Mental Health Challenges and Psychological Protective Resources among Medical Students in Zhejiang Province, China

Authors

Lu Qian

PhD Candidate, Faculty of Educational Sciences and Technology, Universiti Teknologi Malaysia, Malaysia (Malaysia)

Aqeel Khan

Faculty of Educational Sciences and Technology, Universiti Teknologi Malaysia, Malaysia (Malaysia)

Adibah Abdul Latif

Faculty of Educational Sciences and Technology, Universiti Teknologi Malaysia, Malaysia (Malaysia)

Article Information

DOI: 10.47772/IJRISS.2026.100800442

Subject Category: Education

Volume/Issue: 10/8 | Page No: 6882-6895

Publication Timeline

Submitted: 2026-08-07

Accepted: 2026-08-12

Published: 2026-09-08

Abstract

Medical students experience substantial psychological demands arising from intensive academic workloads, competitive learning environments, clinical responsibilities, and uncertainty about professional development. Depression, anxiety, and suicidal ideation are therefore important but distinct mental health concerns in medical education. Although resilience, social support, and mindfulness have each been associated with more favourable psychological outcomes, these resources are often examined separately, limiting understanding of how they may jointly protect medical students. This conceptual paper synthesises recent evidence on mental health challenges and psychological protective factors among medical students, with particular attention to the educational context of Zhejiang Province, China. Guided by Conservation of Resources theory, it proposes an integrated protective resource framework in which resilience represents adaptive personal capacity, social support represents relational and institutional resources, and mindfulness represents attentional and self-regulatory capacity. These resources are conceptualised as complementary mechanisms that may help students preserve, obtain, and regulate resources when facing sustained academic and clinical demands. The framework also emphasises that student mental health cannot be addressed solely through individual-level interventions. Medical schools should coordinate resilience development, peer and faculty support, accessible counselling, mindfulness provision, psychologically safe learning environments, and clear referral procedures for students at risk. However, the proposed relationships remain theoretical and require empirical examination through longitudinal, multicentre, and intervention studies. By integrating individual and contextual protection, this paper provides a theoretically grounded basis for future research and for developing coordinated mental health strategies within medical education in Zhejiang and comparable settings.

Keywords

educational psychology

Downloads

References

1. Agyapong-Opoku, F., Agyapong-Opoku, N., Agyapong, B., & Greenshaw, A. J. (2025). Suicidal behaviors among medical students: A scoping review of systematic reviews and meta-analyses. Behavioral Sciences, 15(9), Article 1215. https://doi.org/10.3390/bs15091215 [Google Scholar] [Crossref]

2. Agyapong-Opoku, N., Agyapong-Opoku, F., Agyapong, B., & Greenshaw, A. J. (2026). Anxiety and depressive symptoms among medical students—A scoping review of systematic reviews and meta-analyses. Frontiers in Public Health, 13, Article 1710333. https://doi.org/10.3389/fpubh.2025.1710333 [Google Scholar] [Crossref]

3. Aljuwaiser, S., Brazzelli, M., Arain, I., & Poobalan, A. (2024). Common mental health problems in medical students and junior doctors: An overview of systematic reviews. Journal of Mental Health, 33(6), 779–815. https://doi.org/10.1080/09638237.2023.2278095 [Google Scholar] [Crossref]

4. Almansour, M., & Almoayad, F. (2024). Exploring challenges and perceptions in the learning environment: An online qualitative study of medical students. BMC Medical Education, 24, Article 147. https://doi.org/10.1186/s12909-024-05116-8 [Google Scholar] [Crossref]

5. Alshehri, A., Alshehri, B., Alghadir, O., & Basamh, A. (2023). The prevalence of depressive and anxiety symptoms among first-year and fifth-year medical students during the COVID-19 pandemic: A cross-sectional study. BMC Medical Education, 23, Article 411. https://doi.org/10.1186/s12909-023-04387-x [Google Scholar] [Crossref]

6. Azim, S. R., Yusoff, M. S. B., & Roslan, N. S. (2025). Mapping the multidimensional factors of medical student resilience development: A scoping review. BMC Medical Education, 25, Article 744. https://doi.org/10.1186/s12909-025-07290-9 [Google Scholar] [Crossref]

