Resilience, stress, and coping among Canadian medical students
Open accessAbstract
BACKGROUND: Numerous studies have established that medical school is a stressful place but coping styles and resilience have not been adequately addressed as protective factors. METHOD: Using a cross-sectional design, 155 students were surveyed using the Connor-Davidson Resilience Scale, Perceived Stress Scale, and the Canadian Community Health Survey Coping Scale. Mean scores were compared by gender and between our sample and normative scores using t-tests. Multivariate linear regression was performed to examine whether stress levels were related to coping and resilience. RESULTS: Medical students had higher perceived stress, negative coping, and lower resilience than age and gender-matched peers in the general population. Male medical students had higher positive coping scores than general population peers and higher resilience, and lower perceived stress than female medical students. Coping scores did not vary by gender in our sample. The multivariate model showed that resilience and negative, but not positive coping, predicted stress. CONCLUSIONS: Medical students are neither more resilient nor better equipped with coping skills than peers in the population. Greater emphasis on self-care among medical trainees is recommended. Emphasizing the importance of self-care during medical training, whether by formal incorporation into the curriculum or informal mentorship, deserves further study.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Burnout prevalence in healthcare settings is significantly higher than in the general population.
“a significantly higher rate compared to the general population (4–6).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [6]
The Introduction (page not available) says about half of medical trainees experience burnout symptoms. The Results (page not available) find significantly higher perceived stress among medical students than among general-population peers. The paper does not establish that burnout prevalence is significantly higher than in the general population, or extend that comparison to healthcare settings generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSeveral studies demonstrate that resilience impacts mental health, including stress management and prevention of burnout.
“Several studies demonstrate the impact of resilience on mental health, showcasing its role in stress management and the prevention of burnout (3, 6, 15–19).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [6]
The Results report that resilience was inversely associated with perceived stress among Canadian medical students, supporting the stress-management part of the claim. The paper does not test whether resilience prevents burnout; burnout appears as background in the Introduction and in a reference title. Its observational association also does not demonstrate a causal impact on mental health. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)
Connor, K. M., & Davidson, J. R. T. (2003) · Depression and Anxiety · doi:10.1002/da.10113 · Cited by 11,793 · see citing works
Bonanno, G. A. (2004) · American Psychologist · doi:10.1037/0003-066x.59.1.20 · Cited by 6,851 · see citing works
(1988) · Cited by 4,111 · see citing works
Campbell‐Sills, L., & Stein, M. B. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20271 · Cited by 3,575 · see citing works
Coping theory and research: past, present, and future
Lazarus, R. S. (1993) · Psychosomatic Medicine · doi:10.1097/00006842-199305000-00002 · Cited by 3,253 · see citing works
Psychological Stress and Disease
Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007) · JAMA · doi:10.1001/jama.298.14.1685 · Cited by 3,168 · see citing works
Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006) · Academic Medicine · doi:10.1097/00001888-200604000-00009 · Cited by 2,909 · see citing works
A methodological review of resilience measurement scales
Windle, G., Bennett, K. M., & Noyes, J. (2011) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-9-8 · Cited by 2,079 · see citing works
Burnout and Suicidal Ideation among U.S. Medical Students
Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., et al. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-149-5-200809020-00008 · Cited by 1,532 · see citing works
Stress and depression among medical students: a cross-sectional study
Dahlin, M., Joneborg, N., & Runeson, B. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02176.x · Cited by 1,226 · see citing works
Further psychometric support for the 10-item version of the Perceived Stress Scale
Roberti, J. W., Harrington, L. N., & Storch, E. A. (2006) · Journal of College Counseling · doi:10.1002/j.2161-1882.2006.tb00100.x · Cited by 984 · see citing works
Quality of Life, Burnout, Educational Debt, and Medical Knowledge Among Internal Medicine Residents
West, C. P., Shanafelt, T. D., & Kolars, J. C. (2011) · JAMA · doi:10.1001/jama.2011.1247 · Cited by 720 · see citing works
How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study
Thomas, M. R., Dyrbye, L. N., Huntington, J. L., Lawson, K. L., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-006-0039-6 · Cited by 614 · see citing works
Sreeramareddy, C. T., Shankar, P. R., Binu, V. S. N., Mukhopadhyay, C., Ray, B., & Menezes, R. G. (2007) · BMC Medical Education · doi:10.1186/1472-6920-7-26 · Cited by 607 · see citing works
Levels and sources of stress in medical students.
