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The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis
Open accessAbstract
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
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“a meta-analysis revealed that approximately 1 in 3 medical students worldwide experiences anxiety, a rate significantly exceeding that of the general population [5].”
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“Regarding anxiety, a meta-analysis reported a pooled prevalence of 33.8%, which was highest in Middle Eastern and Asian countries, but the range varies across individual studies [43].”
InfluentialMengesha, A. K., Misker, M. F., & Tadesse, S. A. (2025) · Scientific Reports · doi:10.1038/s41598-025-99177-4 · Cited by 15
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Sintomas de depressão, ansiedade e estresse em estudantes da saúde e impacto na qualidade de vida
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BackgroundBurnout and clinical learning environment among residents in Tehran: A cross-sectional study
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The Impact of Changing Step 1 to Pass/Fail Reporting on Anxiety, Learning Approaches, and Curiosity
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Maddalena, N. D. C. P., Lucchetti, A. L. G., Moutinho, I. L. D., Ezequiel, O. D. S., & Lucchetti, G. (2023) · International Journal of Social Psychiatry · doi:10.1177/00207640231206061 · Cited by 17
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“For novice researchers, a requirement to engage in research, including simple tasks such as accessing library resources for research, at the medical school level can produce anxiety, possibly adding to already tenuous confidence in their ability to master the medical curriculum [8-10].”
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“8% globally, which is also substantially higher than in the general population [3].”
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“Nevertheless, some studies showed no signi cant difference between mean score of anxiety and gender (21, 28).”
BackgroundResultInfluentialA novel model to predict mental distress among medical graduate students in China
Guo, F., Yi, M., Sun, L., Luo, T., Han, R., Zheng, L., Jin, S., Jun, W., Lei, M., & Gao, C. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03573-9 · Cited by 12
“8% among medical students, which is significantly higher than the general population [3].”
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“Medical students have been shown to present poorer mental health compared to the general population and aged-matched peers (Dyrbye et al., 2006; Quek et al., 2019; Rotenstein et al., 2016) as well as a high prevalence of burnout (Erschens et al., 2019; Frajerman et al., 2019).”
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“Studies have reported that medical schools have one of the most demanding academic programs (Wolf, 1994) and include students at higher risk for developing anxiety disorders, compared to the general population, even under normal circumstances (Quek et al., 2019).”
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Mood and Sleep Quality in Peruvian Medical Students During COVID-19 Pandemic
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Moore, M. B., Yang, D. H., Raines, A. M., Bailey, R. K., & Beg, W. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.929227 · Cited by 11
Sadeghi, H., Alizadeh, A., Vafaie, M., Maleki, M. R., & Khoei, S. G. (2023) · BMC Pediatrics · doi:10.1186/s12887-023-04081-3 · Cited by 11
“Studies, Satisfactory Studies, Good Studies, and Very Good Studies, respectively [12].”
MethodAcademic Burnout, Stress, and the Role of Resilience in a Sample of Saudi Arabian Medical Students
Al-Awad, F. A. (2024) · Medical Archives · doi:10.5455/medarh.2024.78.39-43 · Cited by 11
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More than Cramps in Scrubs: Exploring Dysmenorrhea among Women Healthcare Workers
Yáñez‐Sarmiento, A., Kiel, L., Kaufman, R. A., Abioye, O. F., & Florez, N. (2024) · International Journal of Women s Health · doi:10.2147/ijwh.s452210 · Cited by 11
“14 Similarly, the prevalence of anxiety among women healthcare workers is reported to be 44% 15 and as high as 65% in health sciences students, 16 whereas only one-quarter of the general population is estimated to be susceptible to anxiety.”
BackgroundChen, Q., Mao, C., Qi, L.-H., Luo, Y., Yang, G., Wang, L., Liu, C., Zheng, C., Zhang, J.-X., & Fan, C. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1401129 · Cited by 18
“Notably, medical school students, due to the prolonged duration required for acquiring knowledge and skills in the field of medicine, face heightened levels of mental and physical stress (Adams, 2004; O’Rourke et al., 2010; Quek et al., 2019; Zeng et al., 2019).”
