Background: Stress in nursing students may be related to attrition from nursing programmes and lead to a shortage of nurses entering clinical careers. In addition, stress leads to psychological morbidity which may have profound adverse consequences for individual nursing students. Objectives: To follow a cohort of nursing students from entry to their programme to the end of the first year and to study the interrelationship between a range of psychological variables including personality, stress, coping and burnout. Design: Prospective, repeated measures survey using self-administered questionnaires. Setting: A university school of nursing in Hong Kong. Participants: Students were selected on the basis of entry to their nursing programme in 2004; 158 students entered the study and 147 completed; 37 were male and 121 were female at entry. The mean age of the cohort at entry was 19.1 (S.D. 0.85); ages ranged from 18 to 26. Methods: The questionnaires administered at wave 1 were: the NEO Five Factor Inventory, the Coping in Stressful Situations questionnaire, the 12-item General Health Questionnaire, the Maslach Burnout Inventory and the Stress in Nursing Students questionnaire. At wave 2 the 12-item General Health Questionnaire, the Maslach Burnout Inventory and the Stress in Nursing Students questionnaire were administered. Results: Students suffered greater levels of psychological morbidity and burnout at the second time wave and this was largely explained by the personality trait of neuroticism. Stress also increased and this was largely explained by emotion-oriented coping. Conclusions: Undertaking a nursing programme leads to increased level of stress, burnout and psychological morbidity and this is largely related to individual personality and coping traits. © 2007 Elsevier Ltd. All rights reserved.