Critical thinking in medical education and its association with academic stress in final-year MBBS students: A cross-sectional study

Background: Medical students experience significant academic stress, which may affect their critical thinking (CTh). Although stress among medical students is well documented, its association with CTh, in final-year students, remains underexplored. Aim: To assess the level of academic stress among final-year MBBS students and its association with CTh. Materials and Methods: A cross-section observational study was conducted among 732 final-year MBBS students from medical colleges across Madhya Pradesh. Academic stress was measured using the Medical Student Stressor Questionnaire, and critical thinking skills were assessed using the Critical Thinking Questionnaire. Data were analyzed using descriptive statistics, Mann–Whitney U tests, Spearman’s correlation, and multiple linear regression analysis with a significance level of P < 0.05. Results: Academic-related stress was the most prevalent stress domain. Most students demonstrated average to high levels of CTh, particularly in evaluating, understanding, and applying domains. Sociodemographic variables such as gender, social support, first-generation doctor status, age at MBBS selection, substance use, and prior psychological consultation significantly influenced stress and CTh scores. Regression analysis identified first-generation doctor status and older age at MBBS entry as negative predictors of CTh, whereas prior psychological consultation and having a year back were positive predictors. No significant overall correlation was found between academic stress and CTh. Conclusion: Final-year MBBS students experience considerable academic stress, mainly due to examinations and curriculum demands. Critical thinking showed minimal association with stress, indicating the influence of other contributing factors.