BackgroundYe, X., Yang, G., Zhang, W., Toussaint, L. L., & Zhao, F. (2025) · BMC Nursing · doi:10.1186/s12912-024-02661-x · Cited by 12
Boyd, N., & Alexander, D. (2022) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v28i0.1840 · Cited by 15
“This included (1) sample demographic characteristics (age, gender and year of study), (2) Clinical Outcomes in Routine Evaluation – Outcome Measure (COREOM),51 (3) Warwick-Edinburgh Mental Well-being Scale (WEMWBS),52 (4) Perceived Stress Scale (PSS),53 (5) SelfCompassion Scale – short form (SCS-sf)54 and (6) feedback…”
MethodAlhussain, F. A., Onayq, A. I. B., Ismail, D., Alduayj, M. A., Alawbathani, T. A., & Aljaffer, M. A. (2022) · Journal of Family and Community Medicine · doi:10.4103/jfcm.jfcm_227_22 · Cited by 11
“8% global prevalence of anxiety in medical students.[8] The prevalence of stress is even greater in first year medical students since they need to cope with all sorts of stressors in a short period.”
BackgroundFond, G. B., Picot, A., Bourbon, A., Boucékine, M., Auquier, P., Lançon, C., & Boyer, L. (2020) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-020-01131-0 · Cited by 11
Technologies and Mental Health in University Students: An Unhealthy Combination
da Silva, M. P. F. N., Cardoso, G. M. D. S., Filho, S. R. P., Weber, S. A. T., & Corrêa, C. D. C. (2022) · International Archives of Otorhinolaryngology · doi:10.1055/s-0042-1748807 · Cited by 10
“There is an overall prevalence of anxiety of 26.4% in basic cycle medical students ( fi rst 2 years),19 comparing with our study, the result is similar to that of the literature by the classi fi cation of probable anxiety (25.4%), but when comparing with the classi fi cation of possible anxiety…”
ResultInfluentialShreevastava, A. K., Mavai, M., Mittal, P. S., Verma, R., Kaur, D., & Bhandari, B. (2022) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_1273_21 · Cited by 10
El‐Sayed, M. M., Ghazi, G. A., Kamal, M. A., & Khedr, M. A. (2024) · BMC Nursing · doi:10.1186/s12912-024-02104-7 · Cited by 11
Symptoms of Anxiety and Depression in Italian Nursing Students: Prevalence and Predictors
Curcio, F., de Pinho, L. G., Rago, C., Bartoli, D., Pucciarelli, G., & González, C. I. A. (2024) · Healthcare · doi:10.3390/healthcare12212154 · Cited by 10
Chen, X., Yang, Y., Zhong, C., Zeng, X., Qiu, X., Zhou, X., Liu, C., Tian, Z., Liu, B., & Yin, R. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06909-x · Cited by 11
Faruk, M. O., Mamun, M. A., Siddique, A. B., & Griffiths, M. D. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00603-1 · Cited by 10
The Development of a Comprehensive Mental Health Service for Medical Trainees
Hasan, S., Pozdol, S. L., Nichelson, B. K., Cunningham, S. J., Lasek, D. G., & Dankoski, M. E. (2022) · Academic Medicine · doi:10.1097/acm.0000000000004789 · Cited by 12
Perspectives on mental health services for medical students at a Ugandan medical school
Kihumuro, R. B., Kaggwa, M. M., Nakandi, R. M., Kintu, T. M., Muwanga, D. R., Muganzi, D. J., Atwau, P., Ayesiga, I., Acai, A., Najjuka, S. M., et al. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03815-8 · Cited by 10
Altaf, R., Kling, M., Hough, A., Baig, J., Ball, A. L., Goldstein, J., Brunworth, J., Chau, C., Dybas, M., Jacobs, R. J., et al. (2022) · Cureus · doi:10.7759/cureus.24071 · Cited by 10
“Medical students were found to experience more depressive episodes in in-person 12 months than the general population of 18 to 49-year-olds [3,4]; the test was performed on a large-scale meta-analysis which demonstrated that the prevalence of anxiety in medical students was 33.”
MethodKarim, M. R., Ahmed, H. U., & Akhter, S. (2022) · F1000Research · doi:10.12688/f1000research.122927.1 · Cited by 8
Illness Anxiety Disorder and Distress among Female Medical and Nursing Students
Hawamdeh, S., Moussa, F. L., Al-Rawashdeh, S. Y., Al-Hawamdih, S., & Moussa, M. L. (2023) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/0117450179277976231115070100 · Cited by 9
Vomhof, M., Bau, J., Hüter, P., Stehl, S., Haastert, B., Loerbroks, A., Icks, A., Calo, S., Schuster, L., Pischke, C. R., et al. (2024) · JMIR Formative Research · doi:10.2196/55921 · Cited by 10
Student anxiety in the wake of the COVID-19 pandemic
Zulfiqarova, U., & Dresp, B. (2024) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb7294 · Cited by 9
“Analyses for gender produced no statistically significant difference [4].”
