Medical students' disease
Medical students' disease, also known as hypochondriasis of medical students, medical student syndrome, medical student disorder, medical school syndrome, third year syndrome, second year syndrome, or intern's syndrome, is a condition frequently reported in medical students, who perceive themselves or others to be experiencing the symptoms of the disease(s) they are studying.
The condition is associated with the fear of contracting the disease in question. Some authors suggested that the condition must be referred to as nosophobia rather than "hypochondriasis", because the quoted studies show a very low percentage of hypochondriacal character of the condition, and hence the term "hypochondriasis" would have ominous therapeutic and prognostic indications. The reference suggests that the condition is associated with immediate preoccupation with the symptoms in question, leading the student to become unduly aware of various casual psychological and physiological dysfunctions; cases show little correlation with the severity of psychopathology, but rather with accidental factors related to learning and experience.
Baars (2001) writes:
- Suggestible states are very commonplace. Medical students who study frightening diseases for the first time routinely develop vivid delusions of having the "disease of the week"—whatever they are currently studying. This temporary kind of hypochondria is so common that it has acquired a name, “medical student syndrome.”
Hodges (2004), reviewing the literature, said that "the first descriptions of medical students' disease appeared in the 1960s." He may have been referring to the phrase, for the phenomenon itself was noted much earlier. George Lincoln Walton (1908) reported that
- Medical instructors are continually consulted by students who fear that they have the diseases they are studying. The knowledge that pneumonia produces pain in a certain spot leads to a concentration of attention upon that region which causes any sensation there to give alarm. The mere knowledge of the location of the appendix transforms the most harmless sensations in that region into symptoms of serious menace.
Hodges also said that it was suggested in the 1960s that:
- this phenomenon caused a significant amount of stress for students and was present in approximately 70 to 80 percent of students... papers written in the 1980s and 1990s conceptualized the condition as an illness in the psychiatric spectrum of hypochondriasis.... Marcus found that the dream content of year two medical students frequently involved a preoccupation with personal illness. Marcus's subjects reported many dreams in which they suffered illnesses of the heart, the eyes and the bowels, among others.
Hodges went on to describe work by Moss-Morris and Pétrie who saw medical students' disease as "a normal perceptual process, rather than a form of hypochondriasis." Learning about a disease "creates a mental schema or representation of the illness which includes the label of the illness and the symptoms associated with the condition. Once this representation is formed, symptoms or bodily sensations that the individual is currently experiencing which are consistent with the schema may be noticed, while inconsistent symptoms are ignored."
Howes and Salkovskis (1998) noted that "medical students frequently develop fears and symptoms of illness. This has been termed medical student's disease, nosophobia, hypochondriasis of medical students, and medicalstudentitis." They mentioned two studies, one concluding that about 70% of medical students have groundless medical fears during their studies, and one which found that 78.8% of a randomly chosen sample of medical students showed a history of "medical student disease." However, they cite a number of studies showing a similar incidence of hypochondria in law students and other non-medical students, which they said call into question "the widely held view that medical students are more likely than others to have excessive anxiety about their health."
In popular culture
In his comic classic Three Men in a Boat (1889), Jerome K. Jerome describes the effect as experienced by a layman, who comes to believe he is suffering from almost every disease listed in a medical textbook:
- I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch—hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into—some fearful, devastating scourge, I know—and, before I had glanced half down the list of "premonitory symptoms," it was borne in upon me that I had fairly got it.
- I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever—read the symptoms—discovered that I had typhoid fever, must have had it for months without knowing it—wondered what else I had got; turned up St. Vitus's Dance—found, as I expected, that I had that too,—began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically—read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight...
An episode of the TV show Scrubs called Our Driving Issues features a class of medical students who, despite having been warned about medical students' disease, nevertheless suffer from it.
- Hunter R.C.A, Lohrenz J.G., Schwartzman A.E. "Nosophobia and hypochondriasis in medical students". J Nerv Ment Dis 1964;130:147-52. PMID 14206454
- Nikhil Thakur, Bogdan Preunca "Nosophobia presented as acute hypochondria". TMJ 56(2), 120
- Three Men in a Boat, Gutenberg eText of Jerome K. Jerome's novel
- Medical Student Syndrome: Nosophobia presented as Acute Hypochondria, (2008) Thakur N, Preunca B, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
- Baars, Bernard J. (2001). In the Theater of Consciousness: The Workspace of the Mind. Oxford University Press US. ISBN 0-19-514703-0.
- Hodges, Brian. (2004) Medical Student Bodies and the Pedagogy of Self-Reflection, Self-Assessment, and Self-Regulation, JCT Rochester (Journal of Curriculum Theorizing) 20(2)41.
- Howes, Oliver D. and Paul M. Salkovskis (1998) Health anxiety in medical students. The Lancet v351.n9112 (May 2, 1998): pp1332.
- Walton, George Lincoln (1908) Why Worry? J. B. Lippincott, Philadelphia. Project Gutenberg text