Firth, J. (1986) · BMJ · doi:10.1136/bmj.292.6529.1177 · Cited by 558 · see citing works
Perceived stress during undergraduate medical training: a qualitative study
Radcliffe, C., & Lester, H. E. (2003) · Medical Education · doi:10.1046/j.1365-2923.2003.01405.x · Cited by 558 · see citing works
A Conceptual Model of Medical Student Well-Being: Promoting Resilience and Preventing Burnout
Dunn, L. B., Iglewicz, A., & Moutier, C. Y. (2008) · Academic Psychiatry · doi:10.1176/appi.ap.32.1.44 · Cited by 533 · see citing works
Shah, M., Hasan, S., Malik, S., & Sreeramareddy, C. T. (2010) · BMC Medical Education · doi:10.1186/1472-6920-10-2 · Cited by 472 · see citing works
Demographic and childhood environmental predictors of resilience in a community sample
Campbell‐Sills, L., Forde, D. R., & Stein, M. B. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.01.013 · Cited by 470 · see citing works
Towards an understanding of resilience and its relevance to medical training
Howe, A. C., Smajdor, A., & Stöckl, A. (2012) · Medical Education · doi:10.1111/j.1365-2923.2011.04188.x · Cited by 444 · see citing works
First year medical student stress and coping in a problem‐based learning medical curriculum
Moffat, K. J., McConnachie, A., Ross, S., & Morrison, J. M. (2004) · Medical Education · doi:10.1046/j.1365-2929.2004.01814.x · Cited by 443 · see citing works
Students, Stress and Coping Strategies: A Case of Pakistani Medical School
Shaikh, B. T., Kahloon, A., Kazmi, S. M. A., Khalid, H., Nawaz, K., Khan, N., & Khan, S. J. (2004) · Education for Health · doi:10.1080/13576280400002585 · Cited by 413 · see citing works
Embarking upon a medical career: psychological morbidity in first year medical students
Guthrie, E., Black, D., Shaw, C. M., HAMILTON, J. D., Creed, F. H., & Tomenson, B. (1995) · Medical Education · doi:10.1111/j.1365-2923.1995.tb00022.x · Cited by 356 · see citing works
Coulehan, J., & WILLIAMS, P. C. (2001) · Academic Medicine · doi:10.1097/00001888-200106000-00008 · Cited by 330 · see citing works
Li, P., Zhang, J., Li, M., Li, P., Zhang, Y., Zuo, X., Miao, Y., & Xu, Y. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.12.006 · Cited by 295 · see citing works
Impaired healthcare professional
Baldisseri, M. R. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000252918.87746.96 · Cited by 278 · see citing works
Kjeldstadli, K., Tyssen, R., Finset, A., Hem, E., Gude, T., Grønvold, N. T., Ekeberg, Ø., & Vaglum, P. (2006) · BMC Medical Education · doi:10.1186/1472-6920-6-48 · Cited by 274 · see citing works
Symptoms of anxiety and depression in Estonian medical students with sleep problems
Eller, T., Aluoja, A., Vasar, V., & Veldi, M. (2006) · Depression and Anxiety · doi:10.1002/da.20166 · Cited by 258 · see citing works
Stress, coping and health: enhancing well‐being during medical school
WOLF, T. M. (1994) · Medical Education · doi:10.1111/j.1365-2923.1994.tb02679.x · Cited by 240 · see citing works
Niemi, P. M., & Vainiomäki, P. (2006) · Medical Teacher · doi:10.1080/01421590600607088 · Cited by 208 · see citing works
Identifying and Assisting the Impaired Physician
Boisaubin, E., & Levine, R. (2001) · American Journal of the Medical Sciences · doi:10.1097/00000441-200107000-00006 · Cited by 185 · see citing works
Chronic Pain and Fatigue: Associations with Religion and Spirituality
Baetz, M., & Bowen, R. (2008) · Pain Research and Management · doi:10.1155/2008/263751 · Cited by 161 · see citing works
Self-citationEarly clinical exposure to people who are dying: learning to care at the end of life
