A Longitudinal Study of Stress in Dental Students and Residents

Objectives: To describe and compare stress levels over a one-year period among cohorts of 1^st, 2^nd, 3^rd and 4^th year dental students and dental residents, and to describe sources of stress.

Methods: Data were collected once per month for a full academic year from 1^st, 2^nd, 3^rd and 4^th year dental students and 1^st year residents. We used a visual analogue scale (VAS) to monitor stress levels through the year. The scale consists of 100-millimeter horizontal line with both ends describing the extremes of stress levels as “Not at all stressed” and “Extremely stressed”. Other variables included in the questionnaire were sources of stress and sociodemographic information.

Results: Apart from the very low summer holiday period response rates were 50-82%. There was a gradual increase in dental students’ stress levels throughout the 4-year curriculum with a decline after their graduation. The lowest mean stress point score, on VAS from 0-100, was reported by 2^nd year students in December (25.5) and highest was reported by 4th year students (84.4) in February, 2-3 months prior to graduation. Peak stress periods during the academic year were related to most frequently reported sources of stress. These were “pressure to perform well” and “personal issues”, which were cited respectively by 25-50% and 5.6-50% of participants. Students also often mentioned “exams and grades” (11.5-44.4%). Residents, 3^rd and 4^th year students’ added “patient treatment” (3.9-22.2%). Third year students, transitioning from preclinical to clinical training, stated “learning clinical skills” (3.9%) as another reason. “Workload”(10.5%) and “relationship with professors and staff” (5.3%) were factors mostly reported by residents.

Conclusions: Stress levels vary a lot among dental students depending on their year of study and the time during the academic year. Overall, 1^st year students and residents reported lowest levels of stress and 4^th year students had the highest peak.