Stress Levels and Coping Strategies Among First-Year and Final-Year Medical Students in Public and Private Medical Colleges: A Comparative Cross-Sectional Study
Jul 2026· Journal of Saidu Medical College· 0 citations
TL;DR
Comparing stress levels and coping strategies between first-year and final-year medical students enrolled in public and private medical colleges in District Swat, Khyber Pakhtunkhwa, Pakistan shows medical students experience substantial stress, with final-year students carrying a greater burden.
Abstract
Background: Medical education is highly demanding and exposes students to considerable psychological stress. First-year students often struggle with academic adjustment, whereas final-year students face clinical responsibilities, career uncertainty, and professional pressures.
Objective: To compare stress levels and coping strategies between first-year and final-year medical students enrolled in public and private medical colleges in District Swat, Khyber Pakhtunkhwa, Pakistan.
Methodology: A comparative cross-sectional study was conducted among 248 MBBS students from Saidu Medical College (public sector) and Swat Medical College (private sector). Participants were recruited using a non-probability convenience sampling technique. Data were collected using a structured 38-item questionnaire assessing demographic characteristics, perceived stress, stress-related factors, and coping strategies. Stress scores were categorized into predefined levels ranging from low to extreme stress. Coping mechanisms were classified as problem-focused, non-problem-focused, and maladaptive.
Results: Overall stress levels were higher among final-year students, particularly those enrolled in the private medical college, who demonstrated the highest mean stress score (46.7; 62.3%). Academic stressors constituted the most prominent source of stress (68%), followed by family-related (65%), personal (60.4%), and social stressors (60.2%). Major stressors included curriculum management, excessive academic workload, prolonged class duration, perceived poor educational quality, parental expectations, financial concerns, and uncertainty regarding future career opportunities. Problem-focused coping strategies were the most frequently adopted approaches (71.2%), with studying from the beginning of the academic year, effective schedule management, and seeking guidance from teachers or senior students being the most common adaptive behaviors. Religious activities and physical exercise were also frequently reported, whereas maladaptive coping strategies were comparatively less common.
Conclusion: Medical students experience substantial stress, with final-year students carrying a greater burden. Medical colleges should strengthen academic support, counseling, stress-management programs, and healthy coping practices.
Keywords: Coping Strategies, Medical Students, Psychological Stress, Stress, Undergraduate Medical Education.
OBJECTIVES
To describe stress, coping behaviours, anxiety, psychological support and benzodiazepine use among French final-year medical students sitting a high-stakes national ranking examination and to explore how these patterns relate to exam ranking when interpreted through transactional stress and coping and 'coping reservoir' models.
DESIGN
Cross-sectional questionnaire survey.
SETTING
Single university medical faculty in France; final-year students sitting the national Épreuves Dématérialisées Nationales (EDN) and 'national Objective Structured Clinical Examination (nOSCE)' clinical examination.
PARTICIPANTS
All 387 sixth-year students present for the 2025 nOSCE were invited; 192 (50%) completed the questionnaire (69% women; median age 25 years).
INCLUSION
registered for the national exam and attending nOSCE; exclusion: non-attendance or incomplete questionnaire.
INTERVENTIONS
None.
PRIMARY AND SECONDARY OUTCOME MEASURES
Primary outcomes were self-rated stress for EDN and nOSCE and State-Trait Anxiety Inventory-Y (STAI-Y) state and trait anxiety scores. Secondary outcomes included stress management behaviours, psychological/psychiatric follow-up, benzodiazepine and other psychotropic use and final national ranking.
RESULTS
92% of respondents reported that stress impacted their daily life, particularly attention (83%), sleep (79%) and learning capacity (64%). Overall, 32% had consulted a psychologist/psychiatrist and 15% used benzodiazepines. Most reported regular sport (86%; ≥2 sports 69%) and breathing exercises (61%). Median nOSCE stress was 8/10; median STAI-Y state and trait scores were 45 and 46. Comparing very low versus high/very high trait-anxiety subgroups, ranking did not differ significantly, but low-anxiety students reported more sport (p=0.04), less benzodiazepine use (1/24 vs 10/37; p=0.003) and far less psychological follow-up (1/24 vs 19/46; p<0.0001). Self-reported coping strategies were not associated with better ranking.
CONCLUSIONS
Final-year medical students preparing for a high-stakes national ranking examination report pervasive stress, substantial functional impairment and frequent professional and pharmacological coping, with only limited linkage between anxiety and performance. Within transactional and coping reservoir frameworks, these results highlight the need for reflection on structural assessment practices and for longitudinal institutional strategies to protect learner well-being.
A. Mathé, François Tison, F. Sztark et al.· BMJ Open· 0 citations
Regression analysis showed that age and academic level significantly predicted stress, with younger and Level 200 students reporting higher stress, with younger students and those in Level 200 are particularly vulnerable.
Cindy Agyekumwaa Abankwah, Senoo-Dogbey Vivian Efua, Thelma Donkor et al.· Nursing & Midwifery Rese...· 0 citations
Abstract
Background: The transition to higher education requires students to adapt to new academic demands, social environments, and responsibilities. These changes may increase stress and potentially affect students' ability to adapt academically.
Purpose: This study aimed to determine the association between stress level and academic adaptability among students at STIKES Guna Bangsa Yogyakarta.
Methods: This study employed a quantitative research design with a cross-sectional approach. The population consisted of 340 first-year students at STIKES Guna Bangsa Yogyakarta aged 18–21 years. A total of 93 respondents were selected using random sampling. Data were collected using questionnaires and analyzed using the Pearson Product-Moment correlation test.
