How Medical Influencers Will Impact The Mental Health of Medical Students: A Scenario Analysis (Preprint)

BACKGROUND Introduction: The increasing prominence of influencers with medical backgrounds on social media not only changes how medical students shape their professional identities, learn, and handle mental health, but also prompts important questions about the future path of these processes. Although current research points to both positive and negative effects, the long-term consequences and the growing impact of medical influencers on students remain poorly understood. OBJECTIVE Methods: A qualitative foresight method integrated environmental scanning with inductive analysis of 45 questionnaire responses from medical students, educators, and influencers. Data analysis included open coding, thematic synthesis, and pinpointing key driving forces and critical uncertainties. Using these insights, a scenario analysis was conducted to create four plausible future scenarios along two axes: the impact of medical influencers positive versus negative) and the degree of institutional response (low versus high). METHODS Results: The four scenarios show that the same mechanisms, like relatability, visibility, and peer communication, can produce supportive or harmful results depending on how institutions engage. Without structured interpretive frameworks, there was a higher risk of psychological stress, whereas guided integration helped foster normalization, a sense of belonging, and adaptive identity development. RESULTS Discussion: Findings indicate that mental health outcomes are influenced more by how influencer content is interpreted and contextualized than by mere exposure. The institutional response plays a key role in determining whether this leads to the normalization of mental health issues and help-seeking behaviors, promoting support, or to the acceptance of overwork, unrealistic expectations, and relentless self-optimization, which can heighten pressure and psychological stress. CONCLUSIONS Medical influencers act as informal agents of professional socialization, not neutral sources. Without institutional oversight, they may reinforce overwork, perfectionism, and productivity, increasing students' psychological strain. However, when integrated critically, they can normalize vulnerability, reflective practice, and mental health awareness. The key is whether institutions passively observe or actively shape these narratives. CLINICALTRIAL -