7. Balson, C., York, J., Cipriano, D., Fritz, J. D., Kohlbeck, S., Huang, S., & Lieb, M. (2024). Assessment of a pilot peer support program for suicide prevention on a medical school campus: Impact on awareness, stigma, and self-efficacy for outreach. WMJ, 123(3), 195–198. [Google Scholar] [Crossref]

8. Bitar, A., Boman, J., & Kristoffersson, E. (2025). Burnout and psychological safety: A questionnaire study of medical students. Journal of Medical Education and Curricular Development, 12, 23821205251359380. https://doi.org/10.1177/23821205251359380 [Google Scholar] [Crossref]

9. Chakeeyanun, B., Wongpakaran, N., Wongpakaran, T., & Oon-arom, A. (2023). Resilience, perceived stress from adapted medical education related to depression among medical students during the COVID-19 pandemic. Healthcare, 11(2), Article 237. https://doi.org/10.3390/healthcare11020237 [Google Scholar] [Crossref]

10. Chen, F., Chen, J., Chen, B., Mofatteh, M., Wen, C., Wellington, J., Gong, D., Yang, H., Zeng, Z., Miao, X., Wu, S., & Chen, Y. (2022). Mental health status of medical students during postgraduate entrance examination. BMC Psychiatry, 22, Article 829. https://doi.org/10.1186/s12888-022-04482-1 [Google Scholar] [Crossref]

11. Chen, G., Wang, H., Zhou, L., Yang, J., Xu, L., & Liang, Y. (2024). Development and applications of graduate outcome-based curriculum for basic medical education. Frontiers in Medicine, 11, Article 1400811. https://doi.org/10.3389/fmed.2024.1400811 [Google Scholar] [Crossref]

12. Chen, J., Tuersun, Y., Yang, J., Xiong, M., Wang, Y., Rao, X., & Jiang, S. (2022). Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: A mediation analysis. BMC Medical Education, 22, Article 627. https://doi.org/10.1186/s12909-022-03683-2 [Google Scholar] [Crossref]

13. Cheng, J., Liao, M., He, Z., Xiong, R., Ju, Y., Liu, J., Liu, B., Wu, B., & Zhang, Y. (2023). Mental health and cognitive function among medical students after the COVID-19 pandemic in China. Frontiers in Public Health, 11, Article 1233975. https://doi.org/10.3389/fpubh.2023.1233975 [Google Scholar] [Crossref]

14. da Silva, C. C. G., Bolognani, C. V., Amorim, F. F., & Imoto, A. M. (2023). Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: A systematic review and meta-analysis. Systematic Reviews, 12, Article 79. [Google Scholar] [Crossref]

15. Dai, P., Yi, G., Qian, D., Wu, Z., Fu, M., & Peng, H. (2023). Social support mediates the relationship between coping styles and the mental health of medical students. Psychology Research and Behavior Management, 16, 1299–1313. https://doi.org/10.2147/PRBM.S405580 [Google Scholar] [Crossref]

16. Darvishi, N., Farhadi, M., & Poorolajal, J. (2024). The role of social support in preventing suicidal ideations and behaviors: A systematic review and meta-analysis. Journal of Research in Health Sciences, 24(2), Article e00609. https://doi.org/10.34172/jrhs.2024.144 [Google Scholar] [Crossref]

17. Di Maria, C., & Didelez, V. (2024). Longitudinal mediation analysis with multilevel and latent growth models: A separable effects causal approach. BMC Medical Research Methodology, 24, Article 248. https://doi.org/10.1186/s12874-024-02358-4 [Google Scholar] [Crossref]

18. Dodin, Y., Obeidat, N., Dodein, R., Seetan, K., Alajjawe, S., Awwad, M., Adwan, M., Alhawari, A., ALkatari, A., Alqadasi, A. A.-L., & Alsheyab, G. (2024). Mental health and lifestyle-related behaviors in medical students in a Jordanian university, and variations by clerkship status. BMC Medical Education, 24, Article 1283. https://doi.org/10.1186/s12909-024-06273-6 [Google Scholar] [Crossref]

