Stress and resilience among first-year medical students: a cross-sectional application of the medical student stress scale

BACKGROUND: Burnout and clinical depression are often experienced by medical students in the United States, which impacts individual wellbeing as well as professionalism, empathy, and patient care. This study aimed to evaluate stress and wellbeing among first-year medical students at one accredited M.D. institution by administering the Medical Student Stress Scale (MSSS), a context-specific measure designed to capture multidimensional sources of medical student stress. METHODS: The MSSS, a 22-item questionnaire, was administered to first-year medical students during the 2024-2025 academic calendar, in the fall and spring, alongside a Brief Resilience Scale (BRS) and demographic questionnaire. According to the MSSS, stress was measured by calculating a summative score, ranging from 0 to 88, with higher scores indicative of greater levels of stress. The BRS measures resilience with a total score determined as a summation of the six item responses, categorized as low (1-2.99), normal (3-4.3), or high (4.31-5). RESULTS: The overall response rate was 61% (107/175) in the fall and 47% (87/175) in the spring. Average student stress scores in the fall and spring were 34.3 and 38.8, respectively. The resilience score in the fall and spring was 3.6 and 3.5, respectively. Multivariable linear regression showed that student stress decreased by 10 and 13 points with every 1-point increase on the BRS in the fall and spring, respectively (p < 0.001). This correlates with a 11-15% reduction in stress. Additionally, at both time points, males displayed a significantly lower estimated stress score than females (p = 0.044 and p = 0.016). In the spring, compared to students of Christian faith, Jewish students displayed an estimated 10-point increase in stress (p = 0.024), and Muslim students displayed an estimated 17-point increase in stress (p = 0.005). Additionally, students that reported they were low-income displayed an estimated 8-point increase in stress compared to non-low-income students (p = 0.009). CONCLUSION: To identify trends in both stress and resilience, the MSSS and BRS are feasible surveys to implement in medical schools. Understanding how stress and resilience are affecting medical students provides an opportunity to create tangible interventions to better support student wellness and create resilient physicians.