Stress Factors and Depression Levels of International Medical Students in Bulgaria and Turkish Medical Students

Throughout medical education, medical students are reported to experience high levels of stress and depression. The aim of this study was to compare the stress factors and depression levels of medical students in Bulgaria and Turkey. This cross-sectional comparative study included 546 students (276 international students from abroad studying at the Medical University of Sofia in Bulgaria and 270 Turkish medical students). The questionnaire consisted of sociodemographic questions, a Medical Student Stressor Questionnaire (MSSQ-40 items), and a Beck Depression Inventory (BDI). The Turkish pre-clinical and clinical students had higher levels of stress and depression than the international pre-clinical medical students in Bulgaria. When the medical students were compared, 51.4% of the international medical students in Bulgaria and 28.5% of the Turkish medical students were found to be without depression. Moreover, 26.7% of the Turkish medical students and 12% of the international medical students in Bulgaria had moderate levels of depression. In addition, each domain of the MSSQ had a relationship with depression in both groups of medical students, with the exception of one domain (intrapersonal and interpersonal related stressors), which had no significant relationship with the depression scores of the Turkish clinical students. The findings of our study imply that medical students may need psychological support throughout their education, and this applies especially to Turkish medical students. Knowing the stress factors and depression levels that medical students experience plays an important role in determining the approaches to adopt to them.