19. Donnellan, C., Chakkittakandy, D., & Lydon, C. (2024). Conceptual considerations for understanding resilience in healthcare students. Nursing Open, 11(10), Article e70061. [Google Scholar] [Crossref]

20. Fang, Y., Yang, M., Huang, W., Zhang, Y., Gao, X., Chen, Y., Meng, S., & Zeng, S. (2025). The evaluation of depression, anxiety, and stress among undergraduate dental students in graduation year in mainland China: A cross-sectional study. BMC Medical Education, 25, Article 543. https://doi.org/10.1186/s12909-025-07141-7 [Google Scholar] [Crossref]

21. First, M. B., Clarke, D. E., Yousif, L. H., Eng, A. M., Gogtay, N., & Appelbaum, P. S. (2023). DSM-5-TR: Rationale, process, and overview of changes. Psychiatric Services, 74(8), 869–875. [Google Scholar] [Crossref]

22. Gellisch, M., Olk, B., Schäfer, T., & Brand-Saberi, B. (2024). Unraveling psychological burden: The interplay of socio-economic status, anxiety sensitivity, intolerance of uncertainty, and stress in first-year medical students. BMC Medical Education, 24, Article 945. https://doi.org/10.1186/s12909-024-05924-y [Google Scholar] [Crossref]

23. Gunawan, D., Antico, L., Nardi, W., & Brewer, J. (2025). Developing a mindfulness program for pre-clinical medical students in Indonesia: A mixed-methods study on suitability and appropriateness. BMC Medical Education, 25, Article 1072. https://doi.org/10.1186/s12909-025-07642-5 [Google Scholar] [Crossref]

24. Guo, H.-B., & Qiu, C. (2024). How do stressful life events affect medical students’ academic adjustment? Parallel mediating mechanisms of anxiety and depression. BMC Medical Education, 24, Article 617. https://doi.org/10.1186/s12909-024-05601-0 [Google Scholar] [Crossref]

25. Hadaki, A., Snowbar, A., Alsayes, A., Shoqeir, A., Musa, T., Manlarasool, M. B., & Latifeh, Y. (2025). The cherry on top: Nice but necessary? The impact of social support on perceived stress, depressive symptoms, and academic performance among medical students at Damascus University. BMC Psychology, 13, Article 1092. https://doi.org/10.1186/s40359-025-03329-0 [Google Scholar] [Crossref]

26. Healy, C., Ryan, Á., Moran, C. N., Harkin, D. W., Doyle, F., & Hickey, A. (2023). Medical students, mental health and the role of resilience—A cross-sectional study. Medical Teacher, 45(1), 40–48. https://doi.org/10.1080/0142159X.2022.2128735 [Google Scholar] [Crossref]

27. Hiranwong, T., Wongpakaran, N., Sitthiprawiat, P., Siritikul, S., Jiwtrakul, J., Klaychaiya, S., Chaipinchana, P., Kuntawong, P., Deesomchok, A., Wedding, D., & Wongpakaran, T. (2025). Prevalence and impact of mistreatment on academic motivation among clinical year medical students in Thailand. Scientific Reports, 15, Article 27870. https://doi.org/10.1038/s41598-025-12572-9 [Google Scholar] [Crossref]

28. Huang, F., Lu, W., Zhao, X., Li, N., Zhao, T., Guo, S., Liu, B., Ren, R., Yang, L., Wang, L., Gao, Y., Wang, R., Song, M., Lin, Q., Xu, Y., Jin, N., Liu, K., Bai, M., & Wang, X. (2024). Suicidal ideation in medical students of Hebei Province: Prevalence and associated factors. Frontiers in Psychiatry, 15, Article 1398668. https://doi.org/10.3389/fpsyt.2024.1398668 [Google Scholar] [Crossref]

29. Huang, P. C., Lin, C. Y., Huang, R. Y., Chen, J. S., Griffiths, M. D., Strong, C., Wang, H. W., Chen, C. Y., Ko, N. Y., & Shieh, S. J. (2024). The effect of social support and resource support on emotional exhaustion, insomnia, and suicidal ideation among allied health trainees and post-graduate year doctors in Taiwan. BMC Psychology, 12, Article 322. https://doi.org/10.1186/s40359-024-01811-9 [Google Scholar] [Crossref]

