Phase-contingent resilience effects in multilingual medical students: a cross-sectional examination of student demands-resources theory

Introduction The Student Demands–Resources (SDR) theory proposes that psychological and environmental resources may become more relevant as situational demands increase. This mechanism remains underexamined in medical students. We assessed whether resilience and language proficiency were associated with academic engagement across training phases in a multilingual medical cohort. Methods We surveyed 422 medical students at an international medical school (May–September 2024). Hierarchical multiple regression modeled academic engagement (UWES-9S) as a function of psychological resilience (BRS), Arabic language proficiency, clinical training phase, prior residence, and social support (DSSI). The Resilience × Clinical Phase interaction was specified a priori ; other interactions were exploratory. Results The main-effects model explained 52.8% of variance in engagement ( R 2 = 0.528). Resilience ( β = 0.418, f 2 = 0.370), sex ( β = −0.410, f 2 = 0.356), and Arabic proficiency ( β = 0.370, f 2 = 0.267) showed the largest effects. The resilience–engagement association was stronger in clinical than preclinical students (standardized β : 0.630 vs. 0.291; interaction β = 0.339, p < 0.001, f 2 = 0.129). Female students showed lower overall engagement, with differences concentrated in specific dimensions. Social support showed small positive associations across dimensions. Sensitivity analysis excluding prior residence yielded near-identical estimates and unchanged inference (reduced-model R 2 = 0.525; Δ R 2 = −0.003). Conclusion These hypothesis-generating findings are consistent with phase-contingent resource–engagement associations in SDR theory within medical education. The cross-sectional design and indirect demand proxy do not support causal inference.