© 2015 Sandover et al.; licensee BioMed Central. Background: Incorporating graduate students into undergraduate medical degree programs is a commonly accepted practice. However, it has only recently been recognized that these two types of students cope with their studies in various ways. The aim was to compare the learning approaches, stress levels and ways of coping of undergraduate (UG) and graduate entry medical students (GEMP) throughout their medical course. Methods: From 2007-2011 each of the five year cohorts of undergraduate and GEMP students completed four components of the study. The components included demographics, The Biggs' R-SPQ-2 F questionnaire which determines students' approaches to learning, the Perceived Stress Scale (PSS) used to rate students perceived stress during the past four weeks, and the Ways of Coping (WOC) questionnaire used to assess students' methods of coping with everyday problems. Results: There was a consistent difference between UG and GEMP students approaches to learning over the five years. GEMP students preferred a deep approach while the UG students preferred a superficial approach to learning. This difference became more obvious in the clinical years. There was no statistically significant difference between the groups in stress levels. There were consistent differences in the ways the two groups coped with stress. Conclusions: There were significant differences in approaches to learning and ways of coping with stress between the UG and the GEMP students. These need to be considered when introducing curriculum change, in particular, redesigning an UG program for post graduate delivery.