Perceived stress and coping skills in the newly joined medical undergraduate students: An exploratory study from Eastern India

Objectives: To assess the perceived stress and to evaluate the sources of stress, the prevalence of psychological morbidity (if any) and different coping strategies among the newly joined 1st-semester medical undergraduate students. Methodology: A cross-sectional exploratory study was conducted on all the newly joined 1st-year medical students (who had entered 3 months back) at a tertiary care medical college and teaching hospital in Eastern India. Perceived stress and depressive symptoms were assessed on the Perceived Stress Scale-10 (PSS-10) and Patient Health Questionnaire-9 (PHQ-9). A self-designed questionnaire was used to evaluate different premedical entry-level preparation issues and ongoing psychosocial and academic-related stressors. Coping was evaluated on the Ways of Coping Checklist. Results: Ninety-five first-semester medical undergraduate students (mean age − 18.34 ± 0.95 years) who had joined the Institute 3 months back participated in the study. The mean PSS score was 21.56 ± 3.97 and about 85.3% and 11.6% of the students reported moderate and high degrees of stress. Depressive symptoms were reported by 36.8% (PHQ-9 cut-off ≥10). During medical preparation (as rated on a Likert scale of 0-10), the mean rated stress level was 6.84 ± 2.05. Almost half of the students reported facing problems adjusting to the new place and environment (48.4%), facing language problems (11.6%), and unfavorable hostel facilities (10.5%). Under academic stressors - more than half of the students perceived the vastness of academic curriculum as a major stressor as "often" (53.7%) followed by fear of failure in exams (35.8%). Students followed both negative coping strategies (such as escape avoidance coping, distancing, and confrontive coping) and positive coping strategies (self-controlling, seeking social support, planful problem-solving, and positive appraisal). Significant association of depressive symptom score was found with self-controlling (P - 0.012) and seeking social support (P = 0.015) type of coping. Conclusion: A substantial proportion of undergraduate medical students have moderate to high stress at the entry level (just within the months of joining medical curriculum) and about one-third (36.8%) had depressive symptoms. Most of the students reported of using escape-avoidant type of coping while dealing with the ongoing stressors. More focus on improving resilience and positive adaptive coping skills in the initial formative years of medical educati