30. Huang, Z., Zhang, L., Wang, J., Xu, L., Liu, Z., Wang, T., Guo, M., Xu, X., & Lu, H. (2021). Social support and subjective well-being among postgraduate medical students: The mediating role of anxiety and the moderating role of alcohol and tobacco use. Heliyon, 7(12), Article e08621. https://doi.org/10.1016/j.heliyon.2021.e08621 [Google Scholar] [Crossref]

31. Jahrami, H., AlKaabi, J., Trabelsi, K., Pandi-Perumal, S. R., Saif, Z., Seeman, M. V., & Vitiello, M. V. (2023). The worldwide prevalence of self-reported psychological and behavioral symptoms in medical students: An umbrella review and meta-analysis of meta-analyses. Journal of Psychosomatic Research, 173, 111479. https://doi.org/10.1016/j.jpsychores.2023.111479 [Google Scholar] [Crossref]

32. Jenet, A., Tillmann, J., Ehlers, J., Herzog, K., Nitsche, J., Weckbecker, K., & Münster, E. (2025). Mental health and financial concerns in medical students: Insights from a cross-sectional study in Germany. BMC Medical Education, 25, Article 1273. https://doi.org/10.1186/s12909-025-07723-5 [Google Scholar] [Crossref]

33. Jestin, M., Sharma, S., Jhaveri, D., Mitchell, B., Micciche, D., Venkataraman, V., & Lambert, K. (2023). Mental health differences in medical students based on curriculum and gender. BMC Medical Education, 23, Article 971. https://doi.org/10.1186/s12909-023-04946-2 [Google Scholar] [Crossref]

34. Jeyapalan, T., & Blair, E. (2024). The factors causing stress in medical students and their impact on academic outcomes: A narrative qualitative systematic review. International Journal of Medical Students, 12(2), 195–203. https://doi.org/10.5195/ijms.2024.2218 [Google Scholar] [Crossref]

35. Kaisti, I., Kulmala, P., Hintsanen, M., Hurtig, T., Repo, S., Paunio, T., Miettunen, J., Halt, A.-H., & Jääskeläinen, E. (2024). The effects of mindfulness-based interventions in medical students: A systematic review. Advances in Health Sciences Education, 29(1), 245–271. https://doi.org/10.1007/s10459-023-10231-0 [Google Scholar] [Crossref]

36. Li, J., Zhang, Y., Chan, B. S. M., Tan, S. N., Lu, J., Luo, X., Shen, Y., & Zhang, X. Y. (2022). Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students. Frontiers in Psychiatry, 13, Article 1012298. https://doi.org/10.3389/fpsyt.2022.1012298 [Google Scholar] [Crossref]

37. Li, R., Hassan, N. C., Zhu, Q., Ouyang, S., & Dong, J. (2025). A systematic review on the impact of social support on college students’ wellbeing and mental health. PLOS ONE, 20(7), Article e0325212. [Google Scholar] [Crossref]

38. Li, X., Xu, Y., Li, G., Ning, L., Xie, X., Shao, C., Liu, C., & Yang, X. (2024). The relationship between academic procrastination and anxiety symptoms among medical students during the COVID-19 pandemic: Exploring the moderated mediation effects of resilience and social support. BMC Psychiatry, 24, Article 850. https://doi.org/10.1186/s12888-024-06202-3 [Google Scholar] [Crossref]

39. Lin, Y.-K., Saragih, I. D., Lin, C.-J., Liu, H.-L., Chen, C.-W., & Yeh, Y.-S. (2024). Global prevalence of anxiety and depression among medical students during the COVID-19 pandemic: A systematic review and meta-analysis. BMC Psychology, 12, Article 338. [Google Scholar] [Crossref]

40. Lin, Z.-Z., Cai, H.-W., Huang, Y.-F., Zhou, L.-L., Yuan, Z.-Y., He, L.-P., & Li, J. (2025). Prevalence of depression among university students in China: A systematic review and meta-analysis. BMC Psychology, 13, 373. https://doi.org/10.1186/s40359-025-02688-y [Google Scholar] [Crossref]

