Stress effects: A study of salivary cortisol levels in third-year medical students

  • Tseng T
  • Iosif A
  • Seritan A
  • 2


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.


The physical, mental and emotional stresses experienced during the training and careers of physicians have been linked to increased rates of anxiety, depression and suicide. Increased stress leads to alterations in the hypothalamic-pituitary-adrenal (HPA) axis, which can determine multisystem modulations with acute and chronic consequences. This study investigated salivary cortisol patterns in third-year medical students performing clinical work at a US medical school. Morning and evening salivary cortisol samples were collected from students during the last 2 weeks of each of three successive clinical rotations and while on vacation. Salivary cortisol levels were measured using Siemens radioimmunoassay kits (Siemens Medical Solutions Diagnostics, Los Angeles, CA, USA). Statistical analysis used mixed-effects regression models. Eleven students submitted 64 salivary samples. Statistically significant blunting of the diurnal cortisol variation was observed in students on inpatient rotations. HPA axis changes occur in third-year medical students performing inpatient clinical work. These findings can inform curriculum planning, rotation-specific guidelines and the development of student wellness programmes. Copyright © 2011 John Wiley & Sons, Ltd.

Author-supplied keywords

  • adult
  • anxiety
  • article
  • circadian rhythm
  • cortisol
  • curriculum
  • depression
  • emotional stress
  • female
  • human
  • human experiment
  • hydrocortisone
  • hypothalamus hypophysis adrenal system
  • male
  • medical school
  • medical student
  • mental stress
  • physical stress
  • radioimmunoassay
  • saliva level
  • stress
  • suicide
  • wellbeing
  • wellness

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • T Tseng

  • A M Iosif

  • A L Seritan

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free