title: Analysis of stress levels among medical students, residents, and graduate students at four Canadian schools of medicine.
abstract: OBJECTIVE
  To assess stress in medical students, residents, and graduate science students at four Canadian schools of medicine.
  
  
  METHODS
  Four schools with different curricula in three different parts of Canada participated in the study: the University of Calgary Faculty of Medicine, the University of Alberta Faculty of Medicine, the Dalhousie University Faculty of Medicine, and the McMaster University Faculty of Health Sciences. All the medical students, residents, and graduate science students at each school were surveyed in 1994-95. The three instruments used were the University of Calgary Stress Questionnaire, the Social Readjustment Rating Scale (SRRS), and the Symptom Checklist-90. Demographic data were compared across all four schools. Analysis of variance was calculated for all test-item scores, utilizing a four (school) by three (program) by two (gender) design, which were all between subject factors. Significant main effects were followed up by using planned comparisons (Newman-Keuls, with a probability level of p < .05). Significant interaction effects were followed up by using an analysis of simple effects.
  
  
  RESULTS
  A total of 1,681 questionnaires were returned as follows: 621 of 1,304 (48%) from the medical students, 645 of 1,495 (43%) from the residents, and 415 of 829 (50%) from the graduate science students. There were significant differences between the three groups in the natures and degrees of stress, with the graduate students reporting higher levels of stress. There were significant gender differences as well, with the women reporting higher levels of stress. Overall, stress levels were found to be mild, based on the University of Calgary Stress Questionnaire and the SRRS.
  
  
  CONCLUSIONS
  This study suggests that medical students and residents experience stress at levels that appear acceptable, but ongoing monitoring and the provision of appropriate support systems will continue to be important.
authors.affiliation: Continuing Medical Education, University of Calgary Faculty of Medicine, Alberta, Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Toews
authors.forename: J M
authors.initials: JM
authors.lastname: Lockyer
authors.forename: D J
authors.initials: DJ
authors.lastname: Dobson
authors.forename: E
authors.initials: E
authors.lastname: Simpson
authors.forename: A K
authors.initials: AK
authors.lastname: Brownell
authors.forename: F
authors.initials: F
authors.lastname: Brenneis
authors.forename: K M
authors.initials: KM
authors.lastname: MacPherson
authors.forename: G S
authors.initials: GS
authors.lastname: Cohen
mesh_terms: D000223:Adaptation, Psychological; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D003479:Curriculum; D005260:Female; D006801:Humans; D015994:Incidence; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D011159:Population Surveillance; D018570:Risk Assessment; D017678:Sex Distribution; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology* / Q000517:prevention & control; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires