What extinguishes the flame? A meta-analytic investigation of correlates of burnout in medical trainees

Abstract

Background: Burnout, a work-related psychological syndrome, is highly prevalent in medical trainees. Burnout is associated with deleterious outcomes for the individual practitioner; their colleagues, patients and workplace; and broader society. Designing burnout prevention and reduction interventions for this population is therefore critical. However, burnout research with medical trainees is characterised by different conceptualisations and operationalisations of this complex construct, producing inconsistent findings. Aims: To examine individual and work-related correlates of burnout, as defined by the Maslach Burnout Inventory, in medical trainees. Methods: Thirty-three studies, comprising a pooled sample of 7,229 trainees, were identified from a systematic search of the Embase, PsycInfo, Medline, ERIC and Cochrane Library databases. Study reporting quality was examined using the QualSyst tool and Pearson’s r correlations calculated, in addition to 95% confidence intervals, p-values, heterogeneity statistics and fail-safe Ns. These analyses used a random-effects model. Training level (intern, resident, registrar) and specialty (surgical, non-surgical) were examined as potential moderators. Results: Variables with the strongest relationships across burnout dimensions included poor mental health; conflict between individual and organisational values; low job reward; and high workloads. Subgroup analyses identified emotional intelligence, specialty satisfaction, and income satisfaction as significant correlates specifically for surgical registrars. Conclusions: Interventions targeting burnout in medical trainees should focus on a combination of individual (e.g. improving mental health) and work variables (e.g. reduced workload) for maximum benefits. Observed differences between surgical and non-surgical registrars require further examination, as they may compromise transferability of interventions.