Financial Insecurity and Psychological Stress among Medical Students at Saint James School of Medicine: A Cross-Sectional Study

Abstract : Background: Financial insecurity is a growing concern among medical students and has been increasingly linked to adverse psychological outcomes. Students enrolled in international medical schools may be particularly vulnerable due to limited access to federal financial aid and increased reliance on private funding sources. Objective: This study aimed to examine the relationship between financial insecurity and perceived psychological stress among medical students at Saint James School of Medicine (SJSM). Methods: A cross-sectional survey was conducted among 84 SJSM medical students using an online questionnaire. Financial insecurity was measured using a custom financial insecurity scale, and psychological stress was assessed using the validated Perceived Stress Scale (PSS-10). Descriptive statistics, correlation analysis, and subgroup comparisons were performed. Results: The mean PSS-10 score was 22.0 (SD = 7.98), indicating moderate to high stress levels. Overall, 82% of participants reported moderate or high perceived stress. A statistically significant positive correlation was found between financial insecurity scores and PSS-10 scores (r = 0.600, p < 0.001), demonstrating that greater financial insecurity was associated with higher psychological stress. Most students reported substantial financial strain, with 72.6% expressing concern about tuition affordability and 66.7% reporting that their educational debt felt overwhelming. Female students reported higher mean stress scores (23.8) compared to male students (18.2). Stress negatively affected academic functioning, with 65.5% reporting difficulty concentrating while studying, and more than one-third indicating that financial worries negatively impacted class attendance. Conclusion: Financial insecurity was strongly associated with elevated perceived stress among SJSM medical students. These findings highlight the need for targeted institutional interventions, including expanded financial support systems, improved loan access, and integrated mental health resources to mitigate the academic and psychological impact of financial stress in international medical education settings.