Exploring the evolution of US medical students' social support networks across the continuum: a cross-sectional group...

Perceived social support - feeling cared for and having access to a reliable network - has been linked to reduced stress and burnout, and greater quality of life among medical students. Yet, how perceived support systems evolve throughout medical school remains little explored. We examined how medical students' perceived social support systems shift during medical school adaptively to students' changing academic and emotional needs. Between January and May 2023, we conducted six hour-long group interviews with a cross-sectional convenience sample of 50 medical students (graduating Classes of 2023, 2024, 2025, and 2026) enrolled at a small, community-based medical school in the Midwestern US. Using collaborative interpretation to analyze our interview notes, we found that students shifted their reliance on peer and non-medical support systems (e.g., family, friends, and significant others), but seldom felt supported by both simultaneously. Early in training, peers offered solidarity in an unfamiliar and demanding academic setting, while non-medical supporters were perceived as lacking understanding of the medical school experience. Transitional periods - particularly those preceding the USMLE Step 1 exam, clinical clerkship, and application for residency - coincided with greater emotional stress and dissatisfaction with support, often tied to conflicting notions of students' social availability or medical expertise. Students most valued instrumental support, such as help with meals and errands, during intensive exam preparation, while emotional support was more relevant during clinical rotations. Notably, reliance on peer support diminished during clerkship, but re-emerged during the shared challenges of the residency application. Our findings suggest that medical students' social support needs are dynamic and context-dependent. We recommend targeted interventions, including guidance for non-medical supporters and instrumental support services during high-stress study periods. Our results align with broader literature and offer actionable insights. Enhancing perceived social support across all years of training is essential for fostering resilience and long-term well-being in future physicians.