College Adjustment of Premedical Students amid Overlapping Cohorts after the Medical Crisis in Korea: A Nationwide Cross-Sectional Survey Study

The 2024 medical crisis in South Korea prompted nationwide leaves of absence among medical students, with multiple entering cohorts now studying together in the premedical curriculum. This study examined premedical students’ college adjustment under these conditions, including differences by student characteristics and experiences, its relationship with professional identity, and students’ support needs. A nationwide cross-sectional survey was conducted in May 2026 at all 39 medical schools offering premedical programs. After invalid responses were excluded, the main analyses included 884 students from the 2024–2026 cohorts. Analyses comprised descriptive statistics, the chi-square test, two-level random-intercept multilevel models with students nested within universities, Pearson correlations, and multiple regression. Overall adjustment exceeded the scale midpoint (mean=3.67 of 5), but adjustment in career preparation was lowest, and crisis-related experiences differed significantly by cohort. With cohort, leave duration, class format, and inter-cohort conf lict considered together, lower adjustment was associated with inter-cohort conf lict (b=–0.328) and exclusively combined-cohort classes (b=–0.221). Cohort itself was not significant, and mixed formats did not differ from same-cohort classes. Professional identity correlated positively with adjustment (r=0.60), and attachment and detachment jointly explained 40.6% of the variance. Students prioritized support for the learning environment and career preparation over emotional support, with needs differing by cohort. Recovery efforts should address inter-cohort relationships, reduce exclusively combined-cohort classes, improve the learning environment, and provide support tailored to each cohort with student participation.