41. Liu, Y., & Cao, Z. (2022). The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience. Frontiers in Public Health, 10, Article 938132. https://doi.org/10.3389/fpubh.2022.938132 [Google Scholar] [Crossref]

42. Manley, A. E., Perry, R., Moran, P. A., Dawson, S., Biddle, L. A., & Savović, J. (2026). Effect of medical school initiatives on help seeking for mental health problems among medical students: A systematic review and meta-analysis. BMJ Open, 16(2), e111351. https://doi.org/10.1136/bmjopen-2025-111351 [Google Scholar] [Crossref]

43. Mateen, A., Kumar, V., Singh, A. K., Yadav, B., Mahto, M., & Mahato, S. (2024). Suicide and suicidal ideation in medical students: A systematic review. Cureus, 16(7), Article e65246. [Google Scholar] [Crossref]

44. Ministry of Education of the People’s Republic of China. (2022, March 25). 浙江省对标共同富裕示范区建设,努力办好人民满意的教育——2022年全国教育工作会议经验交流之十 [Zhejiang Province aligns educational development with the construction of the common prosperity demonstration zone: Experience exchange from the 2022 National Education Work Conference]. https://www.moe.gov.cn/jyb_sjzl/s3165/202203/t20220325_610663.html [Google Scholar] [Crossref]

45. Moore, S., Mavaddat, N., Auret, K., Hassed, C., Chambers, R., Sinclair, C., Wilcox, H., & Ngo, H. (2024). The Western Australian medical schools mindfulness project: A randomised controlled trial. BMC Medical Education, 24, Article 1182. https://doi.org/10.1186/s12909-024-06128-0 [Google Scholar] [Crossref]

46. Nowakowska-Domagała, K., Podlecka, M., Sadowski, K., Pietras, T., & Mokros, Ł. (2023). The relationship between chronotype, dispositional mindfulness and suicidal ideation among medical students: Mediating role of anxiety, insomnia and social dysfunction. Journal of Sleep Research, 32(4), Article e13823. https://doi.org/10.1111/jsr.13823 [Google Scholar] [Crossref]

47. Ong, R. S. R., Wong, R. S. M., Chee, R. C. H., Quek, C. W. N., Burla, N., Loh, C. Y. L., Wong, Y. A., Chok, A. K.-L., Teo, A. Y. T., Panda, A., Chan, S. W. K., Shen, G. S., Teoh, N., Chin, A. M. C., & Krishna, L. K. R. (2022). A systematic scoping review moral distress amongst medical students. BMC Medical Education, 22, Article 466. https://doi.org/10.1186/s12909-022-03515-3 [Google Scholar] [Crossref]

48. Peng, P., Hao, Y., Liu, Y., Chen, S., Wang, Y., Yang, Q., Wang, X., Li, M., Wang, Y., He, L., Wang, Q., Ma, Y., He, H., Zhou, Y., Wu, Q., & Liu, T. (2023). The prevalence and risk factors of mental problems in medical students during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders, 321, 167–181. https://doi.org/10.1016/j.jad.2022.10.040 [Google Scholar] [Crossref]

49. Preovolos, C., Grant, A., Rayner, M., Fitzgerald, K., & Ng, L. (2024). Peer mentoring by medical students for medical students: A scoping review. Medical Science Educator, 34, 1577–1602. https://doi.org/10.1007/s40670-024-02108-7 [Google Scholar] [Crossref]

50. Razgulin, J., Argustaitė-Zailskienė, G., Petrolienė, R., & Šmigelskas, K. (2024). Sociocultural adjustment and social support as predictors for international medical sciences students’ anxiety during COVID-19. BMC Medical Education, 24, Article 395. https://doi.org/10.1186/s12909-024-05379-1 [Google Scholar] [Crossref]

51. Rijnhart, J. J. M., Lamp, S. J., Valente, M. J., MacKinnon, D. P., Twisk, J. W. R., & Heymans, M. W. (2021). Mediation analysis methods used in observational research: A scoping review and recommendations. BMC Medical Research Methodology, 21, Article 226. https://doi.org/10.1186/s12874-021-01426-3 [Google Scholar] [Crossref]

