A Global Perspective on Mental Health in Medical Students: Evidence from Systematic Review and Meta-Analysis

Abstract

Background: Medical education is associated with substantial academic pressure and emotional challenges, placing students at increased risk of psychological disorders such as stress, anxiety, and depression. These conditions can adversely affect academic performance, professional development, and future patient care. Objective: To systematically review and meta-analyze the global prevalence of stress, anxiety, and depression among medical students.

Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published up to December 2025. Observational studies reporting the prevalence of stress, anxiety, and/or depression among undergraduate medical students were included. Data were extracted using a standardized form, and study quality was assessed using the Newcastle–Ottawa Scale. A random-effects model was used to calculate pooled prevalence estimates with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Results: A total of 52 studies comprising 41,348 medical students were included. The pooled prevalence of depression was 32.4% (95% CI: 29.1–35.8), anxiety 33.8% (95% CI: 30.2–37.5), and stress 39.6% (95% CI: 35.0–44.3). High heterogeneity was observed across studies (I² > 90%). Subgroup analysis showed higher prevalence among females, preclinical students, and those in low- and middle-income countries. Studies conducted during the COVID-19 pandemic reported increased levels of psychological distress. Conclusion: Stress, anxiety, and depression are highly prevalent among medical students globally, indicating a significant public health concern. Implementation of early screening, mental health support systems, and curriculum reforms is essential to mitigate psychological burden and promote student well-being.