The Prevalence of Academic Stress and Associated Factors among Medical Undergraduates in Sri Lanka: A Cross-sectional Study

Introduction: Medical undergraduates frequently encounter a high level of stress, which can negatively impact on their academic performance. High stress levels further contributes to impairing memory consolidation, learning ability, decision making, and critical thinking. This study aimed to describe the prevalence of perceived academic stress and associated factors among medical undergraduates in two settings in Sri Lanka. 
Methods: A cross-sectional survey involving medical undergraduates aged 18 to 29 years was conducted in two medical faculties in Sri Lanka. Participants completed the validated PAS questionnaire to assess the level of perceived academic stress. 
Results: Responses of 1,496 medical undergraduates (33.7% male, mean age 22.84 years) revealed a stress prevalence of 60%. Final-year students reported a higher level of stress (68.1%) compared to other academic years (first year-62.8%, second year–66.4%, third year–65.3%, fourth year–61.5%), although this difference was not statistically significant (p=1.0). Participants residing in university indoor hostels (67.7%, p=0.002) and outdoor hostels (66.4%, p=0.0001) indicated higher levels of stress than those living at home (48.6%). Sleep duration and stress levels were significantly associated, with participants sleeping less than 7 hours per night being more likely to experience a high level of stress (p=0.008). Students experiencing high levels of stress demonstrate significantly poor sleep quality (p=0.0005). BMI and level of stress were not significantly associated. 
Conclusion: This study reports a high prevalence of perceived academic stress among medical undergraduates, highlighting the need for the implementation of stress management interventions into their curricula.