Burnout During Residency Training: A Literature Review
Open accessAbstract
Objective: Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Methods: Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. Results: An examination of the burnout literature reveals that it is prevalent in medical students (28%–45%), residents (27%–75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can result in negative consequences as a working physician. Burnout also poses significant challenges during early training years in residency. Time demands, lack of control, work planning, work organization, inherently difficult job situations, and interpersonal relationships, are considered factors contributing to residents' burnout. Potential interventions include workplace-driven and individual-driven measures. Workplace interventions include education about burnout, workload modifications, increasing the diversity of work duties, stress management training, mentoring, emotional intelligence training, and wellness workshops. Individual-driven behavioral, social, and physical activities include promoting interpersonal professional relations, meditation, counseling, and exercise. Conclusions: Educators need to develop an active awareness of burnout and ought to consider incorporating relevant instruction and interventions during the process of training resident physicians.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Physicians experiencing burnout are at risk of suboptimal performance and medical or surgical errors, negatively impacting patient care and physician productivity.
“A physician experiencing burnout is at risk of performing suboptimally and committing medical and surgical errors, in turn negatively impacting patient care and physician productivity [2-4].”
From A National Cross-Sectional Study on the Prevalence of Burnout in Filipino Neurosurgery Residents (2024) · cites this paper as [2]
Multiple studies have demonstrated that longer working hours is a significant driver of burnout.
“Multiple studies have demonstrated that longer working hours is a significant driver of burnout [2, 10, 1314].”
From A National Cross-Sectional Study on the Prevalence of Burnout in Filipino Neurosurgery Residents (2024) · cites this paper as [2]
Being unmarried is associated with an increased likelihood of meeting burnout criteria.
“Evidence shows that being unmarried is associated with an increased likelihood to meet burnout criteria [2]”
From A National Cross-Sectional Study on the Prevalence of Burnout in Filipino Neurosurgery Residents (2024) · cites this paper as [2]
Cites
Burnout and self-reported patient care in an internal medicine residency program
Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-5-200203050-00008 · Cited by 2,165 · see citing works
Mindfulness-based stress reduction for health care professionals: results from a randomized trial
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005) · International Journal of Stress Management · doi:10.1037/1072-5245.12.2.164 · Cited by 1,323 · see citing works
Rates of medication errors among depressed and burnt out residents: prospective cohort study
Fahrenkopf, A. M., Sectish, T. C., Barger, L. K., Sharek, P. J., Lewin, D., Chiang, V. W., Edwards, S., Wiedermann, B. L., & Landrigan, C. P. (2008) · BMJ · doi:10.1136/bmj.39469.763218.be · Cited by 1,175 · see citing works
Melamed, S., Shirom, A., Toker, S., Berliner, S., & Shapira, I. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.3.327 · Cited by 943 · see citing works
Thomas, N. K. (2004) · JAMA · doi:10.1001/jama.292.23.2880 · Cited by 750 · see citing works
Managing Emotions During Team Problem Solving: Emotional Intelligence and Conflict Resolution
Jordan, P. J., & Troth, A. C. (2004) · Human Performance · doi:10.1207/s15327043hup1702_4 · Cited by 549 · see citing works
Halbesleben, J. R. B., & Rathert, C. (2008) · Health Care Management Review · doi:10.1097/01.hmr.0000304493.87898.72 · Cited by 519 · see citing works
Toker, S., Shirom, A., Shapira, I., Berliner, S., & Melamed, S. (2005) · Journal of Occupational Health Psychology · doi:10.1037/1076-8998.10.4.344 · Cited by 340 · see citing works
Golub, J. S., Weiss, P. S., Ramesh, A. K., Ossoff, R. H., & Johns, M. M. (2007) · Academic Medicine · doi:10.1097/acm.0b013e3180556825 · Cited by 175 · see citing works
Depression among medical students
Zoccolillo, M., Murphy, G. E., & Wetzel, R. D. (1986) · Journal of Affective Disorders · doi:10.1016/0165-0327(86)90065-0 · Cited by 173 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Burnout in medical students: A systematic review
IsHak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013) · The Clinical Teacher · doi:10.1111/tct.12014 · Cited by 715 · see citing works
Self-citationBurnout syndrome among medical residents: A systematic review and meta-analysis
Rodrigues, H., Cobucci, R., Oliveira, A., Cabral, J. V., Medeiros, L., Gurgel, K., Souza, T., & Gonçalves, A. K. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206840 · Cited by 589 · see citing works
Burnout syndrome among healthcare professionals
Bridgeman, P. J., Bridgeman, M. B., & Barone, J. (2018) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp170460 · Cited by 498 · see citing works
National Survey of Burnout among US General Surgery Residents
Elmore, L. C., Jeffe, D. B., Jin, L., Awad, M. M., & Turnbull, I. R. (2016) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2016.05.014 · Cited by 476 · see citing works
Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic
Dimitriu, M. C. T., Pantea-Stoian, A., Smaranda, A. C., Nica, A. A., Carap, A. C., Constantin, V. D., Davitoiu, A. M., Cirstoveanu, C., Bacalbasa, N., Bratu, O. G., et al. (2020) · Medical Hypotheses · doi:10.1016/j.mehy.2020.109972 · Cited by 319 · see citing works
Burnout risk in medical students in Spain using the Maslach Burnout Inventory-Student Survey
Galán, F., Sanmartín, A., Polo, J., & Giner, L. (2011) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-011-0623-x · Cited by 210 · see citing works
Burnout in French physicians: A systematic review and meta-analysis
Kansoun, Z., Boyer, L., Hodgkinson, M., Villes, V., Lançon, C., & Fond, G. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.056 · Cited by 167 · see citing works
Fainstad, T., Mann, A., Suresh, K., Shah, P., Dieujuste, N., Thurmon, K., & Jones, C. D. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.10752 · Cited by 148 · see citing works
Factors associated with burnout among US neurosurgery residents: a nationwide survey
Attenello, F. J., Buchanan, I. A., Wen, T., Donoho, D. A., McCartney, S., Cen, S. Y., Khalessi, A. A., Cohen-Gadol, A. A., Cheng, J. S., Mack, W. J., et al. (2018) · Journal of Neurosurgery · doi:10.3171/2017.9.jns17996 · Cited by 145 · see citing works
Arima, M., Takamiya, Y., Furuta, A., Siriratsivawong, K., Tsuchiya, S., & Izumi, M. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-043728 · Cited by 138 · see citing works
Simpkin, A. L., Khan, A., West, D. C., Garcia, B. M., Sectish, T. C., Spector, N. D., & Landrigan, C. P. (2018) · Academic Pediatrics · doi:10.1016/j.acap.2018.03.002 · Cited by 125 · see citing works
Mindfulness-based stress reduction for residents: A randomized controlled trial
Verweij, H., van Ravesteijn, H., van Hooff, M. L. M., Lagro-Janssen, A. L. M., & Speckens, A. E. M. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-017-4249-x · Cited by 122 · see citing works
The inevitability of physician burnout: Implications for interventions.
