Objective: Every year, many applicants want to study medicine. Appropriate selection procedures are needed to identify suitable candidates for the demanding curriculum. Although research on medical school admissions has shown good predictive validity for cognitive selection methods (undergraduate GPA, aptitude tests), the literature on applicants with professional and/or academic experience prior to entering medical school remains slim. In our study, we therefore aimed to examine the association between academic success in medical school and having previously completed vocational training in the medical field, voluntary service (≥11 months) or an academic degree. Methods: Data were collected in a multicentre, cross-sectional study at five medical schools in Germany (Baden-Wuerttemberg) from students during medical school (i.e. 3^rd-, 6^th-, and 10^th-semester and final-year students). Academic success was assessed according to scores on the first and second state examinations, the total number of examinations repeated and the number of semesters beyond the standard period of study. For the analysis we calculated ordinal logistic regression models for each outcome variable of academic success. Results: A total of N = 2,370 participants (response rate: RR = 47%) participated in the study. Having completed vocational training was associated with a higher amount of repeated examinations (small effect), while having an academic degree was associated with worse scores on the second state examination (medium effect). No significant association emerged between voluntary service and academic success. Conclusion: The results indicate that professional and academic pre-qualifications pose no advantage for academic success. Possible associations with the financing of study and living conditions of students with pre-qualifications were analysed and discussed in an exploratory manner. However, the operationalisation of academic success from objective and cognitive data should be critically discussed, as the benefits of prior experience may be captured by personal qualities rather than examination results.

Leaders of small and medium-sized enterprises (SMEs) are often confronted with specific burdens, which frequently result in increased levels of stress. Leadership behaviour, in turn, has a significant impact on employees’ health and performance. Using the Population, Intervention, Comparison, Outcome (PICO) method, we conducted a systematic literature search covering publications from 2002 to 2023 using PubMed, PsycInfo and Business Source Premier on stress-reducing and well-being-improving interventions for SME leaders. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess the methodological quality and risk of bias of the included studies regarding selection bias, study design, confounders, blinding, data collection, withdrawal and drop-out. Of the 3150 identified publications, 6 were included after screening. The studies varied in content (cognitive behavioural therapy [CBT]-based, psychoeducation, and mixed interventions) and approach (individual- and organisation-centred). Not all of the examined interventions provided significant outcomes. However, CBT-based and individualised approaches showed a positive trend in reducing SME leaders’ psychosocial stress and improving their well-being. Despite the limited data, it can be concluded that such interventions are beneficial for leaders and their specific needs. Future research should focus on tailored approaches, derived from well-founded theories and integrative interventions addressing SME leaders.

Introduction: Internationally, countries are struggling to provide health care in rural areas. In Germany, where the medical school’s admissions system rewards prior experience, there are a significant number of students with professional experience (e.g., paramedics, nurses). To date, there has been little research on this pre-experienced subgroup. In a rather exploratory approach, preferences for specialty training were compared between students with and without pre-qualifications. The primary aim of the study was to analyze how pre-qualifications and career types according to Holland’s RIASEC (acronym for realistic, investigative, artistic, social, enterprising, conventional) model contribute to interest in working as a rural doctor.Methods: Overall, 2,370 medical students at different stages of their studies (i.e., 3rd, 6th, 10th semester, and final year) completed the questionnaire. Students indicated interest in working as a rural doctor on a 9-point scale, and expressed interest in up to three specialist training programs from a list of 16. In addition, students answered questions about professional and academic pre-qualifications (i.e., vocational training in the medical field, academic degree, voluntary service) and completed a 6-item questionnaire on vocational interests according to the RIASEC model. The study was a multicenter cross-sectional study conducted at all five medical schools in the federal state of Baden-Württemberg, Germany.Results: Results show differences in career aspirations according to different pre-qualifications, especially for the pre-qualifications vocational training and voluntary service. The strongest association was found between having completed vocational training and interest in Anesthesiology, OR = 3.92 [3.22, 4.76]. A linear mixed model revealed that higher interest in practical-technical (realistic RIASEC type) or social activities (social RIASEC type), and lower interest in intellectual-research activities (investigative RIASEC type) predicted interest in rural practice, whereas pre-qualifications did not contribute significantly to the model.Discussion: The findings contribute to a better understanding of the career preferences of medical students with pre-qualifications. Previous experience may lead to the formation of a professional identity and community of practice (CoP) before medical school, which may also influence career preferences. To promote interest in rural medicine, medical schools could encourage interest in social and practical-technical activities within the curriculum and strengthen the profile of general practice.

Background: Leadership in small and medium-sized enterprises (SMEs) is associated with a variety of challenges and stressors, which are reflected in their managers’ commonly experienced high stress levels. In this context, psychological strain can arise, but compared to large companies, SMEs face particular difficulties in implementing mental health promotion intervention. These difficulties partially originate in a profound lack of comprehensive research on the effectiveness and prospects of success of intervention strategies in SMEs. This study aims to close this gap by evaluating a stress management training for managers in SMEs (KMU-GO). Implementing established stress management strategies and making them more accessible within the SME context, the training aims to improve participants’ psychological and physiological well-being. Methods: We conducted a randomized controlled trial with an intervention and a waitlist control group in Germany. The intervention comprised 1.5 days of stress management training and two refresher sessions, focusing on short- and long-term coping strategies and self-reflection. Based on a sample of N = 155 managers, we conducted a multilevel analysis of covariance on psychological measures, namely stress reactivity, depression, and anxiety. Additionally, changes in physiological stress indices (i.e., hair cortisol concentration and salivary alpha-amylase activity) were examined. Results: Regarding the psychological measures, we found significant training effects six months after baseline. Twelve months after baseline, there were no significant differences between the intervention and control groups for either psychological or physiological variables. Conclusion: In conclusion, the present stress management training is effective in reducing psychological strain in SME managers. In order to achieve more sustainable effects, a continuation of the refresher sessions could be considered. Trial registration: Before including the first participant, the KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (registered on 5 November 2020).

