Stress and coping skills in medical students

Article information

Korean J Med Educ. 2025;37(1):59-63

Publication date (electronic) : 2025 February 26

doi : https://doi.org/10.3946/kjme.2025.323

Yu Ra Kim ¹

, Hye Jin Park ²

, Seong Yong Kim^,¹

¹Department of Medical Education and Humanities, Yeungnam University College of Medicine, Daegu, Korea

²Department of Medical Education, Eulji University School of Medicine, Daejeon, Korea

Corresponding Author: Seong Yong Kim (https://orcid.org/0000-0003-3419-2699) Department of Medical Education and Humanities, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82.53.640.6987 Fax: +82.53.629.7093 email: seongyong@med.yu.ac.kr

*These authors contributed equally to this work as first authors.

Received 2024 October 4; Revised 2024 November 26; Accepted 2024 December 24.

Abstract

Purpose

This study aims to confirm the degree of stress perceived by medical students in Korea and to study the difference between the methods used to relieve stress. In addition, this study evaluates the stress relief methods medical students believe are effective.

Methods

The subjects of the study were 147 students of a medical school in Korea who voluntarily participated in an online survey. The degree of stress perceived by medical students in Korea was confirmed, and the differences between the methods used to relieve stress were analyzed, along with the effective stress relief methods considered by the students themselves.

Results

There was no difference found in the degree of stress experienced by medical students based on their year in school and gender. The most commonly reported method to relieve stress was sleep, and it was found that this method provided the highest degree of stress relief.

Conclusion

As stress has been consistently reported as an issue among medical students, tackling stress among medical students should not be handled solely at the individual level.

Keywords: Medical education; Medical student; South Korea; Stress

Introduction

Medical students experience higher levels of stress compared to other college students of the same age [1-3]. It has been shown that the stress experienced by medical students primarily leads to emotional and psychological maladjustment, such as low academic achievement, interpersonal problems, depression, and anxiety. Additionally, stress also affects students’ subjective and psychological well-being, particularly in their day-to-day lives as college students [4]. Studies on stress in medical schools are mainly focused on comparing stress by year in school and gender, as well as the relationship between stress and other psychological factors. However, relatively few studies focused on ways to relieve stress. Serious situations may arise when the stress experienced by medical students is left unattended. Particularly, students tend to have the perspective that stress is an unavoidable phenomenon that all medical students experience. There is also the belief that stress is an issue that can be resolved naturally over time [1,4].

Therefore, this study seeks to confirm the level of stress perceived by medical students in Korea, as well as study the stress relief methods that students believe to be the most effective. It is expected that this study will be used as basic data to formulate effective methods to manage stress in the future. Accordingly, the purpose of this study is to understand the current state of stress of medical students and how it can be effectively relieved. Hence, the following research questions have been established.

First, how do medical students evaluate their stress level, and is there a difference based on students’ gender and year in school for their perceived levels of stress? Second, what are the causes of stress in medical students, and are there differences based on their gender, year in school, and degree of stress? Third, what are the methods most commonly used to relieve stress, and what methods are considered to be the most effective?

Methods

1. Subject of study and data collection

This study was conducted on a total of 147 subjects, consisting of 75 first-year medical students and 72 second-year medical students at a medical college in Daegu region. All participants were informed of the study, and informed consent was obtained. All surveys were conducted online using Google Forms (Google LLC, Mountain View, USA), and a total of 141 questionnaires were analyzed. These questionnaires consisted of 75 questionnaires from first-year medical students and 66 questionnaires from second-year medical students. Six questionnaires were excluded because they were answered insincerely.

2. Instruments

Two medical education experts and one expert from the medical field produced the questionnaire for this study. The questionnaire in this study indicated respondents’ gender and year in school, and it included questions on the frequency of stress that students experienced. These questions were answered on a 5-point Likert scale. Medical students were instructed to indicate their amount of stress on a scale from 1 to 100, where 0% represented no stress and 100% represented the maximum level of stress. In addition, several causes of stress were listed, and students were asked to choose one of them. These causes included academic problems, economic problems, interpersonal problems, and other problems. Respondents were then asked about methods used to relieve stress, which one they use most often, and which method is the most effective. To answer these questions, respondents were asked to choose from the following responses: sleeping, eating, listening to music, looking at art, watching sports, playing a musical instrument, drawing, dancing, exercising, playing games, reading, meeting with friends, watching videos, and other methods. Except for the questions on stress relief methods, where duplicate responses were allowed, respondents could only choose one response when answering questions.

3. Statistical analysis

In this study, the following analysis was conducted to study medical students’ stress relief methods. First, an independent sample T-test was conducted to confirm the difference in stress frequency and differences based on respondents’ gender and year in school. Second, to analyze the causes of stress, cross-analysis was conducted to evaluate the causes of stress based on respondents’ gender and year in school. Third, a frequency analysis was conducted on the methods most commonly used to relieve stress, as well as the methods considered to be the most effective in relieving stress.

4. Ethical statements

This study received an exemption from deliberation from the Institutional Review Board (IRB) of Eulji University because the subject of the study was a survey that had already been conducted in class.

Results

1. Characteristics of participants

Among the 141 students whose responses were used in this study, 75 respondents (53%) were first-year medical students, and 66 respondents (47%) were second-year medical students (Table 1). As for the gender distribution, 89 respondents (63%) were male, and 52 (37%) were female.

Table 1.