Montgomery, A. (2014) · Burnout Research · doi:10.1016/j.burn.2014.04.002 · Cited by 124 · see citing works
Riall, T. S., Teiman, J., Chang, M., Cole, D., Leighn, T., McClafferty, H., & Nfonsam, V. N. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2017.12.017 · Cited by 92 · see citing works
Residency as a Social Network: Burnout, Loneliness, and Social Network Centrality
Shapiro, J., Zhang, B., & Warm, E. J. (2015) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-15-00038.1 · Cited by 87 · see citing works
Zaed, I., Jaaiddane, Y., Chibbaro, S., & Tinterri, B. (2020) · World Neurosurgery · doi:10.1016/j.wneu.2020.08.005 · Cited by 91 · see citing works
Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians
Olson, S. M., Odo, N. U., Duran, A. M., Pereira, A. G., & Mandel, J. H. (2014) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-13-00396 · Cited by 73 · see citing works
Designing and implementing a resiliency program for family medicine residents
Brennan, J., & McGrady, A. (2015) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217415592369 · Cited by 76 · see citing works
Ofei-Dodoo, S., Cleland-Leighton, A., Nilsen, K., Cloward, J. L., & Casey, E. (2020) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000001892 · Cited by 53 · see citing works
A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China
Huang, L., Harsh, J., Cui, H., Wu, J., Thai, J., Zhang, X., Cheng, L., & Wu, W. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00957 · Cited by 55 · see citing works
Mind-body skills training for resident wellness: A pilot study of a brief mindfulness intervention
Romcevich, L. E., Reed, S., Flowers, S. R., Kemper, K. J., & Mahan, J. D. (2018) · Journal of Medical Education and Curricular Development · doi:10.1177/2382120518773061 · Cited by 44 · see citing works
Psychosocial burden in medical students and specific prevention strategies
Bugaj, T., Cranz, A., Junne, F., Erschens, R., Herzog, W., & Nikendei, C. (2016) · Mental Health & Prevention · doi:10.1016/j.mhp.2015.12.003 · Cited by 47 · see citing works
McTaggart, L. S., & Walker, J. P. (2022) · Health Sciences Review · doi:10.1016/j.hsr.2022.100049 · Cited by 30 · see citing works
Mann, A., Fainstad, T., Shah, P., Dieujuste, N., Thurmon, K., Dunbar, K., & Jones, C. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03729-5 · Cited by 24 · see citing works
Ogunyemi, D., Darwish, A. G., Young, G., Cyr, E., Lee, C., Arabian, S., Challakere, K., Lee, T., Wong, S., & Raval, N. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03366-y · Cited by 17 · see citing works
Self-citationA National Cross-Sectional Study on the Prevalence of Burnout in Filipino Neurosurgery Residents
Mercado, C. M., Torres, G. M., & Sih, I. M. (2024) · Research Square (preprint) · doi:10.21203/rs.3.rs-5351715/v1
- Authors
- IsHak, W. W., Lederer, S., Mandili, C., Nikravesh, R., Seligman, L., Vasa, M., Ogunyemi, D., & Bernstein, C. A.
- Affiliations
- University of Southern California (US)
- Venue
- Journal of Graduate Medical Education
- Published
- 2009-12
- Volume
- 1
- Issue
- 2
- Pages
- 236-242
- ISSN
- 1949-8349 (ISSN-L)
- 1949-8357
- PMC
- PMC2931238
- OpenAlex
- W2102806183
- Cited by
- 643
- References
- 10
- Citations by year
- 2026: 33 · 2025: 29 · 2024: 53 · 2023: 51 · 2022: 62 · 2021: 77 · 2020: 73 · 2019: 69 · 2018: 53 · 2017: 56 · 2016: 44 · 2015: 14 · 2014: 12 · 2013: 11 · 2012: 4
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Graduate Medical Education (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- burnout, medical residents, residency training, physician well-being, psychological distress, workload, stress management training, mentoring, emotional intelligence, burnout intervention, burnout prevalence, patient safety, employee performance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
