What’s behind burnout in trainee physicians


Burnout is often seen as something that happens to physicians who have been practicing for years. A new study looks at how burnout impacts trainee physicians.

The topic of burnout and how to prevent or ameliorate it has been discussed for many years. That discussion may reach a fever pitch as the COVID-19 pandemic rages and increases many stressors. A report in JAMA Network Open looks at what’s behind burnout in trainee physicians.1

The investigators used PsycINFO, Embase, Medline, and Cochrane Database of Systemic reviews to find studies that included terms such as trainee, registrar, resident, intern, and foundation year. Two reviewers looked at the studies to assess them for quality of evidence.

The reviewers found that 48 studies met their criteria for inclusion in the meta-analysis. The 48 studies covered 36,266 doctors who had a median age of 29 years. There was 1 study that didn’t include information on the participants’ sex, but overall 52% of the doctors were male. The collected studies illustrated that the work demands of a trainee physician were linked with a roughly 3-fold increase odds of burnout/stress (odds ratio [OR], 2.84; 95% CI, 2.26-3.59). Other things linked with increased odds for stress and burnouts included poor work-life balance (OR, 1.93; 95% CI, 1.53-2.44), concerns about patient care (OR, 2.35; 95% CI, 1.58-3.50), and poor work environment (OR, 2.06; 95% CI, 1.57-2.70). Younger age and being more junior grade weren’t significantly linked with burnout. However, financial worries (OR, 1.35; 95% CI, 1.07-1.72), low self-efficacy (OR, 2.13; 95% CI, 1.31-3.46), perceived or reported poor mental or physical health (OR, 2.41; 95% CI, 1.76-3.31), and being female (OR, 1.34; 95% CI, 1.20-1.50) were linked to it.

The researchers said that one of the strengths was that this study was the first systematic review and meta-analysis that looked at factors in burnout in trainee physicians. One of the limitations was the wide range of factors for burnout and the fact that some needed to be pooled into the same category.

The researchers concluded that odds of burnout and stress was higher for those who had modifiable factors tied to work in comparison to nonmodifiable factors. They believe that their findings indicate that interventions on the organization level could help reduce burnout in trainee physicians.


1. Zhou A, Panagioti M, Esmail A, Agius R, Van Tongeren M, Bower P. Factors associated with burnout and stress in trainee physicians. JAMA Netw Open. 2020;3(8):e2013761. doi:10.1001/jamanetworkopen.2020.13761

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