Prevalence and correlates of perceived stress and psychological health among residents receiving standardized training: a multicenter cross-sectional survey study in China

Medical residents are increasingly conscious of psychological discomfort. However, comprehensive epidemiology on the prevalence and modifiable factors for their perceived stress and psychological health within China’s standardized residency training is lacking. The multicenter cross-sectional survey used convenience sampling to recruit participants from 177 teaching hospitals across 28 Chinese regions. Anonymous online questionnaires assessed demographics, training routines, subjective stress levels, and validated measures, including the Chinese Perceived Stress Scale and the Symptom Checklist-90 (SCL-90). A psychological health issue was defined as an SCL-90 total score ≥ 160, ≥ 43 positive items, or ≥ 2 in any symptom dimension. Among 2,104 respondents, 49.6% reported a psychological health concern, with no significant differences by gender or training duration (P > 0.05). Modifiable risk factors included staying up late (OR = 1.300; 95% CI: 1.059–1.595), frequent night shifts (OR = 1.304; 95% CI: 1.058–1.608), CPSS score (OR = 1.179; 95% CI: 1.157–1.201), and worsening sleep quality (graded effect: relatively poor sleep quality, OR = 1.503; 95% CI: 1.089–2.074; inferior sleep quality, OR = 2.720; 95% CI: 1.395–5.305). CPSS score ≥ 27 best predicts morbidity (AUC = 0.796, sensitivity = 67.4%, specificity = 75.6%), with interpersonal stress (β = 0.149, P < 0.001) and clinical work stress (β = 0.139, P < 0.001) identified as key stressors. Approximately 50% of Chinese medical residents exhibit psychological morbidity, primarily influenced by modifiable stressors. A CPSS score ≥ 27 serves as a preliminary screening threshold, indicating the necessity for training reforms focused on workload modulation and the enhancement of interpersonal skills.