Journal of General Internal Medicine

, Volume 28, Issue 8, pp 1028–1034

Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students

  • Robyn M. Emanuel
  • Sandra L. Frellsen
  • Kathleen J. Kashima
  • Sandra M. Sanguino
  • Frederick S. Sierles
  • Cathy J. Lazarus
Original Research

DOI: 10.1007/s11606-012-2249-4

Cite this article as:
Emanuel, R.M., Frellsen, S.L., Kashima, K.J. et al. J GEN INTERN MED (2013) 28: 1028. doi:10.1007/s11606-012-2249-4



Nonmedical use of prescription psychostimulants such as methylphenidate and amphetamine salts for the purpose of cognitive enhancement is a growing trend, particularly in educational environments. To our knowledge, no recent studies have evaluated the use of these psychostimulants in a medical academic setting.


To conduct an online census of psychostimulant use among medical students.


In 2011, we conducted a multi-institutional census using a 31–48 item online survey regarding use of prescription psychostimulants.


2,732 actively enrolled medical students at four private and public medical schools in the greater Chicago area.


Prevalence and correlates of psychostimulant use


1,115 (41 %) of students responded to the web-based questionnaire (range 26–47 % among schools). On average, students were 25.1 years of age (SD = 2.7, range 20–49), and single (70 %). Overall, 18 % (198/1,115) of this medical student sample had used prescription psychostimulants at least once in their lifetime, with first use most often in college. Of these, 11 % (117/1,115) of students reported use during medical school (range 7–16 % among schools). Psychostimulant use was significantly correlated with use of barbiturates, ecstasy, and tranquilizers (Pearson’s correlation r > 0.5, Student’s t-test p < 0.01); male gender (21 % male versus 15 % female, Chi squared p = 0.007); and training at a medical school which by student self-report determined class rank (68 % versus 51 %, Chi-squared p = 0.018). Non-users were more likely to be first year students (Chi-squared p = 0.048) or to have grown up outside of the United States (Chi-squared p = 0.013).


Use of psychostimulants, including use without a prescription, is common among medical students. Further study of the side effects, medical implications, and use during post-graduate medical training and medical practice is needed to inform evidence-based policy.


cognitive enhancementnootropicsamphetamine saltsmethylphenidatemedical studentsdrug use

Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Robyn M. Emanuel
    • 1
    • 2
  • Sandra L. Frellsen
    • 3
  • Kathleen J. Kashima
    • 4
  • Sandra M. Sanguino
    • 5
  • Frederick S. Sierles
    • 6
  • Cathy J. Lazarus
    • 7
    • 8
    • 9
  1. 1.Mayo ClinicScottsdaleUSA
  2. 2.Chicago Medical SchoolRosalind Franklin University of Medicine and ScienceNorth ChicagoUSA
  3. 3.Department of Medicine at Rush Medical CollegeRush UniversityChicagoUSA
  4. 4.University of Illinois College of MedicineChicagoUSA
  5. 5.Northwestern University, Feinberg School of MedicineChicagoUSA
  6. 6.Department of Psychiatry and Behavioral SciencesRosalind Franklin University of Medicine and ScienceNorth ChicagoUSA
  7. 7.Tulane University School of MedicineNew OrleansUSA
  8. 8.Southeast Louisiana Veterans Health Care SystemNew OrleansUSA
  9. 9.Rosalind Franklin University of Medicine and ScienceNorth ChicagoUSA