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

Abstract

Background: 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. Methods: 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. Conclusion: 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.