Climate change worry, awareness and general anxiety in medical students: a multicentre cross-sectional study with implications for medical curricula

Climate change is an escalating public health threat with growing mental health impacts, including climate change worry. Medical students are both future health professionals and a learner group with high baseline stress and anxiety. Evidence from middle-income settings and disaster-affected regions remains limited. We examined general anxiety and its associations with climate change worry and awareness among Turkish medical students to inform undergraduate curricula. We conducted a multicentre cross-sectional study (October 2024–April 2025) in two Turkish medical schools in the north (Giresun) and south (Hatay). Students completed an online survey with sociodemographic items and validated measures: Climate Change Awareness Scale (CCAwS), Climate Change Anxiety Scale (CCAS; Anxiety and Helplessness), and Anxiety Assessment Scale (AAS). Group comparisons used Mann–Whitney U and Kruskal–Wallis tests with Bonferroni–Dunn post hoc procedures. Overall, 443 students participated (mean age 21.81 ± 2.23 years; 50.8% female). Mean scores were 72.91 ± 13.73 (CCAwS total), 20.51 ± 6.37 (CCAS-Anxiety), 11.71 ± 2.34 (CCAS-Helplessness), and 29.64 ± 9.00 (AAS total); internal consistency was high (α = 0.907–0.934). Compared with clinical students, preclinical students reported higher climate change worry (CCAS-Anxiety; median 21 vs. 20; p = 0.017) and higher general anxiety (AAS total; median 30 vs. 29; p = 0.008), including higher AAS Physiological Tension (p = 0.004), Worry (p = 0.018), and Feeling Unsafe (p = 0.032). Regional differences were limited: Giresun students had higher CCAwS energy consumption awareness (median 13 vs. 12; p = 0.002), while Hatay students had higher AAS Feeling Unsafe (p = 0.040). By year, CCAwS Awareness of Causes was higher in Year 1 than Year 4 (p = 0.032), and CCAS-Anxiety was higher in Year 1 than Year 5 (p = 0.043). Climate change awareness was moderate to high, while climate change worry and general anxiety were more pronounced in preclinical years. Findings support early, balanced integration of climate–health and disaster-related mental health content into medical curricula, alongside coping and action-oriented supports to protect student wellbeing.