Email updates

Keep up to date with the latest news and content from BMC Medical Education and BioMed Central.

Open Access Highly Accessed Open Badges Research article

Perceived Stress, Sources and Severity of Stress among medical undergraduates in a Pakistani Medical School

Mohsin Shah1*, Shahid Hasan2, Samina Malik2 and Chandrashekhar T Sreeramareddy3

Author Affiliations

1 3rd year Undergraduate Medical Student, CMH Lahore Medical College, University of Health Sciences, Abdur Rahman Road, Lahore Cantt, Pakistan

2 Department of Physiology, CMH Lahore Medical College, University of Health Sciences, Abdur Rahman Road, Lahore Cantt, Pakistan

3 Department of Community Medicine, Melaka Manipal Medical College, Malaysia

For all author emails, please log on.

BMC Medical Education 2010, 10:2  doi:10.1186/1472-6920-10-2

Published: 15 January 2010



Recently there is a growing concern about stress during undergraduate medical training. However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases.


A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to March 2009. Perceived stress was assessed using the perceived stress scale. A 33-item questionnaire was used to assess sources of stress and their severity.


The overall response rate was 80.5% (161 out of 200 students). The overall mean perceived stress was 30.84 (SD = 7.01) and was significantly higher among female students. By logistic regression analysis, stressed cases were associated with occurrence of psychosocial (OR 5.01, 95% CI 2.44-10.29) and academic related stressors (OR 3.17 95% CI 1.52-6.68). The most common sources of stress were related to academic and psychosocial concerns. 'High parental expectations', 'frequency of examinations', 'vastness of academic curriculum', 'sleeping difficulties', 'worrying about the future', 'loneliness', 'becoming a doctor', 'performance in periodic examinations' were the most frequently and severely occurring sources of stress. There was a negative but insignificant correlation between perceived stress and academic performance (r = -0.099, p > 0.05).


A higher level of perceived stress was reported by the students. The main stressors were related to academic and psychosocial domains. Further studies are required to test the association between stressed cases and gender, academic stressors and psychosocial stressors.