Objective To explore the influencing factors of psychological distress of medical graduates by structural equation model and to support mental intervention for medical graduates. Methods A total of 493 graduates enrolled in 2021 by Xinjiang Medical University were investigated from September to November 2021. The structural equation model of influencing factors of psychological distress of medical graduates was constructed. Results The results showed that 493 medical postgraduates' psychological distress score (8.00±8.86), total stress score (14.99±13.82) and psychological capital score (123.61±22.13). The results showed that the highest impact on psychological distress was total stress with total effect as 0.848(P<0.001). The second was the satisfaction with the major and the total effect was 0.633(P<0.001). Other influencing factors were ranked with importance from top to bottom were personality, psychological capital and motivation for graduate study. The total effects were -0.119(P<0.001), -0.076(P<0.001) and 0.053(P<0.001) respectively. Conclusions The total pressure and satisfaction with their majors are important ones. The mental health education for medical graduates needs to pay attention to psychological intervention from the aspects of stress reception and to support their career development.