterioration. Psychological distress (83% high level versus 21%), substance use (21% versus 13%), and psychotropic treatment use (18% versus 7.3%) hugely increased. These results highlighted the need to increase support actions for health students.

Mental health and working conditions among French medical students: A nationwide study.

BACKGROUND: Medical students' mental health is a public health problem that has worsened with COVID 19's pandemic. There is a lack of French data. The principal aim was to assess French medical students' mental health. METHODS: An online cross-sectional survey was performed between May 27 and June 27, 2021. An anonymous questionnaire was sent via academic email addresses by medical faculties and secondly on social media. We assessed 7-day anxiety and depressive symptoms were evaluated with the Hospitalization Anxiety and Depression scale, 12-month major depressive episode (MDE) with the Composite International Diagnostic Interview- Short Form, burnout with the Maslach Burnout Inventory, 12-month suicidal ideation, humiliation, sexual harassment, and sexual aggression during their curriculum. Multivariable logistic regression was performed to identify main MDE associated factors. OUTCOMES: 11,754 participants (response rate: 15.3%) were included. Prevalence of 7-day anxiety symptoms, 7-day depressive symptoms, 12-month MDE, and 12-month suicidal thoughts were 52%, 18%, 25%, and 19% respectively. Burnout syndrome concerned 67% of clinical students and residents and 39% of preclinical students. Prevalence of humiliation, sexual harassment, and sexual abuse during their curriculum were 23%, 25%, and 4%, respectively. Having important (OR = 1.44, IC 95 [1.31-1.58], p < 0.001) or very important financial issues (OR = 2.47, IC 95 [2.15-2.85], p < 0.001), experienced humiliation (OR = 1.63, IC 95 [1.46-1.81], p < 0.001), sexual harassment (OR = 1.43, IC 95 [1.28-1.59], p < 0.001) and sexual abuse (OR = 1.52, IC 95 [1.24-1.85], p < 0.001) were associated with an increased risk of MDE. INTERPRETATION: This is the largest study on French medical students' mental health. These results point to very particular conditions in French students environment that need to be addressed to improve their mental health.