Differences in Frequency and Amount of Stress by Gender and Grade

2. Stress frequency and differences based on respondents’ gender and year in school

An independent sample T-test was conducted to confirm the frequency and amount of stress based on respondents’ gender (Table 1). As a result, there was no statistical difference in stress frequency (t=–1.70) and stress amount (t=–1.25) (p>0.01).

An independent sample T-test was conducted to confirm the frequency and amount of stress based on students’ year in school (Table 1). As a result, there was no statistical difference found in stress frequency (t=0.40) and stress amount (t=1.09) (p>0.01).

3. Stress causes

A cross-tabulation was performed to verify the difference in the percentage of stressors based on respondents’ gender (Table 2). The results showed that male respondents indicated academic problems, followed by interpersonal problems, other problems, and economic problems. In contrast, female respondents prioritized academic problems, followed by other problems, economic problems, and interpersonal problems.

Table 2.

Differences in Causes of Stress according to Gender and Grade

A cross-tabulation was performed to verify the difference in the proportion of stressors based on respondents’ year in school (Table 2). The results showed that first-year medical students reported academic problems as their primary stress, followed by interpersonal problems, other problems, and economic problems. Similarly, second-year medical students indicated academic problems as their main stress, followed by interpersonal problems, economic problems, and other problems.

As a result of the chi-square test to determine the statistical significance of differences in stress causes based on respondents’ gender and year in school, it was found that there was no significant difference(p>0.05) (Table 2).

4. The best method to relieve stress

A frequency analysis was conducted to identify the most common ways to relieve stress (Table 3). The results showed that the methods most commonly used to relieve stress, and the methods considered most effective in relieving stress were sleep (24.1% used, 24.8% effective), physical exercise (11.3% used, 22.0% effective), and meeting with friends (7.8% used, 14.9% effective). However, watching videos, eating, and playing games were the next most popular ways to relieve stress.

Table 3.

Analysis of Method to Relieve Stress

Discussion

As a result of this study, there was no difference found in the degree of stress experienced by medical students based on their year in school and gender. The biggest cause of medical students’ stress was reported to be academic problems. It was found that medical students relieve stress by sleeping, watching videos, exercise, eating food, listening to music, meeting friends, and playing game. Medical students identified sleeping, exercise, and meeting with friends as the methods considered most effective in relieving stress. However, it was observed that, except for sleeping, these methods differed from the ones they commonly used to relieve stress. This highlights a discrepancy between the methods commonly employed for stress relief and those perceived as most effective by medical students. Based on the results of this study, the following suggestions can be made.

Stress in medical students is likely the result of their heavy workload, frequent testing, and psychological pressure relating to repeating coursework [5-7]. In addition, the coronavirus disease 2019 pandemic has further contributed to the stress levels of medical students [8].

Now that the pandemic is over, and considering that the things mentioned above are inevitable, the following should be considered, medical schools should work to develop various programs to relieve students’ stress, with more focus placed on enhancing the effort involved and securing physical resources such as space. Because stress-reducing experiences play a significant role in educational environments for stress relief [9], medical schools should work to develop strategies to reduce students’ stress and assist in their ability to recover [10].

This study is limited in that it evaluated medical students from the first 2 years in school, which corresponds to the basic medical curriculum of a medical university in Korea. Therefore, future studies should focus on targeting a wide range of groups in various regions by addressing these limitations.

Notes

Acknowledgements

None.

Funding

No financial support was received for this study.

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

Author contributions

Conception or design of the work; YRK, HJP, SYK: data collection; YRK, SYK: data analysis and interpretation; YRK, HJP, SYK: drafting the article; YRK, HJP: critical revision of the article; YRK, HJP, SYK: and final approval of the version to be published; YRK, HJP, SYK.

References

1. Bramness JG, Fixdal TC, Vaglum P. Effect of medical school stress on the mental health of medical students in early and late clinical curriculum. Acta Psychiatr Scand 1991;84(4):340–345.

2. Bjorksten O, Sutherland S, Miller C, Stewart T. Identification of medical student problems and comparison with those of other students. J Med Educ 1983;58(10):759–767.

3. Lee IR, Kim MK, Kim HW. The influence of coping strategies and social support on the level of perceived stress in medical students. Anxiety Mood 2021;17(1):12–18.

4. Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med 1998;91(5):237–243.

5. Lee KH, Ko Y, Kang KH, Lee HK, Kang J, Hur Y. Mental health and coping strategies among medical students. Korean J Med Educ 2012;24(1):55–63.

6. Han SS, Lee SY, Choi WS, Kim SJ, Park SB, Lee SY. Depression and its influencing factors among Korean medical and engineering students in urban areas using Zung Self-Rating Depression Scale. Korean J Fam Med 2009;30(7):539–548.

7. Kim NC, Kim SH, Lhm HK, et al. Comparison of stress and life satisfaction between non-medical and medical college students. Korean J Psychosom Med 2015;23(1):47–56.

8. Kim YR, Park HJ, Koo BH, Hwang JY, Lee YH. A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study. J Yeungnam Med Sci 2022;39(4):314–321.

9. Natalia D, Syakurah RA. Mental health state in medical students during COVID-19 pandemic. J Educ Health Promot 2021;10:208.

10. Mohmand S, Monteiro S, Solomonian L. How are medical institutions supporting the well-being of undergraduate students?: a scoping review. Med Educ Online 2022;27(1):2133986.

Article information Continued

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.