Career regret, academic-related factors and health-related quality of life among Syrian medical students: a multicentre cross-sectional study
4 affiliations
- 1Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
- 2University of Aleppo Faculty of Medicine, Aleppo, Aleppo Governorate, Syrian Arab Republic
- 3Faculty of Medicine, Homs University, Homs, Syrian Arab Republic
- 4Laboratory of Anatomy, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
Abstract
Objectives: To examine the prevalence of career regret among Syrian medical students and assess its association with health-related quality of life (HRQoL) and academic-related factors. We hypothesised that higher levels of regret would be associated with (1) poorer physical HRQoL, (2) poorer mental HRQoL and (3) lower academic performance.
Design: Multicentre cross-sectional study.
Setting: Public and private medical schools across Syria between May and July 2025.
Participants: A total of 1,702 medical students enrolled in the second through sixth academic years were recruited through convenience and snowball sampling.
Primary and secondary outcome measures: Career regret was assessed using a study-developed five-item measure, summarised as the Regret-5 Mean (R5M). The measure showed good internal consistency and a one-factor structure in the present sample but had not undergone external validation. HRQoL was measured using the 12-Item Short Form Health Survey (SF-12). Associations were examined using bivariate analyses and multivariable linear regression.
Results: A total of 1,702 students were included. Most participants (71.0%) reported that they would probably or definitely choose medicine again; however, 14.0% reported that they probably or definitely would not choose medicine again, 41.4% reported disappointment with medical school and 8.2% reported frequent or constant thoughts of leaving medicine.
In the adjusted model using heteroscedasticity-consistent covariance matrix estimator type 3 (HC3) robust inference, higher Mental Component Summary score (MCS-12) scores were associated with lower R5M (B=−0.023 per point, 95% CI −0.028 to −0.017), as were higher Physical Component Summary score (PCS-12) scores (B=−0.012, 95% CI −0.018 to −0.006), higher study-hours category (B=−0.074, 95% CI −0.111 to −0.036) and more efficient time-management category (B=−0.124, 95% CI −0.173 to −0.075). Sixth-year students had higher R5M than second-year students (B=0.572, 95% CI 0.326 to 0.818), and students with grade point average (GPA) ≤74.99% had higher R5M than those with GPA≥85% (B=0.300, 95% CI 0.164 to 0.435). Female students had lower R5M than male students (B=−0.175, 95% CI −0.264 to −0.086).
Among students in the exploratory higher-regret subgroup, psychological pressure was the most frequently reported contributing factor (467/653, 71.5%).
Conclusions: The findings supported all three prespecified hypotheses: greater career regret was associated with poorer physical and mental HRQoL and lower academic performance. Regret was also higher among students in later academic years and among male students. The cross-sectional, non-probability design prevents causal and nationally representative prevalence inferences. Longitudinal research and external validation of the regret measure are needed.
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BibTeX
@article{kheder2026career,
title = {{Career regret, academic-related factors and health-related quality of life among Syrian medical students: a multicentre cross-sectional study}},
author = {Maria Kheder and Ahmad Bishr Nasra and Sarah Alghoutani and Hiba Al-Hammash and Abdullah Saleh and Alaa Assaad and Shahd Almansour and Nussaiba Kreimesh and Leen Kanaa and Youssef Latifeh and Bayan Alsaid},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-118578},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-118578},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Career regret, academic-related factors and health-related quality of life among Syrian medical students: a multicentre cross-sectional study
AU - Maria Kheder
AU - Ahmad Bishr Nasra
AU - Sarah Alghoutani
AU - Hiba Al-Hammash
AU - Abdullah Saleh
AU - Alaa Assaad
AU - Shahd Almansour
AU - Nussaiba Kreimesh
AU - Leen Kanaa
AU - Youssef Latifeh
AU - Bayan Alsaid
PY - 2026
DA - 2026/10/07
JO - BMJ Open
DO - 10.1136/bmjopen-2026-118578
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-118578
AB - Objectives: To examine the prevalence of career regret among Syrian medical students and assess its association with health-related quality of life (HRQoL) and academic-related factors. We hypothesised that higher levels of regret would be associated with (1) poorer physical HRQoL, (2) poorer mental HRQoL and (3) lower academic performance. Design: Multicentre cross-sectional study. Setting: Public and private medical schools across Syria between May and July 2025. Participants: A total of 1,702 medical students enrolled in the second through sixth academic years were recruited through convenience and snowball sampling. Primary and secondary outcome measures: Career regret was assessed using a study-developed five-item measure, summarised as the Regret-5 Mean (R5M). The measure showed good internal consistency and a one-factor structure in the present sample but had not undergone external validation. HRQoL was measured using the 12-Item Short Form Health Survey (SF-12). Associations were examined using bivariate analyses and multivariable linear regression. Results: A total of 1,702 students were included. Most participants (71.0%) reported that they would probably or definitely choose medicine again; however, 14.0% reported that they probably or definitely would not choose medicine again, 41.4% reported disappointment with medical school and 8.2% reported frequent or constant thoughts of leaving medicine. In the adjusted model using heteroscedasticity-consistent covariance matrix estimator type 3 (HC3) robust inference, higher Mental Component Summary score (MCS-12) scores were associated with lower R5M (B=−0.023 per point, 95% CI −0.028 to −0.017), as were higher Physical Component Summary score (PCS-12) scores (B=−0.012, 95% CI −0.018 to −0.006), higher study-hours category (B=−0.074, 95% CI −0.111 to −0.036) and more efficient time-management category (B=−0.124, 95% CI −0.173 to −0.075). Sixth-year students had higher R5M than second-year students (B=0.572, 95% CI 0.326 to 0.818), and students with grade point average (GPA) ≤74.99% had higher R5M than those with GPA≥85% (B=0.300, 95% CI 0.164 to 0.435). Female students had lower R5M than male students (B=−0.175, 95% CI −0.264 to −0.086). Among students in the exploratory higher-regret subgroup, psychological pressure was the most frequently reported contributing factor (467/653, 71.5%). Conclusions: The findings supported all three prespecified hypotheses: greater career regret was associated with poorer physical and mental HRQoL and lower academic performance. Regret was also higher among students in later academic years and among male students. The cross-sectional, non-probability design prevents causal and nationally representative prevalence inferences. Longitudinal research and external validation of the regret measure are needed.
SN - 2044-6055
SN - 2044-6055
ER -