Post-Pandemic Evaluation: Impact of COVID-19 Pandemic on Medical Students' Mental Health, Self-Esteem, Social Interactions, and Academic Progression in Malaysia

COVID-19 pandemic has brought drastic and unprecedented challenges to the medical education and medical students, affecting them physically, mentally and emotionally. While progressing through the post-pandemic recovery phase, it is crucial to comprehensively evaluate the pandemic's consequences and tackle the underlying problems. To investigate the impact of COVID-19 pandemic on medical students' mental health, social well-being, and academic progression. A cross-sectional study was carried out with voluntary sampling of students from both government and private medical schools in Malaysia. A self-administered online survey form containing three validated psychological tools was distributed (Hospital Anxiety and Depression Scale HADS, Rosenberg Self-esteem Scale, NIH Toolbox Social Relationship Scales). There were also questions regarding the challenges faced by medical students and their academic performance during COVID-19 pandemic. Scores of each questionnaire were tabulated, analyzed and interpreted according to their specific cut-points. Two hundred and thirteen responses were received. 89.2% (n = 190) were domestic students while 10.8% (n = 23) were international students. Out of 32 medical universities in Malaysia, the participants were from 19 of them (9 public and 10 private universities). About half of the participants had contracted COVID-19 infection during the study period (n = 124, 58.2%). Majority had chosen "Lack of on-campus learning and training session causing incompetency" as the most relevant impact of COVID-19 on their academic progression (n = 85, 39.9%). Above 90% of participants passed their Final Academic Assessment in 2020 (91.5%) and 2021 (93.9%). About half of them (n = 86, 40.4%) were having symptoms considerable of anxiety while only 19.2% (n = 41) were having symptoms considerable of depression. Majority had normal self-esteem (n = 177, 83.1%). For social relationship, around two-third of them had great social support and companionship. However, more than half had social distress. The median for the period of time having absolute online classes, absolute physical classes and hybrid classes were 18, 4, and 9 months, respectively. Having absolute online classes of >18 months was associated significantly with higher perceived hostility (16.49 vs. 14.47, p = 0.012). In addition, being infected with COVID-19 was associated significantly with higher self-esteem (26.88 vs. 25.85, p = 0.009). Large proportion of students were affected by COVID-19 pandemic. Absolute online classes has huge impact on emotions of medical students especially from the aspect of perceived hostility. Hence, implementation of online medical education during COVID-19 era requires modifications and improvements.