Association between chronic health problems and quality of life in medical students. Results of the POLLEK cohort study

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Introduction Medical students with chronic diseases constitute a particurarly vulnerable subgroup of young adults, exposed to various health risks, related both to the academic environment and their underlying health condition. Previous findings suggest that medical students with chronic illnesses experience greater deterioration in quality of life (QoL) compared with their healthy peers. The aim of this study was to validate earlier observations from the POLLEK study regarding the relationship between quality of life, health status, and the prevalence of chronic diseases among medical students during a two-year follow-up. Material and methods This study presents results from the final cohort of Polish medical students' longitudinal study (POLLEK), recruited during the academic years 2020/2021-2022/2023 at the Medical University of Silesia in Katowice. A total of 887 first-year students (T1) participated in the baseline assignment, and 705 were followed up in the second year of studies (T2). The questionnaire included measures of quality of life (WHOQOL-BREF), hazardous alcohol use (AUDIT), general health status (GHQ-28), lifestyle indicators, and sociodemographic characteristics. Students were divided into two groups: those with previously diagnosed chronic diseases (DCD) and those without declared chronic diseases (NDCD). Results Among first-year students (T1), 219 (24.7%) reported ever having a diagnosed chronic disease. In the second academic year (T2), this proportion increased to 28.9% ( N = 204). Higher scores for overall QoL ( p < 0.001), and in the somatic ( p = 0.009), psychological (0.006), and environmental ( p = 0.028) domains were observed among first-year students without chronic diseases. Similar patterns were observed during the second academic year, except for the psychological domain ( p = 0.782). Conclusions Chronic diseases are relatively common among medical students and are associated with poorer quality of life, worse self-rated health, and lower psychological wellbeing in the early years of medical education. Students with chronic diseases report consistently lower quality of life, more somatic complaints, and higher levels of anxiety and depressive symptoms, with these differences persisting over time. These findings highlight the need for systematic monitoring of students' wellbeing and early, tailored support, including health-focused interventions, coping support, and appropriate academic accommodations.

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