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      Quality of Life (QoL) among medical students in Saudi Arabia: a study using the WHOQOL-BREF instrument

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          Poor Quality of Life (QoL) among medical students is associated with an unhealthy lifestyle, psychological distress, and academic failure, which could affect their care for patients in the future. This study aimed to evaluate the reliability and validity of the Arabic WHOQOL-BREF tool among Saudi medical students and to assess the effect of gender, educational level, and academic performance on their QoL.


          This was a cross-sectional study among medical students of King Abdulaziz University in February 2016, using the Arabic version of the WHOQOL-BREF instrument.


          Six-hundred-thirty medical students were included, where females constituted (51.1%). Cronbach’s α coefficient for the overall domains of WHOQOL-BREF was 0.86. Students’ self-reported QoL mean score was 3.99 ± 0.95, and their mean score for the overall satisfaction with health was 3.66 ± 1.06. The environmental domain had the highest mean score (67.81 ± 17.39). High achievers showed lower psychological health, while poor academic performance was associated with better psychological health and social relationship QoL scores ( P < 0.013 and P < 0.014, respectively).


          The WHOQOL-BREF is valid and reliable for assessing QoL among Saudi medical students. Although gender and academic year had no impact on the students’ QoL, better-performing students reported lower psychological health and social relationships scores.

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          Most cited references 29

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          Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment

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            Stress and depression among medical students: a cross-sectional study.

            To assess the exposure to different stressors and the prevalence of depression among medical students at different levels of education, taking gender differences into account. Students were asked to complete a new stress inventory called the Higher Education Stress Inventory (HESI), the Major Depression Inventory (MDI), slightly modified, and questions on suicidal ideation developed by Meehan. The study was carried out at the Karolinska Institute Medical University, Stockholm, Sweden. Matched controls from the general population were used. All registered students in Years 1, 3 and 6 were enrolled in the study (n = 342). The response rate was 90.4%. Year 1 students gave high ratings to the workload and lack of feedback stressors. Year 3 students gave high ratings to 'Worries about future endurance/competence' and 'Pedagogical shortcomings'. In Year 6, both the latter factors were rated highly, but Year 6 students also gave higher ratings than the 2 other groups to 'Non-supportive climate'. In all 3 cohorts students complained of lack of feedback. Female students gave higher ratings than males to 4 out of 7 factors. Several stress factors were identified as being associated with depression. The prevalence of depressive symptoms among students was 12.9%, significantly higher than in the general population, and was 16.1% among female students versus 8.1% among males. A total of 2.7% of students had made suicide attempts, but none during the previous year. Year 1 students indicated experiencing the highest degree of pressure from studies. A gender difference regarding stress levels was also seen, where women reported higher levels of stress than men. Medical students had higher depression rates than the general population, and women students had higher rates than men.
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              Medical student distress: causes, consequences, and proposed solutions.

              The goal of medical education is to graduate knowledgeable, skillful, and professional physicians. The medical school curriculum has been developed to accomplish these ambitions; however, some aspects of training may have unintended negative effects on medical students' mental and emotional health that can undermine these values. Studies suggest that mental health worsens after students begin medical school and remains poor throughout training. On a personal level, this distress can contribute to substance abuse, broken relationships, suicide, and attrition from the profession. On a professional level, studies suggest that student distress contributes to cynicism and subsequently may affect students' care of patients, relationship with faculty, and ultimately the culture of the medical profession. In this article, we review the manifestations and causes of student distress, its potential adverse personal and professional consequences, and proposed institutional approaches to decrease student distress.

                Author and article information

                +966567249549 ,
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                9 September 2019
                9 September 2019
                : 19
                [1 ]ISNI 0000 0001 0619 1117, GRID grid.412125.1, Department of Internal Medicine, Faculty of Medicine, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [2 ]ISNI 0000 0004 1790 7311, GRID grid.415254.3, Department of Surgery, , King Abdulaziz Medical City, ; Jeddah, Saudi Arabia
                [3 ]ISNI 0000 0001 0619 1117, GRID grid.412125.1, Department of Pediatrics, Faculty of Medicine, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [4 ]ISNI 0000 0004 0607 9688, GRID grid.412126.2, Clinical Research Unit, , King Abdulaziz University Hospital, ; Jeddah, Saudi Arabia
                [5 ]ISNI 0000 0001 0619 1117, GRID grid.412125.1, Medical Education Department, Faculty of Medicine, , King Abdulaziz University, ; Jeddah, Kingdom of Saudi Arabia
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2019


                grade point average (gpa), medical students, medical education, quality of life (qol)


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