American medical students in Israel: Stress and coping

Medical students studying abroad have to adapt to a new cultural environment in addition to the usual stresses of medical school. This study explored the perceived stress and coping ability of students of the New York State/American Programme, Sackler School of Medicine, Tel Aviv University, who study medicine in Israel but are expected to return to America to practice. Students were surveyed using the Ways of Coping Checklist (WCCL), Appraisal Dimension Scale (ADS) and two instruments specifically designed for the study. The results supported the view that students having difficulty adapting to their new cultural environment also have difficulty at medical school. This pattern is a negative spiral in which anxiety and depression impair cognitive performance, which leads to academic difficulties and emotional distress. Improvements in student social support and primary prevention were implemented as a result of the study. Limitations of the study are discussed.