Background:
Medical education is globally recognized as a demanding path that can severely impact students' lifestyle choices and mental health. In the rapidly changing educational landscape of the MENA region, these pressures may be exacerbated. Documenting the prevalence of risk behaviors—such as psychoactive substance use, sleep deprivation, and chronic stress—is a critical first step toward designing effective support systems. This study aimed to comprehensively characterize the sociodemographic profile, lifestyle habits, and psychosocial well-being of medical students at the Faculty of Medicine of Sousse, Tunisia.

Methods:
A descriptive cross-sectional study was conducted during the 2023–2024 academic year using an exhaustive online sampling strategy targeting students from the second year to internship. A self-administered questionnaire collected detailed data on sociodemographics, lifestyle factors (physical activity, sleep patterns, tobacco and alcohol consumption), and mental health indicators (perceived stress levels). Descriptive statistics were analyzed to determine the prevalence of these risk factors across the student population.

Results:
The study included 701 medical students (median age 22 years; 69.1% female). The results revealed a concerning psychosocial burden: 89.1% of students reported moderate to high levels of perceived stress. Risk behaviors were prevalent, with 12.1% of participants reporting psychoactive substance use and 9.6% identifying as active smokers. Furthermore, sleep patterns were frequently compromised. Despite these challenges, students demonstrated academic resilience, maintaining a median of 4 hours of daily revision.

Conclusion:
Tunisian medical students face significant health challenges marked by widespread stress and notable substance use behaviors. These findings underscore an urgent need for institutions to implement comprehensive wellness programs, including stress management workshops and substance cessation support. Addressing these determinants is essential for nurturing a healthy and resilient future healthcare workforce.