InfluentialHan, C., Ding, J., He, H., Peiyao, Z., Zhang, X., Xiaowen, Y., & Zheng, A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1496248 · Cited by 9
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“This makes medical students vulnerable, and more prone to burnout and anxiety relative to enrolees in other programs [115,116].”
Depression in Romanian Medical Students—A Study, Systematic Review, and Meta-Analysis
DUICA, L. C., Negoita, S. I., Pleșea-Condratovici, A., Moroianu, L.-A., Ignat, M. D., Nicolcescu, P., Ciubară, A., Robles-Rivera, K., Mititelu-Tarțău, L., & Pleșea-Condratovici, C. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14165853 · Cited by 12
Yusefi, A. R., Beigzadeh, A., & Kaya, F. (2025) · BMC Medical Education · doi:10.1186/s12909-025-08063-0 · Cited by 24
Effect of lockdown due to COVID-19 pandemic on mental health of pre-medical students of Maharashtra
Khetan, M. S., Vaishnao, L. S., & Kewalramani, M. S. (2020) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20203917 · Cited by 9
“Gender Normal (0-7) Mild anxiety (8-9) Moderate anxiety (10-14) Severe anxiety (15-19) Very Severe anxiety (> 20) No.”
BackgroundWang, C., Darbari, I., Tolaymat, M., Quezada, S. M., Allen, J., & Cross, R. K. (2022) · Psychology in the Schools · doi:10.1002/pits.22809 · Cited by 11
Az orvostanhallgatók számára fenntartott mentálhigiénés segítségnyújtás szerepe.
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“The global prevalence rates of anxiety and depression in medical students before the pandemic were approximately 34% and 28%, respectively, with the rates in European countries being at approximately 28% [9] and 20% [25].”
BackgroundViolencia y estrés percibido por estudiantes de primer año medicina de una universidad pública, 2016
Amemiya, I., Oliveros, M., Evangelista, Z. A., Chávez, M. M., & Barrientos, A. (2019) · Anales de la Facultad de Medicina · doi:10.15381/anales.v80i4.16296 · Cited by 9
Consommation de cigarettes et de cigarettes électroniques des étudiants en santé
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Mortazavi, F., & Ghardashi, F. (2021) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045211056922 · Cited by 9
“…students’ lived experiences in the COVID-19 pandemic, both as a part of the wider population and as a specific group exhibiting higher levels of depression and anxiety than the general population as a result of severe psychological pressures in the environment where they train (Quek et al., 2019).”
BackgroundMental health help-seeking among Brazilian medical students: Who suffers unassisted?
Bastos, T. M., Bumaguin, D. B., Astolfi, V. R., Xavier, A. Z., Hoffmann, M. S., Ornell, F. R., Spritzer, D. T., Bassols, A. M. S., DIEMEN, L. V., Laskoski, P. B., et al. (2022) · International Journal of Social Psychiatry · doi:10.1177/00207640221082930 · Cited by 9
“Recent systematic reviews and meta-analyses have estimated that around one in three medical students globally have anxiety (Quek et al., 2019), while more than one in four students suffer from significant depressive symptoms (Puthran et al.”
BackgroundAlnaser, A. R., Joudeh, R. M., Zitoun, O. A., Battah, A., Al-Odat, I. A., Jum’ah, M., & Battah, A. A. (2021) · Middle East Current Psychiatry · doi:10.1186/s43045-021-00150-4 · Cited by 9
“Moreover, the rates of AX and Dep in Jordanian MSs are higher than those in other Asian countries such as Bangladesh, where around 66% had different levels of AX and 50% had Dep symptoms during May 2020 [34].”
