The second year of medical school is widely considered a difficult year. During the second year, the students may experience their first patient interaction as well as working with physicians directly in a hospital or in a clinic. In addition, during the second year of medical school, students may decide that they do not like working with patients and still have the opportunity to change degree programs without losing credit hours. To help address the issues faced by second-year medical students, a growing number of universities have begun to implement programs and initiatives to support their graduate student populations. However, little information is available on the causes of emotional stress, and the effectiveness of programs and initiatives offered as support, in the second year of medical school. The purpose of the qualitative phenomenological study was to examine the fourth-year medical students' perceived causes of emotional stress they experienced in their second year of medical school. Another purpose was to identify the coping behaviors the fourth-year medical students used in their second year to reduce the emotional stress. The sample population for this research came from 15 Generation Y medical students who have completed their second year at a northeastern US medical school in March 2011. Phenomenology was the primary theoretical framework used to describe the meaning of the lived experiences of these 15 participants. Key themes exposed included: peer relationships, personal relationship, economic status, academic performance, and techniques to reduce emotional stress. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]