52. Ru, X., Chen, L., Chen, Z., Huang, Y., Liu, R., & Ye, Q. (2025). A study on the psychological well-being and professional identity of medical students following post-epidemic reopening. Medicine Advances, 3(4), 346–355. https://doi.org/10.1002/med4.70040 [Google Scholar] [Crossref]

53. Saad, S., & Ali, S. (2025). Academic resilience in medical students: Exploring students’ perception of social support provided by peers and teachers to help at-risk students for the successful academic journey. BMC Medical Education, 25, Article 271. https://doi.org/10.1186/s12909-025-06858-9 [Google Scholar] [Crossref]

54. Selak, Š., Crnkovič, N., Šorgo, A., Gabrovec, B., Cesar, K., & Žmavc, M. (2024). Resilience and social support as protective factors against suicidal ideation among tertiary students during COVID-19: A cross-sectional study. BMC Public Health, 24, Article 1942. https://doi.org/10.1186/s12889-024-19470-1 [Google Scholar] [Crossref]

55. Seo, E. H., Yang, H.-J., Kim, S.-G., & Yoon, H.-J. (2022). Ego-resiliency moderates the risk of depression and social anxiety symptoms on suicidal ideation in medical students. Annals of General Psychiatry, 21, Article 19. https://doi.org/10.1186/s12991-022-00399-x [Google Scholar] [Crossref]

56. Shan, Y., Ji, M., Xie, W., Li, R., Qian, X., Zhang, X., & Hao, T. (2022). Interventions in Chinese undergraduate students’ mental health: Systematic review. Interactive Journal of Medical Research, 11(1), e38249. https://doi.org/10.2196/38249 [Google Scholar] [Crossref]

57. Sheldon, E., Ezaydi, N., Desoysa, L., Young, J., Simmonds-Buckley, M., Hind, D., & Burton, C. (2024). Barriers to help-seeking, accessing and providing mental health support for medical students: A mixed methods study using the candidacy framework. BMC Health Services Research, 24, Article 738. https://doi.org/10.1186/s12913-024-11204-8 [Google Scholar] [Crossref]

58. Sinval, J., Oliveira, P., Novais, F., Almeida, C. M., & Telles-Correia, D. (2025). Exploring the impact of depression, anxiety, stress, academic engagement, and dropout intention on medical students’ academic performance: A prospective study. Journal of Affective Disorders, 368, 665–673. https://doi.org/10.1016/j.jad.2024.09.116 [Google Scholar] [Crossref]

59. Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374, n2061. https://doi.org/10.1136/bmj.n2061 [Google Scholar] [Crossref]

60. Tie, H., Luo, Y., & Chen, D. (2024). Thinkings on the reform of medical education system in China. Medical Education Online, 29(1), Article 2302677. https://doi.org/10.1080/10872981.2024.2302677 [Google Scholar] [Crossref]

61. Wadi, M., Shorbagi, A., Shorbagi, S., Taha, M. H., & Yusoff, M. S. B. (2024). The impact of the Systematic Assessment for Resilience framework on students’ resilience, anxiety, depression, burnout, and academic-related stress: A quasi-experimental study. BMC Medical Education, 24, Article 506. https://doi.org/10.1186/s12909-024-05444-9 [Google Scholar] [Crossref]

62. Wang, H., Ying, X., Zhang, L., Yang, T., & Zhang, W. (2025). The association between doctor–patient conflict and uncertainty stress during clinical internships among medical students: A panel study. Healthcare, 13(9), 1080. https://doi.org/10.3390/healthcare13091080 [Google Scholar] [Crossref]

63. Wang, J., Liu, M., Bai, J., Chen, Y., Xia, J., Liang, B., Wei, R., Lin, J., Wu, J., & Xiong, P. (2023). Prevalence of common mental disorders among medical students in China: A systematic review and meta-analysis. Frontiers in Public Health, 11, 1116616. https://doi.org/10.3389/fpubh.2023.1116616 [Google Scholar] [Crossref]