BackgroundInfluentialWang, D., Lin, B., Zhang, S., Xu, W., & Liu, X. (2024) · Journal of Medical Internet Research · doi:10.2196/50664 · Cited by 10
Emotional Profiles of Anxiety, Depression, and Stress: Differences in School Anxiety
Vicent, M., Suriá, R., Gonzálvez, C., Aparicio-Flores, M. D. P., Sanmartín, R., & García-Fernández, J. (2023) · Psychological Reports · doi:10.1177/00332941231184384 · Cited by 8
“This is also a stage in which people are more conscious of the image they project to their peers (Daros et al., 2019; Gonz´alez et al., 2019; Guerrero-Barona et al., 2019; Tian-Ci Quek et al., 2019).”
InfluentialGrüneberg, C., Bäuerle, A., Karunakaran, S., Darici, D., Dörrie, N., Teufel, M., Benson, S., & Robitzsch, A. (2024) · JMIR Medical Education · doi:10.2196/58183 · Cited by 9
“These findings are consistent with extant research documenting the psychological vulnerability of medical students, illustrating elevated levels of anxiety and depression [1,6,50].”
Vagiri, R. V., Mohlabe, K., Mailula, L., Nhubunga, F., Maepa, M., Mphasha, M. H., Mokoena, M. P., Mayimele, N. N., Bangalee, V., Grootboom, W., et al. (2025) · Healthcare · doi:10.3390/healthcare13060649 · Cited by 8
Factors Associated With Suicidal Ideation in College Students of Health Sciences
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“Among the various studies on anxious and depressive symptomatology in university students, it has been shown that in medical students the prevalence rate of anxiety symptoms is 33.8 % [14].”
InfluentialL’hote, D., Potiron, L., & Levaillant, M. (2026) · BMC Medical Education · doi:10.1186/s12909-025-08386-y · Cited by 8
Liebig, L., Balogh, E., Birkás, B., Faubl, N., Zelko, E., Gräfe, W., Pieper, S., Gottschall, M., & Riemenschneider, H. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1735186 · Cited by 9
AlJahwari, B., AlKamli, A., Al‐Huseini, S., Chan, M. F., AlMahroqi, B., Saadoon, M. A., Ambusaidi, A., Ganesh, A., & Al‐Adawi, S. (2022) · Middle East Current Psychiatry · doi:10.1186/s43045-022-00214-z · Cited by 8
“[14] reported in a meta-analysis that the rate of anxiety among medical students in the Middle East and Asia exceeds those of their counterparts in the rest of the world, making it especially necessary to explore this statistical prevalence.”
BackgroundAlmutairi, A., & Jahan, S. (2022) · Health Psychology Research · doi:10.52965/001c.37016 · Cited by 8
Büssing, A., Zupanic, M., Ehlers, J. P., & Taetz-Harrer, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191711098 · Cited by 8
“It was advised that medical schools facilitate help-seeking behaviors when their students feel stressed and anxious in order to avoid stigmatizing mental health problems [42].”
BackgroundMartínez‐Fierro, M. L., Ayala-Haro, A. E., Pinedo-Hurtado, M. E., Solís-Galván, J. A., Veloz, I. G., Velazquez-Lopez, Z. Y., Camacho-Martinez, A. G., Ávila-Carrasco, L., Vázquez-Reyes, S., Velasco-Elizondo, P., et al. (2022) · Brain Sciences · doi:10.3390/brainsci12091223 · Cited by 10
Metadata
- Authors
- Tian-Ci Quek, T., Wai-San Tam, W., X. Tran, B., Zhang, M., Zhang, Z., Su-Hui Ho, C., & Chun-Man Ho, R.
- Affiliations
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119007, Singapore
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 119007, Singapore
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
- Huaibei Normal University (CN)
- Department of Psychological Medicine, National University Health System, Singapore 119007, Singapore
- Corresponding author
- Zhang, Zhisong
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-07-31
- Volume
- 16
- Issue
- 15
- Pages
- 2735
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6696211
- OpenAlex
- W2965255255
- Cited by
- 990
- References
- 136
- Citations by year
- 2026: 141 · 2025: 130 · 2024: 186 · 2023: 165 · 2022: 174 · 2021: 124 · 2020: 66 · 2019: 3
- FWCI
- 16.82
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- National University of Singapore (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- This study received funding from the National Social Science Fund (General Project of Education) (BBA170063)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- anxiety, medical students, prevalence, risk factors, mental health, medical education, help-seeking, stigma, gender differences, year of study
- MeSH terms
- Anxiety, Humans, Risk Factors, Students, Medical, Global Health, Models, Statistical, Prevalence, Odds Ratio
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