Stressors and coping strategies among Egyptian medical students under the integrated curriculum: a multicenter cross-sectional study

TL;DR

Egyptian medical students under a new curriculum experience high academic stress, with females and those with chronic illnesses being most affected.

Contribution

This study identifies key stressors and coping strategies among Egyptian medical students under an integrated curriculum, highlighting gender and socioeconomic disparities.

Findings

Academic-related stressors had the highest stress levels, with 'lack of time to review' and 'large content load' being top stressors.

Female students and those with chronic illnesses experienced higher stress and lower coping scores.

Students predominantly used emotion-focused and avoidance coping strategies rather than problem-focused ones.

Abstract

Egypt’s recent shift to an integrated (5+2) medical curriculum aims to enhance clinical competence but may also intensify stress among students. Understanding stressors and coping mechanisms is critical for promoting student well-being. This study aims to assess the levels and domains of stress, identify their predictors, and evaluate coping strategies among undergraduate medical students in Egypt.

A multicenter cross-sectional study was conducted among 984 undergraduate medical students from Egyptian universities between April and May 2024 with response rate of 98.4%. Data were collected via a structured online questionnaire including demographics, the validated Medical Student Stressor Questionnaire (MSSQ), and the Coping Scale. Stressor domains were scored on a 0–4 Likert scale and coping on a 1–4 scale. Univariate and multivariate regression analyses identified predictors of stress and coping levels.Results:Academic-Related Stressors (ARS) recorded the highest mean score (2.97 ± 0.81), with “lack of time to review” and “large content load” as top stressors. Drive and Desire-Related Stressors (DRS) scored lowest (1.80 ± 1.18). High to severe stress prevalence was greatest in Academic Related Stress (ARS, 82.6%), followed by Group Activities-Related Stressors (GARS, 57.2%) and Interpersonal/Intrapersonal-Related Stressors (IRS, 54.7%). Female students showed significantly higher odds of stress in ARS, TLRS, SRS, DRS, and GARS and had lower coping scores (β = –0.21, p = 0.025). Rural residence increased odds of IRS (AOR = 1.67, p =0.047). Monthly income between 5,000 and 10,000 L.E. was associated with lower coping scores (β = –0.93, p = 0.040). Upcoming exams amplified stress across GARS,and TLRS. Chronic illness was linked to higher SRS (AOR = 1.81, p = 0.01). Overall, students relied more on emotion-focused and avoidance coping, while problem-focused strategies were less frequently employed.

Egyptian medical students face substantial stress, predominantly academic in nature, under the integrated curriculum. Targeted institutional strategies—such as workload adjustments, clear academic expectations, anti-abuse measures, and resilience training—are needed to foster a healthier learning environment.

The online version contains supplementary material available at 10.1186/s12909-025-08487-8.

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