Results: The findings showed that 53 respondents (56.99%) experienced severe stress, 33 respondents (35.48%) experienced moderate stress, and 7 respondents (7.53%) experienced mild stress. Regarding academic adaptability, 60 respondents (64.52%) demonstrated high adaptability, while 33 respondents (35.48%) demonstrated moderate adaptability. The Pearson Product-Moment analysis showed a statistically significant negative association between stress level and academic adaptability (p = 0.002; r = −0.315).
Conclusions: There was a statistically significant negative association between stress level and academic adaptability among students at STIKES Guna Bangsa Yogyakarta. The low-strength negative correlation indicates that students with higher stress levels tended to have lower academic adaptability.
Eltanina Ulfameytalia Dewi, Aan Devianto, Angelique Haliwela et al.· Holistic Nursing Plus· 0 citations
Background and Aim: Stress is a critical factor influencing students’ mental health, academic performance, and professional development, particularly among interns who must balance academic responsibilities with workplace demands. Despite the growing body of literature on student stress, limited studies have focused on provincial and faith-based institutions. This study aimed to identify the stress factors experienced by student interns, examine their coping mechanisms, and determine the relationship between these variables and selected socio-economic characteristics.
Materials and Methods: This study employed a quantitative descriptive-correlational research design involving 40 student interns (n = 40) from Christ the King College de Maranding during the first semester of the 2025–2026 academic year. Data were collected using a validated three-part questionnaire covering socio-economic profile, stress factors, and coping mechanisms. Descriptive statistics, including frequency, percentage, and weighted mean, were utilized, while Chi-square and Pearson correlation tests were applied to determine significant relationships among variables.
Results: Findings revealed that student interns experienced moderate to high levels of stress, particularly regarding parental pressure, academic workload, financial difficulties, and fear of failure. Commonly employed coping mechanisms included goal setting, accountability, acceptance of failure, and effective time management. Statistical analysis further indicated that socio-economic variables, stress factors, and coping mechanisms did not demonstrate significant relationships (p > 0.05).
Conclusion: Student interns experience considerable stress regardless of socio-economic background; however, they demonstrate adaptive coping strategies that support resilience and academic functioning. The findings highlight the importance of institutional support programs aimed at strengthening emotional resilience, stress management, and professional preparedness among interns. Moreover, the study contributes to the limited body of literature concerning student stress and coping within provincial and faith-based educational settings.
Clyde Alvia· Journal of Education and Lea...· 0 citations
Poor academic performance among Nigerian secondary school students, particularly in highstakes examinations such as the West African Senior School Certificate Examination (WASSCE)
and the Joint Admissions and Matriculation Board (JAMB) examinations, remains a major
educational concern. While prior research has examined several determinants of academic
outcomes, limited attention has been given to the role of stress and coping strategies. This study
examined the relationship between perceived stress and academic performance, and
investigated whether coping strategies (emotion-focused and problem-focused coping) mediate
this relationship among secondary school students. A correlational research design was
adopted, involving 168 students (122 females, 46 males) drawn from public secondary schools
in Nkanu West Local Government Area of Enugu State. Participants completed the Perceived
Stress Scale and the Brief COPE Scale, while academic performance was assessed using thirdterm examination scores from the 2023/2024 academic session. Data were analysed using
hierarchical regression and mediation analysis with age and gender controlled. Results
indicated that perceived stress did not significantly predict academic performance, nor did it
significantly predict emotion-focused or problem-focused coping strategies. Furthermore,
neither coping strategy significantly predicted academic performance, and mediation effects
were not supported. These findings suggest that the relationship between stress and academic
performance may be more complex than initially assumed and may involve other psychological
or contextual factors. The study underscores the need for future research to explore alternative
mediators and moderators, such as resilience and social support, and highlights the
importance of socially driven learning environments in shaping academic outcomes.
C. Chikwendu· INTERNATIONAL JOURNAL OF SOC...· 0 citations
Background: First-year students of the Medical Education Program at the Faculty of Medicine, Universitas Malahayati experience substantial academic pressure from the beginning of their studies. These challenges may generate significant stress and encourage students to adopt avoidance coping strategies as a way of managing academic demands and adaptation difficulties.
Purpose: To explore avoidance coping behaviours among first-year students of the Medical Education Program.
Method: A qualitative phenomenological design was employed. Data were collected through Focus Group Discussions (FGDs). Participants were selected using purposive sampling to obtain diverse perspectives based on gender, academic achievement (high, moderate, and low block scores), age, and residential status (living in dormitories and non-dormitories). Data were analysed using thematic analysis to identify patterns and themes related to avoidance coping behaviours among first-year medical students.
Results: The findings revealed that avoidance coping behaviours among first-year medical students were manifested through several strategies, including escape coping, distraction coping, behavioural avoidance, and emotion-focused coping. The most frequently reported strategies were distraction coping and behavioural avoidance, including excessive social media use, sleeping, engaging in recreational activities, and postponing academic responsibilities. These behaviours were influenced by internal factors, such as emotional responses and self-regulation abilities, as well as external factors, including academic demands and environmental pressures.
Conclusion: Avoidance coping behaviours among first-year medical students emerged as responses to academic demands and adaptation challenges within the medical education environment. Understanding these coping patterns may support the development of appropriate psychological support strategies for students during the early stages of medical education.
Keywords: Avoidance Coping; Exploration; First-Year Students; Medical Students.
Ratna Gumilang Sari, S. Lestari, Mardheni Wulandari et al.· JOURNAL OF Mental Health Con...· 0 citations
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