{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:54:45Z","timestamp":1781643285260,"version":"3.54.5"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical Student Syndrome (MSS) is often understood as a manifestation of illness anxiety disorder where medical students misinterpret benign symptoms as signs of a serious illness. Current explanations rely heavily on psychological factors; however, these fail to capture the systemic reasoning errors that underly MSS. This paper proposes a mixed model: that MSS results from a combination of the Bayesian reasoning failure of base rate neglect and psychological stressors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An observational cross-sectional study of medical students was conducted\n                      <jats:inline-formula>\n                        <jats:tex-math>$$\\left(n=112\\right)$$<\/jats:tex-math>\n                      <\/jats:inline-formula>\n                      . Participants completed an anonymous survey assessing self-reported MSS, responses to medical diagnostic scenarios modelled on Kahneman and Tversky\u2019s \u201clibrarian or farmer\u201d problem, and prioritisation of diagnostic reasoning components. Descriptive statistics and categorical analysis of qualitative responses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A history of MSS was reported by 56.3% of participants. Diagnostic accuracy was low for both medical scenarios (48.3% correct for differentiating between stroke and migraine; 33.3% for differentiating between pheochromocytoma and panic disorder) and the Bayesian reasoning task (41.1% correct). 71% of students who answered medical questions incorrectly also failed the Bayesian task, suggesting a shared underlying process. 14% of students with a history of MSS answered both questions correctly. Students ranked pathophysiology and symptoms of the presenting complaint as most important in diagnosis, and epidemiology as the least important (mean rank\u2009=\u20098.8\/9). Self-analysis of errors showed that most students attributed their mistakes to poor probabilistic reasoning rather than a lack of knowledge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings support the explanation of MSS as partially a statistical reasoning error rather than a purely psychological condition. Training in Bayesian reasoning, integration of epidemiology into diagnostic teaching, and diversification of assessment formats may mitigate MSS and enhance diagnostic accuracy for medical students.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-09018-9","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:47:06Z","timestamp":1773668826000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medical student syndrome: a bayesian reasoning failure"],"prefix":"10.1186","volume":"26","author":[{"given":"Ryan C.","family":"Clarkson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naeem","family":"Paruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"9018_CR1","doi-asserted-by":"crossref","unstructured":"Abdulghani HM, Marwa K, Alghamdi NA, Almasoud RN, Faraj AT, Alshuraimi AF et al. Prevalence of the medical student syndrome among health professions students and its effects on their academic performance. Medicine. 2023; 102(43).","DOI":"10.1097\/MD.0000000000035594"},{"key":"9018_CR2","doi-asserted-by":"crossref","unstructured":"Adhikari K, Atreya A, Bhandari S, Gnawali L, Menezes RG, Nepal S, et al. Prevalence of Medical Student Syndrome among Medical Students of Nepal. J Nepal Health Res Counc. 2024 December;22(03):616\u201321.","DOI":"10.33314\/jnhrc.v22i03.5330"},{"key":"9018_CR3","doi-asserted-by":"crossref","unstructured":"Abdellatif MA, Abdel Salam HA, Ali HT, Hussein SM, Abdalla AA, Khorkhash MK et al. The journey of medical field students: uncovering medical student syndrome, personality traits, and their interactions. BMC Psychology. 2025; 13(490).","DOI":"10.1186\/s40359-025-02788-9"},{"key":"9018_CR4","doi-asserted-by":"crossref","unstructured":"Weiss ST, Samet JM. An assessment of physician knowledge of epidemiology and biostatistics. Acad Med. 1980; 55(8).","DOI":"10.1097\/00001888-198008000-00007"},{"issue":"9","key":"9018_CR5","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1016\/j.jclinepi.2006.03.005","volume":"59","author":"C Estellat","year":"2006","unstructured":"Estellat C, Faisy C, Colombet I, Chatellier G, Burnand B, Durieux P. French academic physicians had a poor knowledge of terms used in clinical epidemiology. J Clin Epidemiol. 2006;59(9):1009\u2013e10144.","journal-title":"J Clin Epidemiol"},{"issue":"2","key":"9018_CR6","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1177\/0272989X8100100205","volume":"1","author":"TS Wallsten","year":"1981","unstructured":"Wallsten TS. Physician and medical student bias in evaluating diagnostic information. Med Decis Mak. 1981;1(2):145\u201364.","journal-title":"Med Decis Mak"},{"issue":"8","key":"9018_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0202769","volume":"13","author":"M Rubio","year":"2018","unstructured":"Rubio M, S\u00e1nchez-Ronco M, Mohedano R, Hernando A. The impact of participatory teaching methods on medical students\u2019 perception of their abilities and knowledge of epidemiology and statistics. PLoS ONE. 2018;13(8):1\u201312.","journal-title":"PLoS ONE"},{"issue":"272","key":"9018_CR8","doi-asserted-by":"publisher","first-page":"282","DOI":"10.31729\/jnma.8531","volume":"62","author":"D Devkota","year":"2024","unstructured":"Devkota D. Medical Student Syndrome and Imposter Syndrome: Are They Real? JNMA J Nepal Med Assoc. 2024;62(272):282\u20133.","journal-title":"JNMA J Nepal Med Assoc"},{"issue":"2","key":"9018_CR9","doi-asserted-by":"publisher","first-page":"204253331351248","DOI":"10.1177\/2042533313512480","volume":"5","author":"LZ Waterman","year":"2014","unstructured":"Waterman LZ, Weinman JA. Medical student syndrome: fact or fiction? A cross-sectional study. JRSM Open. 2014;5(2):2042533313512480.","journal-title":"JRSM Open"},{"issue":"2","key":"9018_CR10","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1055\/s-0043-1768683","volume":"13","author":"SH Abdullah","year":"2023","unstructured":"Abdullah SH, Ahmed AE, Algebail HGE, Fatooh A, Ismail LNA, Radwan NK, et al. Medical Students\u2019 Syndrome among Medical Students in the University of Sharjah, UAE. Avicenna J Med. 2023;13(2):77\u201381.","journal-title":"Avicenna J Med"},{"key":"9018_CR11","doi-asserted-by":"crossref","unstructured":"Tversky A, Kahneman D, Availability. A heuristic for judging frequency and probability. Cogn Psychol 1973 September; 5(2): 207\u201332.","DOI":"10.1016\/0010-0285(73)90033-9"},{"key":"9018_CR12","volume-title":"Thinking Fast and Slow","author":"D Kahneman","year":"2011","unstructured":"Kahneman D. Thinking Fast and Slow. New York: Farrar, Straus and Giroux; 2011."},{"issue":"9","key":"9018_CR13","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.3390\/math10091558","volume":"10","author":"K Binder","year":"2022","unstructured":"Binder K, B\u00f6cherer-Linder K, B\u00fcchter T, Eichler A, Krauss S, Steib N, et al. How to Train Novices in Bayesian Reasoning. Mathematics. 2022;10(9):1558.","journal-title":"Mathematics"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-09018-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09018-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09018-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:12:09Z","timestamp":1781640729000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-09018-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["9018"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-09018-9","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]},"assertion":[{"value":"23 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study underwent prospective institutional ethics screening and was deemed low risk by the Research Ethics Committee of Forward Observations. The requirement for full ethics committee review was waived in accordance with the organisation\u2019s research governance frameworks due to its voluntary nature, participant anonymity creating a lack of identifiable personal health data as defined by Recital 26 (EU) 2016\/679, and minimal risk to participants. The study was conducted in accordance with this determination. All participants provided informed consent prior to participation, and anonymity was preserved throughout data collection and analysis. The study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"659"}}