Abstract
BACKGROUND: International medical students face unique challenges in adjusting to new sociocultural environments, particularly in resource-limited settings. In Egypt, despite calls for increasing cultural diversity in medical education, limited research has explored how international students adapt and what factors influence their experience. This study aimed to assess the sociocultural adaptation of international medical students at Mansoura University to inform targeted strategies enhancing their inclusion and well-being. METHODS: A cross-sectional study was conducted among international medical students at Mansoura University between September and November 2024 using an online survey. Data were collected through convenience and snowball sampling, along with a non-probability proportionate quota based on academic year. The survey included sociodemographic items and the Sociocultural Adaptation Scale-Revised (SCAS-R), a validated tool that assesses five aspects of sociocultural adaptation on a five-point Likert scale. RESULTS: A total of 395 international students participated, with a mean SCAS-R adaptation score of 3.37 (SD = 0.69). Adaptation was highest among 1st-year students (3.52) and lower in subsequent years (2nd: 3.21; 3rd: 3.39; 4th: 3.31; 5th: 3.48). Males reported higher scores in personal interest/community involvement (3.09 vs. 2.86, p = 0.011) and language proficiency (4.25 vs. 4.00, p = 0.036). Arab students had significantly higher overall adaptation than non-Arabs (3.40 vs. 3.21, p = 0.046), primarily due to stronger language proficiency (4.42 vs. 2.76, p < 0.001). Students with sufficient income showed better adaptation in communication (3.41 vs. 3.15, p = 0.021), ecological adjustment (3.32 vs. 2.99, p = 0.008), and language (4.18 vs. 3.83, p = 0.039). CONCLUSION: The findings of this study emphasize the need for medical institutions to implement inclusive support strategies, including bilingual language training, targeted financial assistance, and sustained integration efforts beyond the first academic year. TRIAL REGISTRATION: Not applicable.