Objectives: Although there is much focus on burnout and psychological distress amongst doctors, studies about stress and wellbeing in medical students are limited but could inform early intervention and prevention strategies.

Design: The primary aim of this mixed methods, cross-sectional survey was to compare objective and subjective levels of stress in Final Year Medical students (2017) and to explore their perspectives on the factors they considered relevant to their wellbeing.

Setting: University College Dublin, the largest University in Ireland.

Participants: 161 of 235 medical students participated in this study (response rate 69%).

Results: 65.2% of students scored over accepted norms for the Perceived Stress Scale (34.8% low; 55.9% moderate; 9.3% high). 35% scored low; 28.7% moderate and 36.3% high on the Subjective Stress Scale. Thematic Analysis identified worry about exams, relationships, concern about future, work-life balance and finance; 1 in 3 students reported worry, irritability and hostility; many felt worn out. Cognitive impacts included over-thinking, poor concentration, sense of failure, hopelessness and procrastination. Almost a third reported sleep and appetite disturbance, fatigue and weariness. A quarter  reported a “positive reaction” to stress. Positive strategies to manage stress included connection and talking, exercise, non-study activity  and meditation. Unhelpful strategies included isolation and substance use. No student reported using the college support services or sought professional help.

Conclusions: Medical students experience high levels of psychological distress, similar to their more senior doctor colleagues. They are disinclined to avail of traditional college help services. Toxic effects of stress may impact their cognition, learning, engagement and empathy and increase patient risk and adverse outcomes. The focus of wellbeing in doctors should be extended upstream and embedded in the curriculum where it could prevent future burnout, improve retention to the profession and deliver better outcomes for patients.

The participants in this study were Final Year Medical Students from Ireland’s largest University, University College Dublin (UCD). A typical final medical year is made up of around 240 students who are divided into four groups and then rotate through the different specialities of Paediatrics, Obstetrics and Gynaecology, Public Health, Medicine of the Elderly, General Practice and Psychiatry. 

The class included both Graduate Entry (GEM) and undergraduate (non-GEM) students. In UCD GEM and undergraduate students come together at year 4. Students were informed of the study and invited to participate in week five of their six-week Psychiatry Module.

Data was collected as part of a larger project that examines the impact of an eLearning module on Stress and Self-care. We embedded a new problem based small group teaching module on stress and self-care within the curriculum at pre-clinical and clinical teaching. We further developed an interactive eLearning module on Stress and Self-care and made this available to the same groups. The present study is descriptive and mixed-methods in nature and focuses on baseline stress levels in medical students prior to exposure to any educational intervention, embedded or electronic.

Students were assured that all data was anonymised and confidential. Ethical approval for the study was obtained from the Head of School in accordance with University College Dublin Regulations. Due to the sensitive nature of the questions, students were informed of the student support services available to them and encouraged to seek help if needed.

Data presented in Excel format. See also Questionnaire relating to the dataset.