Introduction In this study, the relationship between imposter syndrome and irrational procrastination was examined in first- and second-year pre-clinical medical students (M1s and M2s, respectively). Imposter syndrome describes the phenomenon whereby individuals feel that they are undeserving of their accomplishments despite evidence to the contrary. It has been associated with low self-esteem, higher rates of procrastination, and burnout, making it a critical component in gauging student wellness. Methods Anonymous surveys were sent to one hundred twenty M1 students and one hundred twenty-six M2 students, all of whom attend the same university, and twenty-eight responses were collected over the span of two weeks. The surveys were composed of two questions on school year and gender, seven questions from the Impostorism Scale, and nine questions from the Irrational Procrastination Scale. Analysis was conducted using a Kolmogrov-Smirnov test and Spearman’s correlations on IBM SPSS Statistics 28.0.1.0. Results The Kruskal-Wallis test demonstrated that M2 students scored higher on the Irrational Procrastination Scale when compared to M1 students (H(1) = 5.785, p = .016). Additionally, Spearman’s correlation indicated that the Impostorism and Irrational Procrastination Scores did not correlate in the data (r(28) = .373, p = .051). Conclusions Based on this analysis, imposter syndrome and procrastination appear to be prevalent issues among the M1 and M2 students surveyed in this study, with higher rates of procrastination seen in M2 students.

In this single-institution remote survey study of a California medical school, anxiety and assertiveness were found to inversely correlate in preclinical medical students.

Background/ Objectives Patients with poor sleep are at high risk for developing diabetes (T2DM). Since T2DM is linked to increased risk of obstructive sleep apnea (OSA), and Metformin is commonly used to treat T2DM, we examined how Metformin affects sleep stages in patients with concurrent T2DM and OSA-related symptoms of snoring and fatigue. T2DM patients on Metformin, progressively develop increased insulin resistance associated with sleep disturbances, and poor glycemic control. We explored changes in sleep patterns in T2DM patients on Metformin. We explored if Metformin affects sleep Architecture in T2DM patients. Methods Evaluate PSG (polysomnogram data from T2DM patients on Metformin along with data on age, BMI and sex. Data to be analyzed as mean +SE and linear regression, t test p< 0.5 taken as significant. Results Non-obese patients taking Metformin experienced a significant decrease in REM duration compared to patients on alternative therapies (p = 0.036). There was no such change in REM for obese patients taking Metformin. While there was no change in N3 duration with Metformin use, linear regression identified a moderate negative correlation between N3 and age in patients taking non-Metformin therapies (R2 = 0.4555). No significant correlations between sleep stage duration and patient sex, smoking status, or body-mass index (BMI) were identified. Conclusion T2DM patients on Metformin had OSA with reduced deep sleep (N3) and REM (Rapid Eye Movement) sleep. These diabetic patients with OSA being treated with Metformin had decreased REM sleep, regardless of sex, smoking history, and BMI. N3 and REM sleep are needed for timely secretion of growth hormone and memory consolidation. Metformin affects sleep architecture and impacts N3 and REM sleep. This may contribute to the development of insulin resistance. Future studies are needed to explore potential causes for this decrease and how it may affect treatment of T2DM.

UNSTRUCTURED The development of confident and assertiveness physicians through the process of medical education is essential for effective patient care. Through medical training, future physicians obtain the knowledge and skillset necessary to accomplish this, but they may face stressors that negatively impact their mental health. This study aims to provide insights into the relationship between US medical student assertiveness and anxiety in the current pass/fail USMLE Step 1 medical education landscape. This was achieved by surveying 30 US MD student at a single Californian institution using the Simple Rathus Assertiveness Scale-Short Form and the General Anxiety Disorder Assessment 7. It was found that M1 participants were more likely to feel uncomfortable returning purchases than their M2 counterparts and that female participants were more likely to ask a loud theater couple to be quiet compared to males. These differences in responses by academic year and gender indicate areas of future study, particularly regarding the personality characteristics of current medical students and whether there are changing trends in medical student assertiveness and its association with medical student well-being.

Background/Objectives: Patients with poor sleep are at high risk of developing type II diabetes mellitus (T2DM). Since T2DM is linked to increased risk of obstructive sleep apnea (OSA), and Metformin is commonly used to treat T2DM, we examined how Metformin affects sleep stages in patients with concurrent T2DM and OSA-related symptoms of snoring and fatigue. Patients with T2DM on Metformin progressively develop increased insulin resistance associated with sleep disturbances and poor glycemic control. We therefore explored sleep pattern changes in patients with OSA symptoms and T2DM on Metformin, with a special focus on whether Metformin affects sleep architecture. Methods: Polysomnogram (PSG) data from patients with T2DM on Metformin was evaluated along with data on age, body-mass index (BMI), and biological sex. Data analysis included mean ± standard deviation, t-test with p < 0.05 taken as significant, and linear regression. Results: Patients with a BMI of less than 30 (non-obese) and taking Metformin exhibited a significantly shorter rapid eye movement sleep stage (REM) duration than patients on alternative therapies (p = 0.036). No such difference in REM was found for patients with a BMI of 30 or greater (obese) taking Metformin. While there was also no significant difference in slow-wave sleep stage (N3) duration with Metformin use, linear regression identified a moderate negative correlation between N3 and age in patients taking non-Metformin therapies (R² = 0.4555). No significant correlations between sleep stage duration and patient sex, smoking status, or BMI greater than 30 were identified. Conclusions: Overall, patients with OSA and T2DM on Metformin had lower mean quantities of N3, and REM sleep compared to those not on Metformin. Non-obese patients with T2DM and OSA being treated with Metformin were observed to have less REM sleep, regardless of sex or smoking history. N3 and REM sleep are needed for the timely secretion of growth hormone and memory consolidation. Since Metformin is correlated with differences in N3 and REM sleep, it may contribute to the development of insulin resistance. Future studies are needed to explore potential causes for this relationship and how it may affect the treatment of T2DM.