Perceived Stress and Coping Skills in the Newly Joined Medical Undergraduate Students

Abstract

Objectives: To assess the perceived stress and to evaluate the sources of stress, the prevalence of psychological morbidity (if any) and different coping strategies among the newly joined 1st-semester medical undergraduate students. Methodology: A cross-sectional exploratory study was conducted on all the newly joined 1st-year medical students (who had entered 3 months back) at a tertiary care medical college and teaching hospital in Eastern India. Perceived stress and depressive symptoms were assessed on the Perceived Stress Scale-10 (PSS-10) and Patient Health Questionnaire-9 (PHQ-9). A self-designed questionnaire was used to evaluate different premedical entry-level preparation issues and ongoing psychosocial and academic-related stressors. Coping was evaluated on the Ways of Coping Checklist. Results: Ninety-five first-semester medical undergraduate students (mean age − 18.34 ± 0.95 years) who had joined the Institute 3 months back participated in the study. The mean PSS score was 21.56 ± 3.97 and about 85.3% and 11.6% of the students reported moderate and high degrees of stress. Depressive symptoms were reported by 36.8% (PHQ-9 cut-off ≥10). During medical preparation (as rated on a Likert scale of 0–10), the mean rated stress level was 6.84 ± 2.05. Almost half of the students reported facing problems adjusting to the new place and environment (48.4%), facing language problems (11.6%), and unfavorable hostel facilities (10.5%). Under academic stressors – more than half of the students perceived the vastness of academic curriculum as a major stressor as “often” (53.7%) followed by fear of failure in exams (35.8%). Students followed both negative coping strategies (such as escape avoidance coping, distancing, and confrontive coping) and positive coping strategies (self-controlling, seeking social support, planful problem-solving, and positive appraisal). Significant association of depressive symptom score was found with self-controlling (P - 0.012) and seeking social support (P = 0.015) type of coping. Conclusion: A substantial proportion of undergraduate medical students have moderate to high stress at the entry level (just within the months of joining medical curriculum) and about one-third (36.8%) had depressive symptoms. Most of the students reported of using escape–avoidant type of coping while dealing with the ongoing stressors. More focus on improving resilience and positive adaptive coping skills in the initial formative years of medical education to prevent psychological morbidities and burnout in future years of medical education.