American medical students in Israel: stress and coping--a follow-up study

BACKGROUND: Medical students studying abroad face the double stress of adjusting to a new cultural environment while at the same time, coping with the usual stresses of medical school. In a previous article, we examined the perceived stress and coping of American medical students studying in Israel. AIMS: The current study was designed to follow up changes in made in response to the original study. PARTICIPANTS: First year students, NY/American Program, Sackler School of Medicine, Tel Aviv University, Israel. METHODS: Ways of Coping Checklist (WCCL), Appraisal Dimension Scale (ADS) and two instruments specifically designed for the study. RESULTS: Students' coping with their adjustment to Israel was highly correlated to their adjustment to medical school. There was significant improvement in student mental health and student satisfaction and a corresponding reduction in dysfunctional defence mechanism and a previous pattern of heavy drinking. DISCUSSION: The results are discussed in terms of improvements in the student support system proposed at the time of the initial study as well as changes in the student body. Limitations and future directions for research are also discussed.