Although medical students with pre-medical qualifications (e.g., paramedic training) may enhance diversity within the student body, they have received little attention in international research. Their prior experience may influence study satisfaction through different learning strategies or working alongside their studies. This study investigates how pre-qualifications relate to three dimensions of study satisfaction (content, conditions, and coping with study load) and examines whether deep-processing learning strategies (elaboration and critical thinking) and part-time employment help explain these associations. The authors conducted a cross-sectional survey at five German medical schools across different stages of study (3rd, 6th and 10th semester, final year). A structural equation model tested (a) whether pre-qualifications (i.e., academic degree, vocational training in the medical field) moderated the relationship between deep-processing strategies and study satisfaction and (b) whether part-time employment mediated the relationship between pre-qualifications and study satisfaction, controlling for age, gender, undergraduate GPA, semester, and medical school. Associations between deep-processing strategies and satisfaction did not differ by pre-qualifications. Regardless of students' pre-qualifications, elaboration was positively (ß = .51) and critical thinking negatively (ß = -.31) associated with satisfaction with study contents. Students with vocational training or prior academic degree more often worked part-time to finance studies; part-time employment was associated with lower satisfaction with study conditions (ß = -.07) but higher satisfaction with coping with study load (ß = .08). Indirect effects via part-time employment were significant but small. The findings suggest that elaboration may be a particularly relevant learning strategy for satisfaction with study contents, regardless of students' prior professional or academic qualifications. The negative association between critical thinking and satisfaction highlights the complexity of students' perceptions of study contents. Although associations involving part-time employment were small, the findings contribute to a better understanding of students with professional and academic pre-qualifications and may inform efforts to support increasingly diverse medical student populations.

Zusammenfassung: Die Psychosomatische Medizin und Psychotherapie ist in Deutschland ein eigenständiges medizinisches Fach mit biopsychosozialem Krankheitsverständnis und ausgeprägter psychotherapeutischer Kernkompetenz. Trotz ihrer klinischen Bedeutung ist bislang wenig darüber bekannt, welche Medizinstudierenden sich für das Fach interessieren. Vor dem Hintergrund der Überalterung der im Fach tätigen Ärztinnen und Ärzte untersucht die Studie Zusammenhänge zwischen ausbildungsbezogenen und psychologischen Merkmalen sowie dem Interesse an einer Facharztweiterbildung in Psychosomatischer Medizin und Psychotherapie. In einer multizentrischen Querschnittsstudie wurden 3.833 Studieninteressierte und Medizinstudierende an fünf medizinischen Fakultäten in Baden-Württemberg befragt. Erhoben wurden Facharztinteressen, soziodemografische und ausbildungsbezogene Merkmale sowie standardisierte Instrumente zu studienbezogener Beanspruchung (MBI-SS), Selbstwirksamkeit, Gewissenhaftigkeit (BFI-K) und beruflichen Interessen (RIASEC). Die Analyse erfolgte mittels bivariater Tests und logistischer Regressionsmodelle. Die Psychosomatische Medizin und Psychotherapie wurde von 6,7% der Befragten als eines der bevorzugten Weiterbildungsfächer angegeben (Rang 12 von 16). Bivariate Analysen zeigten Zusammenhänge zwischen mehreren Variablen und dem Interesse an der Psychosomatischen Medizin und Psychotherapie. In multivariaten Analysen waren Studierende mit Interesse an diesem Fach im Mittel älter (OR=1,11), zeigten stärkere soziale (OR=1,20) sowie künstlerisch-sprachliche Interessen (OR=1,22) und geringere praktisch-technische (OR=0,85) und intellektuell-forschende Interessen (OR=0,92). Zudem berichteten sie niedrigere Gewissenhaftigkeit (OR=0,95). Studierende im Praktischen Jahr zeigten seltener Interesse als Studierende der Vorklinik (OR=0,50). Für die Studieninteressierten zeigten sich kaum Zusammenhänge. Die Ergebnisse ermöglichen eine differenzierte Beschreibung einer bislang wenig untersuchten Subgruppe von Medizinstudierenden. Die identifizierten Merkmale weisen auf ein spezifisches Interessenprofil und ausgewählte ausbildungsbezogene Merkmale hin, die mit zentralen Anforderungen der Psychosomatischen Medizin und Psychotherapie vereinbar ist. Die Befunde unterstreichen die Bedeutung gezielter Maßnahmen zur Stärkung der Sichtbarkeit und Attraktivität des Fachs im Medizinstudium und liefern Anhaltspunkte für die curriculare Gestaltung sowie die Nachwuchsgewinnung.