Perceived Stress, Burnout, Depression, and Resilient Coping among Postgraduate Medical Residents in Kerala: A Cross-Sectional Study

Background: Postgraduate medical residency involves heavy workload and sustained academic pressure, increasing vulnerability to burnout and depression. However, contemporary evidence regarding psychological morbidity among postgraduate medical residents in Kerala remains limited. Objectives: To estimate the prevalence of perceived stress, burnout, depressive symptoms, and resilient coping among postgraduate medical residents; examine their associations with selected sociodemographic characteristics; and explore relationships among these variables. Methods: A cross-sectional online survey was conducted among postgraduate medical residents at a Government Medical College in Kerala between November 2024 and June 2025. Validated instruments assessed perceived stress (PSS-10), burnout (abbreviated Copenhagen Burnout Inventory), resilient coping (Brief Resilient Coping Scale), and depressive symptoms (PSQ-4D). Associations were examined using Chi-square or Fisher's exact tests, and crude odds ratios with 95% confidence intervals were calculated for significant binary associations. Results: A total of 176 residents participated (64.8% female; mean age 26.9 ± 2.1 years). Burnout was present in 56.3% of residents, depressive symptoms in 50.0%, and low resilient coping in 51.7%. Moderate and high perceived stress were reported by 67.6% and 22.2% of participants, respectively. Burnout was significantly associated with depressive symptoms (OR = 10.17, 95% CI: 5.02–20.60; p < 0.001), as well as with higher perceived stress and lower resilient coping (p < 0.01). Perceived stress and depressive symptoms differed significantly across specialties, with surgical residents showing the highest prevalence of depressive symptoms. Conclusions: Burnout and depressive symptoms were highly prevalent and strongly associated with one another. Institutional strategies addressing workload, supervision, and mental health support may improve resident well-being.