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April 14, 1989

Depression in Medical Students-Reply

JAMA. 1989;261(14):2066. doi:10.1001/jama.1989.03420140067023

In Reply.—  We agree with Merrill and colleagues that personality factors are major determinants of a variety of personal and professional outcomes among medical students and physicians. However, our own findings indicate a more complex state of affairs than the model that they present. There is indeed a cluster of personality attributes, including self-esteem, locus of control, and self-confidence, which predicts subjective well-being in medical students both concurrently and up to 2 years later.1,2 In our research, the Rosenberg Self-Esteem Scale is not the best measure to represent this cluster. Medical students are uniformly high in self-esteem compared with population norms, and 4 years of medical school do little to alter scores on this measure. We have elsewhere observed that those highest in self-esteem could probably profit from a touch of self-doubt or humility.1 In other words, an absence of depressive symptoms during medical school does not necessarily