Mental Well-Being in First Year Medical Students: A Comparison by Race and Gender A Report from the Medical Student CHANGE Study Rachel R. Hardeman & Julia M. Przedworski & Sara E. Burke & Diana J. Burgess & Sean M. Phelan & John F. Dovidio & Dave Nelson & Todd Rockwood & Michelle van Ryn Received: 19 September 2014 /Revised: 18 January 2015 /Accepted: 22 January 2015 /Published online: 13 March 2015 # W. Montague Cobb-NMA Health Institute 2015 Abstract Purpose In this study, authors sought to characterize race and gender disparities in mental health in a national sample of first year medical students early in their medical school experience. Method This study used cross-sectional baseline data of Med- ical Student CHANGES, a large national longitudinal study of a cohort of medical students surveyed in the winter of 2010. Authors ascertained respondents via the American Associa- tion of Medical Colleges questionnaire, a third-party vendor- compiled list, and referral sampling. Results A total of 4732 first year medical students completed the baseline survey; of these, 301 were African American and 2890 were White. Compared to White students and after adjusting for relevant covariates, African American students had a greater risk of being classified as having depressive (relative risk (RR)=1.59 [95 % confidence interval, 1.37– 2.40]) and anxiety symptoms (RR=1.66 [1.08–2.71]). Wom- en also had a greater risk of being classified as having depres- sive (RR=1.36 [1.07–1.63]) and anxiety symptoms (RR - 1.95 [1.39–2.84]). Conclusions At the start of their first year of medical school, African American and female medical students were at a higher risk for depressive symptoms and anxiety than their White and male counterparts, respectively. The findings of this study have practical implications as poor mental and overall health inhibit learning and success in medical school, and physician distress negatively affects quality of clinical care. Keywords Depression . Anxiety . Medical students . Race . Gender Medical school, particularly the preclinical years, is conceiv- ably one of the most stressful times in a promising physician’ s life. It is not surprising that medical students experience high levels of psychological distress and mental illness [1–13]. Studies of the prevalence of anxiety among medical students revealed that between 40 and 79 % of medical students expe- rience high levels of anxiety [14]. This is in comparison to approximately 14 % in the general population of the same age group [15]. In addition, depression among medical students is more prevalent than among demographically comparable Electronic supplementary material The online version of this article (doi:10.1007/s40615-015-0087-x) contains supplementary material, which is available to authorized users. R. R. Hardeman (*) : D. J. Burgess : D. Nelson Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, 1 Veterans Drive, Building 9, Mail code: 152, Minneapolis, MN 55417, USA e-mail: hard0222@umn.edu R. R. Hardeman : D. J. Burgess : D. Nelson Department of Medicine, University of Minnesota, Minneapolis, MN, USA J. M. Przedworski : T. Rockwood Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis, MN, USA S. E. Burke : J. F. Dovidio Department of Psychology, Yale University, New Haven, CT, USA S. M. Phelan : M. van Ryn Mayo Clinic College of Medicine, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA J. Racial and Ethnic Health Disparities (2015) 2:403–413 DOI 10.1007/s40615-015-0087-x