Objective: Medical students frequently experience burnout, stress, anxiety, and depression. Research on this issue in Russia is scarce and challenging to compare due to the lack of studies on this topic in the country. The aim of the present study was to comparatively analyze the mental well-being and mental health needs of medical students in St. Petersburg, Russia, over time using the same methodology. Methods: An anonymous structured online survey was conducted among students of a medical institute in June–July 2024. The Short General Health Questionnaire (GHQ-12), Oldenburg Burnout Inventory (OLBI), and CAGE questionnaire were used in the study. Results were compared with the data of a survey conducted at the same institute in 2020. Results: The sample included responses from 152 students (76.3% women). The majority of respondents (95.4%) reported experiencing significant stress in their lives, with education-related factors (83.6%), uncertainty about the future (72.4%), and the current geopolitical situation (73.0%) being the leading sources of stress. According to the GHQ-12, screening was positive in 88.2% of students (cf 84.8% in 2020; p = 0.389). Screening for burnout using the OLBI showed positive results in 87.5% (cf 73.3% in 2020; p = 0.002) of students for disengagement and 90.1% (cf 80.0% in 2020; p = 0.012) of students for exhaustion. Screening with the CAGE tool identified a risk of problematic alcohol use in 20.4% of students (cf 20.0% in 2020; p = 0.930). Conclusions: The study showed increased burnout in students in 2024 compared to 2020 and stable rates of problematic alcohol use and positive screening for minor mental disorders.