Dear Editor
After entering university, students experience varying degrees of psychological disorders, including anxiety and depression, due to challenges encountered during their studies [1]. Medical students’ resilience provides a protective role against environmental stressors and improves quality of life during clinical training. Resilience among medical interns who have completed the highly stressful rotation in emergency medicine has been reported in most studies to be notably different—and often more prominent—than among other students and samples. Through repeated exposure and practice under the stressful conditions of the emergency educational environment, these trainees strengthen and develop resilience, progressing toward growth and maturation into “physicians.” This is among the constructive advantages of working in the emergency department setting.
This letter was written to report the findings of a cross-sectional study on the resilience of emergency department interns and to emphasize the need for educational planning to enhance this characteristic.
We assessed the resilience of 77 medical interns admitted in February 2016 at the emergency department of Mazandaran University of Medical Sciences in 2022 using a “gold standard” instrument, namely the Conner and Davidson Resilience Scale. These interns included 37 male participants (mean age: 25 years) and 40 female participants (mean age: 24 years) who had completed the emergency medicine course. Most participants—55.8%—had high resilience. A total of 44.15% of the participants had moderate resilience, and 0% had low resilience. The lowest resilience score among the students was 44, and the highest score was 121. In addition, female interns had a higher mean resilience score than male interns. Furthermore, individuals with higher resilience scores had a higher mean age than the others. For a realistic interpretation, it should be noted that the cross-sectional design and the relatively small sample size were limiting factors of the study; thus, the results cannot be used to infer cause-and-effect relationships in general. However, in this investigation, interns showed an appropriate level of resilience after completing the emergency department course. Studies indicate that female medical students obtain higher empathy scores, suggesting their readiness for patient interactions [2]. This result implies that with increasing age and greater social experiences, individuals may develop higher resilience (2), which helps them more effectively confront and cope with the specific pressures and challenges of the profession.
By strengthening resilience, students are better prepared to navigate the challenges of this highly demanding professional period and to develop the emotional endurance required for long-term success in health care. The availability of supportive resources, together with a nurturing environment provided by the university, is essential [3]. Social support among medical students also plays a role in their resilience [4], particularly because students may expect different levels of support from peers and instructors [5].
Although, in this study, more than half of the participants achieved high resilience scores, it still seems necessary for the Ministry of Health, Treatment, and Medical Education’s medical education planning to make additional efforts to support students in order to enhance resilience, thereby ensuring the delivery of high-quality care and medical education and helping physicians maintain work–life balance.

References

1. Zhang C, Zhao L, Dong T, Zhao J, Gao C, Zhao F. A prospective study of sleep status, anxiety, and depression levels of college students at a university in Shandong Province, China. Front Psychol. 2024; 15:1361632. [DOI:10.3389/fpsyg.2024.1361632] [PMID]
2. Hsu HC, Sung TC. Exploring gender differences in empathy development among medical students: A qualitative analysis of reflections on juvenile correctional school visits. Med Educ Online. 2025; 30(1):2500556. [DOI:10.1080/10872981.2025.2500556] [PMID] [PMCID]
3. Chye SM, Kok YY, Chen YS, Er HM. Building resilience among undergraduate health professions students: Identifying influencing factors. BMC Med Educ. 2024; 24(1):1168. [DOI:10.1186/s12909-024-06127-1] [PMID] [PMCID]
4. Casapulla S, Rodriguez J, Nandyal S, Chavan B. Toward resilience: Medical students' perception of social support. J Am Osteopath Assoc. 2020; 120(12):844-54. [DOI:10.7556/jaoa.2020.158] [PMID]
5. Saad S, Ali S. Academic resilience in medical students: exploring students' perception of social support provided by peers and teachers to help at-risk students for the successful academic journey. BMC Med Educ. 2025; 25(1):271. [DOI:10.1186/s12909-025-06858-9] [PMID] [PMCID]