Career regret, academic-related factors and health-related quality of life among Syrian medical students: a multicentre cross-sectional study.

objectivesTo examine the prevalence of career regret among Syrian medical students and assess its association with health-related quality of life (HRQoL) and academic-related factors. We hypothesised that higher levels of regret would be associated with (1) poorer physical HRQoL, (2) poorer mental HRQoL and (3) lower academic performance.

designMulticentre cross-sectional study.

settingPublic and private medical schools across Syria between May and July 2025.

participantsA total of 1,702 medical students enrolled in the second through sixth academic years were recruited through convenience and snowball sampling. PRIMARY AND SECONDARY OUTCOME MEASURES: Career regret was assessed using a study-developed five-item measure, summarised as the Regret-5 Mean (R5M). The measure showed good internal consistency and a one-factor structure in the present sample but had not undergone external validation. HRQoL was measured using the 12-Item Short Form Health Survey (SF-12). Associations were examined using bivariate analyses and multivariable linear regression.

resultsA total of 1,702 students were included. Most participants (71.0%) reported that they would probably or definitely choose medicine again; however, 14.0% reported that they probably or definitely would not choose medicine again, 41.4% reported disappointment with medical school and 8.2% reported frequent or constant thoughts of leaving medicine.In the adjusted model using heteroscedasticity-consistent covariance matrix estimator type 3 (HC3) robust inference, higher Mental Component Summary score (MCS-12) scores were associated with lower R5M (B=-0.023 per point, 95% CI -0.028 to -0.017), as were higher Physical Component Summary score (PCS-12) scores (B=-0.012, 95% CI -0.018 to -0.006), higher study-hours category (B=-0.074, 95% CI -0.111 to -0.036) and more efficient time-management category (B=-0.124, 95% CI -0.173 to -0.075). Sixth-year students had higher R5M than second-year students (B=0.572, 95% CI 0.326 to 0.818), and students with grade point average (GPA) ≤74.99% had higher R5M than those with GPA≥85% (B=0.300, 95% CI 0.164 to 0.435). Female students had lower R5M than male students (B=-0.175, 95% CI -0.264 to -0.086).Among students in the exploratory higher-regret subgroup, psychological pressure was the most frequently reported contributing factor (467/653, 71.5%).

conclusionsThe findings supported all three prespecified hypotheses: greater career regret was associated with poorer physical and mental HRQoL and lower academic performance. Regret was also higher among students in later academic years and among male students. The cross-sectional, non-probability design prevents causal and nationally representative prevalence inferences. Longitudinal research and external validation of the regret measure are needed.