DEATH ANXIETY AMONG MEDICAL STUDENTS: PREVALENCE AND IMPLICATIONS

Abstract

BACKGROUND: Death Anxiety is related to an awareness of the reality of dying and death. There is some evidence that physicians' fear of death has a negative impact on their own wellbeing and influences their care of terminal ill patients. The first time that physicians face death in a professional context is at medical school. The nature, development and implications of death anxiety in medical students are currently poorly understood.AIMS: To examine medical students' death anxiety: (1) prevalence, gender differences and change over time; (2) associations with attitudes towards end of life care (EOLC) and psychological wellbeing.METHODS: Four cohorts of core science students and 4 cohorts of clinical students at the University of Cambridge Medical School participated for up to 3 consecutive years (N=953). Questionnaires concerning death anxiety (Collett-Lester Fear of Death Scale), psychological wellbeing (Hospital Anxiety and Depression Scale, Interpersonal Reactivity Index) and attitudes towards EOLC (Sullivan's statements) were administered each year.RESULTS: Death Anxiety was moderate among students of all training levels and remained stable over time. No gender differences were found except for the subscale 'death of others', where men scored significantly lower than women in 5 of the 6 years. In core science and clinical years weak negative correlations (r=-.18 --.42) were present between death anxiety and wellbeing. Consistent weak to moderate correlations (r=.27-.50) between death anxiety and attitudes towards EOLC revealed that students with higher death anxiety were more afraid of negative personal impact of EOLC.CONCLUSION: While death anxiety was not high among most medical students, its association with low wellbeing and negative attitudes towards EOLC are concerning. Addressing death anxiety during medical education appears to be important to enhance the quality of EOLC and the student's psychological health.