Table 2 Exploratory factor analysis item coefficients

msss1

I notice fluctuations in appetite.

0.08

0.03

0.46

msss2

I have difficulty asking for help.

0.45

0.21

0.2

msss3

I have trouble falling/staying asleep.

−0.02

0.24

0.38

x

msss4

I receive less satisfaction from learning.

0.11

−0.04

0.65

msss5

I am unable to relax.

−0.05

0.69

0.23

msss6

I feel anxious.

−0.08

0.69

0.27

msss7

I am unable to enjoy activities outside of classes/rotations.

0.01

0.49

0.29

msss8

I feel pressure extracurricular activities (student groups, research, etc.).

0.2

0.37

−0.11

x

msss9

I notice that I drink alcohol in excess.

0.02

−0.08

0.33

x

msss10

I use drugs in excess (prescription and/or non-prescription).

−0.01

− 0.04

0.47

x

msss11

I feel hopeless that I will ever get my degree.

0.08

0.25

0.59

msss12

I feel depressed.

0

0.32

0.61

msss13

I am stressed about finances.

0.17

0.07

0.28

x

msss14

I have a hard time motivating myself to study.

0.18

−0.06

0.62

msss15

I feel emotionally exhausted.

0.11

0.46

0.38

msss16

I feel bothered by the amount of exposure to death and human suffering.

0.3

0.06

0.17

x

msss17

I am fearful of failing.

0.13

0.52

0.28

msss18

I exercise less.

0.18

0.18

0.15

x

msss19

I feel unsupported by my peers.

0.54

0.18

0.09

msss20

I feel competition from my peers.

0.54

0.29

−0.19

msss21

I feel unsupported by faculty.

0.8

−0.09

0.16

msss22

I feel taken advantage of by faculty (i.e. research mentors, professors, and/or school administrators).

0.68

−0.1

0.02

msss23

It is challenging to maintain relationships with others outside of school.

0.08

0.34

0.19

x

msss24

I feel pressure from others (parents, professors, mentors, etc) to get good grades.

0.39

0.23

0.06

msss25

I feel unmotivated to attend class.

0.18

−0.06

0.41

x

msss26

I feel pressure from myself to get good grades.

0.1

0.71

−0.38

x

msss27

I am overly self-critical.

−0.01

0.85

−0.03

msss28

I feel need to be perfect.

0.2

0.77

−0.29

x

msss29

I am unsure of abilities as student.

0.07

0.49

0.36

msss30

I hardly have enough time to get things done.

−0.04

0.41

0.32

msss31

I feel overwhelmed by everything there is to do.

0.01

0.53

0.43

msss32

I struggle maintaining a healthy school-life balance.

0.15

0.59

0.16

msss33

It is challenging to start or maintain romantic relationships.

0.12

0.31

0.19

x

msss34

I think about dropping out of school.

0.09

0

0.79

msss35

I question my decision to enter medical school.

0.15

−0.05

0.76

x