Levels of stress in medical students due to COVID-19.

For medical schools, the COVID-19 pandemic necessitated examination and curricular restructuring as well as significant changes to clinical attachments. With the available evidence suggesting that medical students' mental health status is already poorer than that of the general population, with academic stress being a chief predictor, such changes are likely to have a significant effect on these students. This online, cross-sectional study aimed to determine the impact of COVID-19 on perceived stress levels of medical students, investigate possible contributing and alleviating factors, and produce recommendations for medical schools to implement during future healthcare emergencies. The majority (54.5%) of respondents reported levels of stress ranging from moderate to extreme. Higher levels of stress were significantly associated with female gender (p=0.039) and international status (p=0.031). A significant association was also noted between reported stress and the transition to online learning (p<0.0001) and online assessment formatting (p<0.0001), concerns for personal health (p<0.0001) and for the health of family members (p<0.0001). Students who reported higher stress levels were less confident in their government's management of the crisis (p=0.041). Additionally, students who reported lower stress agreed highly that their medical school had an appropriate response to the crisis (p<0.0001), had provided sufficient information regarding the crisis (p=0.015), that they trust their school in handling the continuing of their education (p=0.020) and that their school had appropriate plans in place to support the continuing of education (p=0.017).