{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:11:47Z","timestamp":1781629907275,"version":"3.54.5"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Kafr El Shiekh University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Egypt\u2019s recent shift to an integrated (5+2) medical curriculum aims to enhance clinical competence but may also intensify stress among students. Understanding stressors and coping mechanisms is critical for promoting student well-being. This study aims to assess the levels and domains of stress, identify their predictors, and evaluate coping strategies among undergraduate medical students in Egypt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter cross-sectional study was conducted among 984 undergraduate medical students from Egyptian universities between April and May 2024 with response rate of 98.4%. Data were collected via a structured online questionnaire including demographics, the validated Medical Student Stressor Questionnaire (MSSQ), and the Coping Scale. Stressor domains were scored on a 0\u20134 Likert scale and coping on a 1\u20134 scale. Univariate and multivariate regression analyses identified predictors of stress and coping levels.Results:Academic-Related Stressors (ARS) recorded the highest mean score (2.97 \u00b1 0.81), with \u201clack of time to review\u201d and \u201clarge content load\u201d as top stressors. Drive and Desire-Related Stressors (DRS) scored lowest (1.80 \u00b1 1.18). High to severe stress prevalence was greatest in Academic Related Stress (ARS, 82.6%), followed by Group Activities-Related Stressors (GARS, 57.2%) and Interpersonal\/Intrapersonal-Related Stressors (IRS, 54.7%). Female students showed significantly higher odds of stress in ARS, TLRS, SRS, DRS, and GARS and had lower coping scores (\u03b2 = \u20130.21, p = 0.025). Rural residence increased odds of IRS (AOR = 1.67, p =0.047). Monthly income between 5,000 and 10,000 L.E. was associated with lower coping scores (\u03b2 = \u20130.93, p = 0.040). Upcoming exams amplified stress across GARS,and TLRS. Chronic illness was linked to higher SRS (AOR = 1.81, p = 0.01). Overall, students relied more on emotion-focused and avoidance coping, while problem-focused strategies were less frequently employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Egyptian medical students face substantial stress, predominantly academic in nature, under the integrated curriculum. Targeted institutional strategies\u2014such as workload adjustments, clear academic expectations, anti-abuse measures, and resilience training\u2014are needed to foster a healthier learning environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-025-08487-8","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T01:04:53Z","timestamp":1768525493000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stressors and coping strategies among Egyptian medical students under the integrated curriculum: a multicenter cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"given":"Mahmoud","family":"Abd El-Nasser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya Elsayed","family":"Abdelwahed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour Edin","family":"Darwish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Rabiea Abdelnaby Fathallah","family":"Hamad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya Muhammed Ali","family":"Suleiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khloud Ahmed Saad","family":"Elsayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahma AbdElfattah","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa M.I.","family":"Ghallab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Medical students\u2019 health collaboration team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed F.","family":"Elbialy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafik F.","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud A.","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Ashraf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa A.","family":"Seleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Naeim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Nemr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana A.","family":"Heigab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Ragheb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud N.","family":"Mahmoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"issue":"1","key":"8487_CR1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1749-6632.1998.tb09546.x","volume":"840","author":"BS McEWEN","year":"1998","unstructured":"McEWEN BS. 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BMJ 2007 Sept;335(7621):624\u20135.","journal-title":"BMJ 2007 Sept"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-025-08487-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-08487-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-08487-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:46:53Z","timestamp":1781628413000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-025-08487-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8487"],"URL":"https:\/\/doi.org\/10.1186\/s12909-025-08487-8","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"assertion":[{"value":"12 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study adhered to the principles of the Declaration of Helsinki, the International Conference on Harmonisation\u2013Good Clinical Practice (ICH-GCP) guidelines, and applicable local regulations [\n                      \n                      ,\n                      \n                      ]. Ethical approval was obtained from the Ethics Committee of the Faculty of Medicine, Kafrelsheikh University, Egypt (MKSU50-1-11). Informed consent was obtained on the first page of the questionnaire, which detailed the study\u2019s objectives, potential risks and benefits, confidentiality measures, and the right to withdraw at any time.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"118"}}