64. Wang, S., Wei, T., Zhu, R., Li, S., Liu, X., Cai, Y., & Gong, R. (2023). Perceived entrapment predicts first-onset suicidal ideation: A longitudinal study among medical students in China. Frontiers in Public Health, 10, Article 1049975. https://doi.org/10.3389/fpubh.2022.1049975 [Google Scholar] [Crossref]

65. World Federation for Medical Education. (2025). WFME declaration on institutions’ responsibility to support medical students, physicians in postgraduate education and physicians in practice. https://wfme.org/wp-content/uploads/2025/02/WFME-Declaration-2025_v10_clean.pdf [Google Scholar] [Crossref]

66. World Health Organization. (2022). World mental health report: Transforming mental health for all. [Google Scholar] [Crossref]

67. Yamazaki, J., Kizuki, M., & Fujiwara, T. (2022). Association between frequency of conversations and suicidal ideation among medical students during COVID-19 pandemic in Japan. International Journal of Environmental Research and Public Health, 19(11), Article 6385. https://doi.org/10.3390/ijerph19116385 [Google Scholar] [Crossref]

68. Yang, S., Yang, X., Li, X., Chen, L., Zheng, Y., & Dai, Z. (2026). Core self-evaluation and learning burnout among first-year medical students: A three-wave longitudinal study on the mediating roles of anxiety-related distress and problematic digital media use. Frontiers in Medicine, 13, Article 1818069. https://doi.org/10.3389/fmed.2026.1818069 [Google Scholar] [Crossref]

69. Yay-Pence, A., Aslan, S., Coldur, M., Atalay, Z., Beba, B., Coskun-Sayin, C., Aydin, E., Gumus, Z., Uckan, A. S., Sahinoglu, E. N., Arslanyurek, I., Sok Cakici, S., & Ekmekci-Ertek, I. (2025). Online mindfulness-based versus cognitive-behavioural stress reduction for medical students: A randomized controlled trial. Psychiatry Research, 351, Article 116632. https://doi.org/10.1016/j.psychres.2025.116632 [Google Scholar] [Crossref]

70. Yogeswaran, V., & El Morr, C. (2021). Effectiveness of online mindfulness interventions on medical students’ mental health: A systematic review. BMC Public Health, 21, Article 2293. https://doi.org/10.1186/s12889-021-12341-z [Google Scholar] [Crossref]

71. Young, C., & Juliani, M. (2023). Universal brief mental health screenings for first-year medical students: A 6-year retrospective of the Keck Checks program. Academic Medicine, 98(7), 782–787. https://doi.org/10.1097/ACM.0000000000005169 [Google Scholar] [Crossref]

72. Yusefi, A. R., Beigzadeh, A., & Kaya, F. (2025). Resilience as a predictor of mental health among medical students: A cross-sectional study using PLS-SEM. BMC Medical Education, 25, Article 1476. https://doi.org/10.1186/s12909-025-08063-0 [Google Scholar] [Crossref]

73. Zhang, Y., Lin, X., Yu, L., Bai, X., Li, X., & Long, W. (2024). Sources of stress and coping strategies among Chinese medical graduate students: A qualitative study. BMC Medical Education, 24, Article 624. https://doi.org/10.1186/s12909-024-05603-y [Google Scholar] [Crossref]

74. Zhao, C., Ding, N., Yang, X., Xu, H., Lai, X., Tu, X., Lv, Y., Xu, D., & Zhang, G. (2021). Longitudinal effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems in Chinese undergraduate students. Frontiers in Public Health, 9, 752210. https://doi.org/10.3389/fpubh.2021.752210 [Google Scholar] [Crossref]

75. Zheng, D., Qin, Q., Peng, Y., Zhong, H., Huang, Y., Wang, H., Tan, Q., & Li, Y. (2024). Pre-COVID-19 short sleep duration and eveningness chronotype are associated with incident suicidal ideation during the COVID-19 pandemic in medical students: A retrospective cohort study. Frontiers in Public Health, 12, Article 1406396. https://doi.org/10.3389/fpubh.2024.1406396 [Google Scholar] [Crossref]

Metrics

Views & Downloads

Similar Articles