MacLeod, R., Parkin, C., Pullon, S., & Robertson, G. A. J. (2003) · Medical Education · doi:10.1046/j.1365-2923.2003.01412.x · Cited by 155 · see citing works
Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls
Graff, L. A., Walker, J. R., Clara, I. P., Lix, L. M., Miller, N., Rogala, L., Rawsthorne, P. E., & Bernstein, C. N. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.529 · Cited by 126 · see citing works
Commentary: Medical Student Distress: A Call to Action
Dyrbye, L. N., & Shanafelt, T. D. (2011) · Academic Medicine · doi:10.1097/acm.0b013e31821da481 · Cited by 104 · see citing works
Burnout and Suicidal Ideation among U.S. Medical Students
THIERS, B. H. (2009) · Yearbook of Dermatology and Dermatologic Surgery · doi:10.1016/s0093-3619(08)79167-6 · Cited by 96 · see citing works
Using Behavior Change Plans to Improve Medical Student Self-Care
Kushner, R. F., Kessler, S., & McGaghie, W. C. (2011) · Academic Medicine · doi:10.1097/acm.0b013e31821da193 · Cited by 95 · see citing works
Nurturing resiliency in medical trainees
Dyrbye, L. N., & Shanafelt, T. D. (2012) · Medical Education · doi:10.1111/j.1365-2923.2011.04206.x · Cited by 77 · see citing works
Richman, J. A. (1992) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1992.tb01360.x · Cited by 34 · see citing works
Quality of Life, Burnout, Educational Debt, and Medical Knowledge Among Internal Medicine Residents
Stockman, J. A. (2012) · Yearbook of Pediatrics · doi:10.1016/j.yped.2011.12.003 · Cited by 31 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
García-León, M. Á., Pérez-Mármol, J. M., Gonzalez-Pérez, R., García-Ríos, M. D. C., & Peralta-Ramírez, M. I. (2019) · Physiology & Behavior · doi:10.1016/j.physbeh.2019.02.001 · Cited by 197 · see citing works
Othman, N., Ahmad, F., El Morr, C., & Ritvo, P. (2019) · International Journal of Mental Health Systems · doi:10.1186/s13033-019-0275-x · Cited by 177 · see citing works
Quintiliani, L., Sisto, A., Vicinanza, F., Curcio, G., & Tambone, V. (2022) · Psychology, Health & Medicine · doi:10.1080/13548506.2021.1891266 · Cited by 142 · see citing works
Moral distress and burnout in internal medicine residents
Sajjadi, S., Norena, M., Wong, H., & Dodek, P. (2017) · Canadian Medical Education Journal · doi:10.36834/cmej.36639 · Cited by 94 · see citing works
A pilot study of a longitudinal mindfulness curriculum in undergraduate medical education
MacLean, H., Braschi, E., Archibald, D., Sanchez-Campos, M., Jebanesan, D., Koszycki, D., & Gonsalves, C. (2020) · Canadian Medical Education Journal · doi:10.36834/cmej.56726 · Cited by 20 · see citing works
Digital resilience interventions for healthcare workers: a systematic review
Larsson, M., Ho, D. M., Kirschner, M., Seifritz, E., & Manoliu, A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1519670 · Cited by 14 · see citing works
- Authors
- Rahimi, B., Baetz, M., Bowen, R., & Balbuena, L.
- Affiliations
- University of Saskatchewan (CA)
- ORCID
- Balbuena, Lloyd
- Venue
- Canadian Medical Education Journal
- Published
- 2014-12-17
- Volume
- 5
- Issue
- 1
- Pages
- e5-e12
- ISSN
- 1923-1202 (ISSN-L)
- PMC
- PMC4563614
- OpenAlex
- W1507552269
- Cited by
- 123
- References
- 41
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 13 · 2023: 14 · 2022: 27 · 2021: 21 · 2020: 8 · 2019: 10 · 2018: 4 · 2017: 8 · 2015: 1
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Canadian Medical Education Journal (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- resilience, perceived stress, coping, medical students, medical education, gender differences, self-care, protective factors, negative coping, positive coping
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
