Medical Students' Death Anxiety: Severity and Association With Psychological Health and Attitudes Toward Palliative Care

Pia Thiemann, Thelma Quince, John Benson, Diana Wood, Stephen Barclay

Death anxiety is related to awareness of the reality of dying and death and can be negatively related to a person's psychological health. Physicians' death anxiety also may influence their care for patients approaching death. Doctors face death in a professional context for the first time at medical school, but knowledge about death anxiety among medical students is limited. To examine medical students' death anxiety in relation to: 1) its severity, gender differences and trajectory during medical education, and 2) its associations with students' attitudes towards palliative care and their psychological health. Four cohorts of core science and four cohorts of clinical students at the University of Cambridge Medical School took part in a questionnaire survey with longitudinal follow-up. Students who provided data on the revised Collett-Lester Fear of Death Scale were included in the analysis (N=790). Medical students' death anxiety was moderate, with no gender differences and remained very stable over time. High death anxiety was associated with higher depression and anxiety levels and greater concerns about the personal impact of providing palliative care. The associations between high death anxiety and lower psychological health and negative attitudes towards palliative care are concerning. It is important to address death anxiety during medical education in order to enhance student's psychological health and the quality of their future palliative care provision.