Assessment of the Influence of Medical School Curriculum on the Mental Health of Students in Pamo University of Medical Sciences, Port Harcourt, Rivers State

ABSTRACT 

Mental health is a critical component of wellbeing, and medical students are at heightened risk of psychological distress due to the intensity of their academic workload, demanding curricula, and clinical responsibilities. This study assessed the influence of the medical school curriculum on the mental health of students at PAMO University of Medical Sciences, Port Harcourt, Rivers State, with objectives to evaluate students’ knowledge of mental health, identify unique curriculum-related stressors, determine their impact on mental wellbeing, and explore unintended psychological consequences. A descriptive cross-sectional design was used, with 350 students selected through stratified sampling proportionate to level and systematic selection. Data were collected via a semi-structured, self-administered questionnaire covering knowledge, challenges, stressors, and consequences, and analyzed using SPSS v29. Respondents had a mean age of 19.23 ± 2.31 years; 74.0% were female, and 77.2% demonstrated good mental health knowledge. However, 94.1% reported sleep deprivation from academic demands, 52.1% frequent burnout, 42.9% frequent anxiety, and 19.6% frequent depression. High-priority stressors included overwhelming study volume (59.4% significantly affected) and difficulty balancing academics with personal life (39.0% significantly affected). Only 5.3% reported access to institutional mental health support, while stigma and fear of judgement discouraged help-seeking in 42.0%. Common coping strategies were avoidance (“just move on,” 56.8%) and informal peer support (36.1%). The findings reveal that while knowledge of mental health is high, curriculum-related stressors significantly compromise wellbeing, with limited formal support and persistent stigma exacerbating the problem. Institutional reforms—such as integrating structured wellness programs, providing accessible counselling, adjusting workload, and fostering a supportive learning culture—are recommended to promote resilience, enhance academic performance, and safeguard future patient care.

TABLE OF CONTENTS 

TITLE....................................................................................……………………………….. i 

CERTIFICATION................................................................................................................. iii 

DECLARATION..................................................................................................................... iv 

DEDICATION.......................................................................................................................... v 

ACKNOWLEDGEMENTS................................................................................................... vi 

TABLE OF CONTENTS...................................................................................................... vii 

LIST OF TABLES................................................................................................................... x 

LIST OF FIGURES................................................................................................................ xi 

ABSTRACT............................................................................................................................ xii 

CHAPTER ONE...................................................................................................................... 1 

INTRODUCTION.................................................................................................................... 1 

1.1 BACKGROUND INFORMATION................................................................................. 1 

1.2 PROBLEM STATEMENT............................................................................................... 6 

1.3 JUSTIFICATION.............................................................................................................. 9 

1.4 RESEARCH QUESTIONS............................................................................................. 12 

1.5 GENERAL AND SPECIFIC OBJECTIVES................................................................ 12 

1.5.1 AIM............................................................................................................................. 12 

1.5.2 SPECIFIC OBJECTIVES........................................................................................ 12 

CHAPTER TWO................................................................................................................... 14 

LITERATURE REVIEW..................................................................................................... 14 

2.1 INTRODUCTION............................................................................................................ 14 

2.2 CONCEPTUAL FRAMEWORK................................................................................... 15 

2.3 THEORETICAL REVIEW............................................................................................ 16 

2.4 EMPIRICAL REVIEW................................................................................................... 19 

2.4.1 Knowledge of Mental Health among Medical Students........................................ 19 

2.4.2 Unique Challenges in Medical Education............................................................... 21 

2.4.3 The Effect of Curriculum-Related Stressors on Mental Health ........................... 22 

2.4.4 Unintended Consequences of the Curriculum........................................................ 23 

2.5 Critical Analysis and Gaps in the Literature............................................................. 24 

CHAPTER THREE............................................................................................................... 26 METHODOLOGY................................................................................................................ 26 

3.1. ​ STUDY AREA............................................................................................................ 26 

3.2. STUDY DESIGN........................................................................................................ 26 

3.3. ​ STUDY POPULATION............................................................................................ 27 

3.3.1. ​INCLUSION CRITERIA....................................................................................... 27 

3.3.2. ​ EXCLUSION CRITERIA..................................................................................... 27 

3.4. ​ SAMPLE SIZE DETERMINATION....................................................................... 27 

3.5. SAMPLING TECHNIQUE............................................................................................ 31 

3.6 STUDY INSTRUMENTS................................................................................................ 31 

3.7 DATA COLLECTION.................................................................................................... 31 

3.8 DATA MANAGEMENT................................................................................................. 31 

3.8.1 Measurement of variables........................................................................................ 31 

3.8.2 Statistical analysis..................................................................................................... 32 

3.9 ETHICAL CONSIDERATIONS.................................................................................... 32 

3.10 LIMITATIONS.............................................................................................................. 32 

CHAPTER FOUR.................................................................................................................. 33 

RESULTS............................................................................................................................... 33 

CHAPTER 5........................................................................................................................... 53 

DISCUSSION, CONCLUSION AND RECOMMENDATION......................................... 53 

5.1. DISCUSSION.................................................................................................................. 53 

5.2. CONCLUSION............................................................................................................... 61 

5.3. RECOMMENDATIONS................................................................................................ 62 

REFRENCES......................................................................................................................... 64 

APPENDIX 1.......................................................................................................................... 71 

CONSENT FORM................................................................................................................. 71 

APPENDIX 2.......................................................................................................................... 72 

LETTER OF ETHICAL APPROVAL................................................................................ 72 

APPENDIX 3.......................................................................................................................... 73 

QUESTIONNAIRE: .............................................................................................................. 73