ArticleBMC medical education2026
Examining the multidimensional structure of stress among international medical students: a construct-based approach.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInternational medical students experience diverse stressors that extend beyond academic demands to include challenges of cultural adaptation, institutional management, and experiences of discrimination. Understanding the structure of these interrelated stress domains is essential for developing effective educational and support strategies. This study examined the multidimensional structure of stress among international medical students using a construct-based analytical approach grounded in the Transactional Model of Stress and Coping.
methodsA cross-sectional survey was conducted with 322 international students enrolled in the English-language medical program at the Medical University of Varna, Bulgaria. Participants completed a self-report questionnaire informed by standardized instruments, including the University Stress Scale and the Academic Stress Scale. Confirmatory factor analysis (CFA) was used to test a four-factor model comprising academic, adaptation, management, and discrimination-related stress.
resultsThe proposed model demonstrated good fit to the data (χ
conclusionsThe findings underscore the need for comprehensive institutional strategies that address multiple dimensions of student well-being. Implementing culturally responsive counseling, peer mentoring, and transparent administrative communication may reduce overall stress and enhance adaptation and resilience among international medical students.
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