1. A
Protocol
: About
Medical Student Syndrome
Among Forth Year Medical Students
At Ain Shams University, Cairo, Egypt
1518
Ahmed
Mohamme
d Ali
: Prepared By

2. Introduction
dical student syndrome (MSS), also known as hypochondriasis of medical students
cal student disease (MSD) or medical student disorder, is a condition frequently
d in medical students, who perceive themselves or others to be experiencing the
ms of the disease(s) they are studying (i.e., it refers to health complaints that are
sults of medical expertise rather than genuine pathology
hondriasis is classified as one of the somatoform disorders, a class that was
ated to accommodate the differential diagnosis of disorders characterized primarily
ical symptoms for which no demonstrable organic explanations or physical
s exist. The DSM-IV-TR stipulates that the symptoms are not under voluntary
(thus excluding malingering and factitious disorders) and are not fully explained
wn physiological causes (excluding psychological factors affecting the medical
on). The disorders in the somatoform class include somatization disorder,
ion disorder, pain disorder, hypochondriasis, BDD, and undifferentiated
form disorder
ing to Ferguson (1996), MSS ''points to the important role played by factual
l knowledge in the interpretation of physiological signs and symptoms'' (p.315). By
w, some medical students would have a tendency to interpret vague bodily
ms in terms of the latest disease they have learnt about. This tendency would
me stronger as medical knowledge grows (Ferguson, 1996
mple, the student reads about brain tumor which is associated with headache. If,
cidence, the individual suffers from a headache, he or she may presume they have
tumor. It is not limited to medical students; anyone who reads medical material is
tible. However, it is most frequently observed in medical students
adage states: "if a medical student hears hoof-beats outside the window they think
bra" - in other words they conclude that the common sound is ascribable to the
ast. As one continues in clinical medicine, the opposing adage: "common things
commonly" becomes a more valuable motto
ndition is associated with the fear of contracting the disease in question. Some
suggested that the condition must be referred to as nosophobia rather than
hondriasis", because the quoted studies show a very low percentage of
ondriacal character of the condition, and hence the term "hypochondriasis" would
minous therapeutic and prognostic indications. The reference suggests that the
on is associated with immediate preoccupation with the symptoms in question,
the student to become unduly aware of various casual psychological and
ogical dysfunctions; cases show little correlation with the severity of
pathology, but rather with accidental factors related to learning and experience

3. 2001) writes
tible states are very commonplace. Medical students who study frightening
s for the first time routinely develop vivid delusions of having the "disease of the
—whatever they are currently studying. This temporary kind of hypochondria is so
mon that it has acquired a name, “medical student syndrome
(2004), reviewing the literature, said that "the first descriptions of medical
s' disease appeared in the 1960s." He may have been referring to the phrase, for the
menon itself was noted much earlier. George Lincoln Walton (1908) reported that
l instructors are continually consulted by students who fear that they have the
s they are studying. The knowledge that pneumonia produces pain in a certain spot
a concentration of attention upon that region which causes any sensation there to
rm. The mere knowledge of the location of the appendix transforms the most
ss sensations in that region into symptoms of serious menace
s also said that it was suggested in the 1960s that
nomenon caused a significant amount of stress for students and was present in
mately 70 to 80 percent of students... papers written in the 1980s and 1990s
ualized the condition as an illness in the psychiatric spectrum of
ondriasis.... Marcus found that the dream content of year two medical students
tly involved a preoccupation with personal illness. Marcus's subjects reported
reams in which they suffered illnesses of the heart, the eyes and the bowels, among
went on to describe work by Moss-Morris and Pétrie who saw medical students'
as "a normal perceptual process, rather than a form of hypochondriasis." Learning
disease "creates a mental schema or representation of the illness which includes
l of the illness and the symptoms associated with the condition. Once this
ntation is formed, symptoms or bodily sensations that the individual is currently
ncing which are consistent with the schema may be noticed, while inconsistent
oms are ignored
and Salkovskis (1998) noted that "medical students frequently develop fears and
ms of illness. This has been termed medical student's disease, nosophobia, and,
ondriasis of medical students." They mentioned two studies, one concluding that
0% of medical students have groundless medical fears during their studies, and one
ound that 78.8% of a randomly chosen sample of medical students showed a
of "medical student disease." However, they cite a number of studies showing a
incidence of hypochondria in law students and other non-medical students, which
d call into question ‘’the widely held view that medical students are more likely
others to have excessive anxiety about their health
ndrome is becoming more common as people use the Internet and come to their

4. anxiously clutching various print-outs of rare disease symptoms, whereas
y all they have is something common and benign. It is part of the downside of the
d opulent information flow available on-line, especially where that information is
f dubious quality or is accessed by an amateur who cannot temper the information
reasoned and informed opinion
the older studies about MSS is the study of Woods and colleagues (1966) that was
out to determine the incidence and various manifestations of MSS. These authors
hat 79% of the respondents in their sample of medical students (n=33) had
enced MSS complaints at some point during their medical education
ingly, MSS seems not to be specific for medical students. Hardy and Calhoun
studied worries about mental health in a sample of undergraduates who followd a
n abnormal psychology. Students who planned to major in psychology reported
orries about their psychological health than those planning to major in another
ne. However, it was also the case that the process of learning about various
tric diseases decreased students’ worries about their mental health, which is quite
posite of the MSS phenomenon
Objectives
ry Objective
m of this study is to determine the prevalence of MSS complaints among forth year
al students
dary Objectives
lore whether certain mental disorders are related to MSS-
lyze gender differences regarding MSS-

5. Methodology
Type
s sectional study will be carried out among forth year medical students
ipants
tudy is completely on voluntary basis
ion criteria
year medical students, males and females, only those who are welling to participate will
rviewed and they can withdraw from the research at any time
sion criteria
h
year medical student, and patient with verified physical diseases by physician
ntinuation criteria
iring the sample size from voluntaries, and at well of the participants
ple Size
culated using the total number of students registered at forth academic year ( 2101
CI and 5% significance level, is estimated using Epi-info ( version 3.5.3 ) to be 253
y Tools
udents sample will be asked to answer the following questionnaires
graphic Data-1
al Student Hypochondriasis questionnaire-2
in questions are (all are dichotomous response questions with answers yes-no-
e
u worry a lot about catching diseases
u read medical books and worry that you have all the symptoms described
tain memories accompany painful symptoms
al psychiatric assessment using structured clinical interview for DSM-IV-TR-3
e F: generalized anxiety disorders
e G: somatoform disorders  hypochondriasis only

6. lton Depression Scale for depressed mode
Analysis:
lected data will be summarized and categorized using Microsoft Excel.
nce of outcome variables along 95% CI will be calculated.
ation between the outcome and different study variables will be observed and quantified.
Consideration:
rticipation was entirely on voluntary basis.
dents are guaranteed the confidentiality.
rticipants has the right to be informed of any health condition revealed during the study,
uld be helped to get the appropriate care.
mmunity has a right to be informed about the outcome of the study, and any potential
tions.
vestigator have the ethical obligation to play an advocacy role to improve the health
on of the community based on the result of the study.
References:
S
current diagnosis and treatment: family medicine 2ne edition.
lance: medical statistics.
a practical guide for health researchers.
R RESEARCHES
sy proneness and thought suppression as predictors of the medical student syndrome
iatric mordibility among third year medical students at Ain Shams University
ence of emotional disorders among medical students in Malaysian university
ITES
medicine.medscape.com
n.wikipedia.org
.cdc.gov
rans4mind.u-net.com
cid4.org
eal-depression-help.com
dis.ifas.ufl.edu