Introduction: As the prevalence of stress is rising rapidly among the community, it is important to understand their stressors and coping strategies for creating a psychological-friendly environment for the students in the future. The study aim was to explore the stress level, stressors, and coping strategies among first year medical students in Malaysian public universities and factors contributed to the stress at the end of year. Methodology: A multicenter cross-sectional study involving four Malaysian public universities. The 12-item General Health Questionnaire (GHQ-12), Medical Student Stressor Questionnaire (MSSQ) and Brief COPE inventory were self-administered to measure stress level, sources of stress and coping strategies respectively among the participants. Calculated sample size was 387. Results: Out of 387 selected participants, 359 (92.7%) responded to this survey. This study found that the prevalence of distressed first year medical students at the end of year was 50%. The major stressors across the universities were academic-related issues. The top five coping strategies were religion, active coping, positive reinterpretation, acceptance and planning. University, parent income, and academic, group activities, and desire related stressors were significant factors contributing to the students’ stress (p-value < 0.05). Conclusion: This study found that there was a high prevalence of distressed among first year medical students at the end of year, the major stressors were related to academic and contributing factors of stress were related to university, coping strategy, types of stressor and parent income status. Training first year medical students on adaptive coping strategies, managing stressors, and improving peer-group supports to the students will help to improve this condition.

Introduction: Various studies had been done on medical students stress, but there is yet no comparative study done between universities in Asia and Europe. Universiti Sains Malaysia (USM) and Universiteit Maastricht (UM) share a lot in common in terms of medical education as both actively apply PBL-oriented education into their curriculum. It will be interesting to find out the effect of differing culture, one Eastern and another Western, on the prevalence of stress and stressors among medical students of both universities. Method: A comparative study was conducted on medical students from USM and UM. Psychological distress was measured by the 12 item General Health Questionnaire and stressors were measured by the 40 item Medical Student Stressor Questionnaire. The calculated sample size was 215 per university. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 20. Result: Results showed that the overall prevalence of psychological distress among medical students of USM and UM was 25.9% and no significant difference was found between the two universities. Binary logistic regression test showed that medical students in pre-clinical phase were 1.84 times more likely to develop psychological distress than medical students in clinical phases (B = 0.612, odd ratio (CI95%) = 1.84 (1.16, 2.93), p = 0.010). The major stressors were related to academic requirements, UM medical students perceived the stressors as causing less stress than USM medical students (t-stat (df) = 5.33 (380), p-value < 0.001). Conclusion: Psychological health among medical students in the two universities was comparable. Academic requirements were the most stressful events as perceived by the students, but UM medical students had more positive perception toward the stressors than USM medical students. Pre-clinical students experienced higher psychological pressures than the clinical students. The medical schools should provide more attention to pre-clinical students because they might need psychological support from them.