Abstract

Background

Medical students in Palestine face academic demands alongside political instability, movement restrictions, and economic uncertainty. We assessed psychological distress and examined its correlates, while exploring bivariate associations with self-reported academic performance.

Methods

This convergent mixed-methods study was conducted across five Palestinian universities during 2024–2025. A cross-sectional survey included 391 undergraduate medical students. Psychological distress was measured using the Arabic 12-item General Health Questionnaire (GHQ-12) and analyzed using bivariate tests and multivariable ordinal logistic regression. Twenty semi-structured interviews were analyzed thematically. The two strands were integrated during interpretation through side-by-side comparison, narrative weaving, and a joint display.

Results

Mean GHQ-12 score was 15.63 ± 7.08; 66.0% of students were classified above the study-defined normal/minimal band. Higher distress categories were associated with unhealthy or partially healthy diet, lack of moral support, lower motivation, acceptable self-rated academic level, living alone, and frequent political anxiety. Self-reported academic performance showed bivariate associations with living arrangement, study hours and pattern, class participation, and perceived academic effects of political events. Qualitative findings complemented these associations by describing loneliness, disrupted routines, workload, limited psychological support, career uncertainty, financial strain, movement-related stress, and social-media comparison.

Conclusions

Psychological distress was common and was associated with modifiable academic, psychosocial, lifestyle, and contextual factors. Palestinian medical schools should combine accessible mental-health support with academic mentoring, contingency policies during disruption, and targeted support for socially isolated students.

Title

BMC medical education

Publisher

springer

Publisher Country

United Kingdom

Indexing

Scopus

Impact Factor

2.0

Publication Type

Both (Printed and Online)

Volume

25

Year

2026

Pages

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