Association Between Perceived Medical School Diversity Climate and Change in Depressive Symptoms Among Medical Students: A Report from the Medical Student CHANGE Study

Purpose: To determine whether perceptions of the medical school diversity climate are associated with depression symptoms among medical students.

Methods: Longitudinal web-based survey conducted in the fall of 2010 and spring of 2014 administered to a national sample of medical students enrolled in 49 schools across the U.S. (n = 3756). Negative diversity climate measured by perceptions of the institution's racial climate; exposure to negative role modeling by medical educators; frequency of witnessing discrimination in medical school. Depression symptoms measured by the PROMIS Emotional Distress-Depression Short-Form.

Results: 64% of students reported a negative racial climate; 81% reported witnessing discrimination toward other students at least once, and 94% reported witnessing negative role modeling. Negative racial climate, witnessed discrimination, and negative role modeling were independently and significantly associated with an increase in depression symptoms between baseline and follow-up. Adjusting for students' personal experiences of mistreatment, associations between depressive symptoms and negative racial climate and negative role modeling, remained significant (.72 [.51-.93]; .33 [.12-.54], respectively).

Conclusions: Among medical students, greater exposure to a negative medical school diversity climate was associated with an increase in self-reported depressive symptoms.