<b>Suicidal Ideation and Its Contributing Factors Among Medical Students</b>

Background: Suicidal ideation represents a critical public health issue among medical students, who are disproportionately affected by depression, academic stress, and psychological distress compared to their non-medical peers. Despite global recognition of this vulnerability, limited data exist from low- and middle-income countries, particularly Pakistan, where cultural and institutional factors may compound mental health risks. Objective: To determine the prevalence of suicidal ideation among medical students in a public medical college in Lahore, Pakistan, and to identify the associated psychosocial and academic risk factors. Methods: A cross-sectional observational study was conducted from March to September 2017 among 250 undergraduate medical students selected through stratified random sampling. Participants completed a self-administered 15-item questionnaire assessing depression, suicidal ideation, academic stress, social isolation, and coping mechanisms. Descriptive and inferential statistics, including odds ratios and 95% confidence intervals, were calculated using SPSS version 17.0. Results: Suicidal ideation was reported by 34.0% of students, with 21.6% experiencing frequent thoughts. Depression was present in 84.0% of respondents and was significantly associated with suicidal ideation (p < 0.001). Academic stress (OR = 4.18), social isolation (OR = 5.95), and family issues (OR = 4.82) were independently associated with elevated suicide risk. Female students and those in senior years reported higher prevalence. Conclusion: Suicidal ideation among Pakistani medical students is highly prevalent and closely linked with academic and psychosocial stressors. Institutional mental health strategies focusing on early identification, academic reform, and targeted support services are urgently needed to mitigate risk.