Stress and Difficulties Among International Medical Undergraduates of a Medical College In Karachi, Pakistan

Objective: To determine stress and difficulties among international medical undergraduate students in Karachi Study Design: A cross-sectional study. Place and Duration Of Study: Dow International Medical College, Ojha Campus, Karachi from January 2014-2015. Methodology: 204 International students were interviewed using modified Kessler scale of mental distress. Data was entered and analyzed by SPSS version 21. Frequencies and Percentages were calculated for gender, age, GPA scoring, residence and proficiency in English/Urdu. Chi square tests were used for the significance of association. Univariate analysis Odds ratios with 95% confidence intervals were calculated, multiple logistic regressions were used to determine adjusted Odds ratio independent variables, and those with P<0.05 were retained. Results: Mean age was 21.46 ± 1.96 SD with majority (56.9 %) being hostel residents. More than half (64.2 %) had low GPA. More than two – third were proficient in English and only 34.2% used Urdu. Significantly more students (53.9%) had difficulties in hostel. 35.3% had adjustment problem within new country. Most students (61.3%) had problem with teaching methods and 85.3% reported administration problems. 57.4% students feel stressed due to factors which included being female, living in hostel, not proficient in English and teaching methodology. Students who had difficulty adjusting with new culture had protective affect from stress. Conclusion: This study identified various socio-cultural and academic stressors. Apart from quality medical education, a pivotal role of the institute enrolling overseas students is to render a cordial environment in multiple facets. The authors would like to advise future studies to establish a relationship between factors and outcomes.