Abstract
Background: When there are high demands besides less resources, a person experiences a feeling of fear that is known as “Stress”. Students of professional schools/colleges and universities are encounter more stress than the general population as they are in a transitory phase from adolescence to adulthood. It has been highlighted that medical education has greater association with stress. There are three examination systems that are been followed by medical colleges of Pakistan (modular, semester and annual systems). However, to the best of our knowledge, no data is available to show the association of stress with current examination systems in our country.
 Aims: The objectives of our study were to find out the association of stress with different examination systems and to identify the frequency of stress causing and coping factors adopted by 1st, 2nd and 3rd year medical students studying in colleges having different examination systems i.e. modular, semester and annual.
 Study Design: Comparative cross-sectional study.
 Place & Duration of Study: This study was conducted from December 2018 to April 2019 in three medical colleges of Sindh having above mentioned examination systems.
 Study Population: Medical students of 1st 2nd and 3rd year.
 Methodology: To assess depression, anxiety and stress among study population, DASS Scale was used. To identify the stress causing and coping factors in the students Likert scale based proforma with 19 factors were given to the selected participants
 Results: There was no significant association of examination system with depression, anxiety and stress, however various stress causing and coping factors were found significant in altering medical student`s life.
 Conclusion: According to our study, the frequency of stress in the medial students has no association with the examination systems (modular, semester and annual), currently followed by the medical colleges in Sindh, Pakistan.
Highlights
When demands exceed the available resources, a person experience a feeling of fear known as “Stress” [1]
When event of examination was considered as a variable, it was found to be one of the significant stress causing factors with a p-value (0.025), This finding of our study was similar to one of the study conducted on the students of medical college in Islamabad [15] and was in accordance to other studies conducted across the globe including USA [16]
Homesickness was highly associated as a stress causing factor in the target population of our study, highlighted by Rab et al; he documented medical students residing in hostels were more prone to stress in comparison to the students living in their homes [18]
Summary
When demands exceed the available resources, a person experience a feeling of fear known as “Stress” [1]. Stress can act as a motivator and is indispensable for survival If this phenomenon is triggered readily or concurrently associated with multiple stressors, it can challenge a person's mental and physical health. Students in professional schools/colleges and universities are supposed to encounter stress, more than the general population as they are in a transitory phase from adolescence to adulthood [2,3]. Stressful condition can affect academic performance, social life and may lead to dementia [5], hypertension, aging, obesity [6], impaired immune system, suppressed fertility and various digestive problems [7,8]. Students of professional schools/colleges and universities are encounter more stress than the general population as they are in a transitory phase from adolescence to adulthood. To the best of our knowledge, no data is available to show the association of stress with current examination systems in our country.
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