Purpose
Surgery is one of the most demanding specialties, requiring both academic excellence and emotional resilience. This study investigates how stress resilience, empathy, and academic performance (Step 1 and Step 2 scores) influence clinical performance in Surgery. By identifying key success factors, the findings aim to inform the development of wellness programs and academic interventions to support students in high-stress environments.

Methods
Data from medical students at the Kirk Kerkorian School of Medicine at UNLV (2022-2026) were analyzed. Stress scores were assessed across the preclinical phase (P1), clinical phase (P2), and career exploration phase (P3), along with empathy scores during the same periods. These metrics were evaluated in relation to Step 1 and Step 2 scores. The relationship between these factors and clinical performance in Surgery was examined using paired t-tests and regression analysis.

Results
Stress levels significantly decreased from the preclinical to career exploration phase (t = 4.38, p = 0.00003), reflecting improved resilience over time. Empathy scores across phases showed a weak correlation with Surgery clinical performance (r = 0.11), while Step 1 scores were a significant predictor (p = 0.038). Stress resilience and empathy did not significantly predict clinical performance in Surgery.

Conclusions
Step 1 scores significantly predict clinical performance in Surgery, while stress resilience and empathy have limited influence. However, the substantial change in stress levels highlights the importance of targeted stress management interventions for students in high-stress specialties. Although empathy was not directly associated with performance, its broader implications for patient care and student well-being warrant further exploration. These findings emphasize the importance of integrating academic, emotional, and adaptive strategies into the training of future surgeons to optimize both their performance and well-being.