Physical exercise-induced mental health benefits in future physicians: a dual-chain mediation of peer support and professional identity formation

Abstract

Objective: This study investigates the dual chain mediating roles of peer support and professional identity formation in the relationship between physical exercise and mental health among medical students. Methods: A cross-sectional survey was conducted on 420 medical students in China, using structural equation modeling (SEM) to test hypothesized pathways. Results: Exercise frequency demonstrated a significant direct association with better mental health (β = 0.28, P < 0.001). Two distinct mediating pathways were supported: (1) a significant serial mediation chain (exercise → peer support → professional identity → mental health; β = 0.044, P < 0.001) and (2) a significant parallel mediation chain (exercise → professional identity → mental health; β = 0.074, P < 0.001). Multi-group analysis revealed that the mediating role of professional identity was significantly stronger in clinical-year students (e.g., path from exercise to professional identity: Δβ = 0.10, P = 0.005). Limitations: The cross-sectional design precludes causal inference, and the cultural and professional specificity of the sample may affect generalizability. Conclusion: These findings highlight the complex psychosocial mechanisms through which exercise is associated with enhanced mental health in future physicians, with implications for targeted intervention design.