Burnout syndrome among trainee doctors in a nationally accredited postgraduate medical training system

Abstract

Background

Burnout syndrome is an occupational condition resulting from chronic work-related stressors and it tends to be higher in medical professionals. This study aims to assess burnout among trainee doctors within a nationally accredited postgraduate medical education (PGME) system and identify self-reported contributing factors.

Methods

This cross-sectional study utilized data from the annual Trainees Survey conducted by the National Institute for Health Specialties (NIHS), the national accrediting body responsible for postgraduate medical education (PGME). The survey, which included the Oldenburg Burnout Inventory (OLBI) to assess emotional exhaustion and disengagement, was disseminated to all doctors enrolled in accredited training programs between March and October 2023.

Results

Out of 1618 residents and interns invited, 653 (40.4%) completed the OLBI. There were 473 females (72.4%), 201 Emirati (30.8%) trainees with 212 interns (37.8%) and 440 residents (61.1%). The most common specialties were Pediatrics (103 trainees; 15.8%), Internal Medicine (71 trainees; 10.9%) and Family Medicine (71 trainees; 10.3%). Using validated OLBI cut-off scores, burnout syndrome was identified (with either emotional exhaustion or disengagement) in 136 trainees (20.8%). On the disengagement scale, 79 trainees (12.1%) reported feeling disengaged at work, indicating a cynicism profile. On the exhaustion scale, 113 trainees (17.3%) reported feeling exhausted from work duties, indicating an overextended profile. Burnout in both dimensions, representing a severe burnout profile, was identified in 56 participants (8.6%). High burnout levels were particularly noted in Internal Medicine, Family Medicine, General Surgery, and among medical interns. Multivariate analysis identified duty hour violations (adjusted OR 1.42) and lower satisfaction with supervision and teaching (adjusted OR 0.31) as significant predictors of burnout.

Conclusions

Burnout affects approximately one-fifth of trainee doctors in this nationally accredited system, with duty hour violations and inadequate supervision emerging as modifiable risk factors. These findings support targeted interventions focusing on workload regulation and enhanced faculty engagement to improve trainee well-being.

Introduction

Burnout syndrome among medical trainees has emerged as a critical concern in healthcare systems worldwide, with significant implications for physician well-being, patient safety, and healthcare delivery [1, 2]. The World Health Organization recognizes burnout as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed, classified under ICD-11 code QD85 [3]. Burnout is characterized by three core dimensions: emotional exhaustion, depersonalization (or cynicism), and reduced sense of personal accomplishment [4]. Burnout among medical trainees is a mature and extensively researched field. A comprehensive systematic review and meta-analysis by Zhou et al. (2020), encompassing 48 studies and 36,266 medical trainees, highlighted the significant impact of workplace factors on burnout, reporting that high work demands were associated with a nearly threefold increase in burnout risk [5]. Similarly, global estimates suggest a pooled burnout prevalence of approximately 51% among medical residents [6], underscoring the magnitude of this occupational health crisis [6].

The consequences of burnout extend across multiple domains, affecting the work environment, patient care, and personal health. At the organizational level, burnout contributes to decreased job satisfaction, negative workplace culture, reduced staff retention, and increased absenteeism [6]. From a patient safety perspective, physicians experiencing burnout demonstrate higher rates of medical errors, reduced attention to detail, and diminished patient engagement, ultimately compromising the quality of care delivered [7]. Furthermore, burnout has been linked to adverse personal health outcomes including hypertension, diabetes mellitus, gastrointestinal disorders, sleep disturbances, and impaired family well-being [8, 9]. A recent systematic review and meta-analysis demonstrated a significant association between burnout and increased risk of cardiovascular disease, including myocardial infarction [10].

Doctors in training represent a particularly vulnerable population for burnout due to the inherent demands of postgraduate training. Extended training periods, prolonged and irregular working hours, high clinical responsibility, sleep deprivation, and the pressure of continuous evaluation create a confluence of stressors that distinguish trainees from the general workforce [11, 12]. Several modifiable factors have been identified as contributors to trainee burnout, including excessive duty hours, inadequate supervision, limited autonomy, poor work-life integration, and insufficient faculty engagement in educational activities [13, 14]. Notably, supportive learning environments characterized by accessible mentorship, constructive feedback, and reasonable workload distribution have been associated with lower burnout rates, suggesting potential targets for institutional intervention [15, 16].

In the United Arab Emirates (UAE), a previous multicenter study conducted in 2018 among resident physicians reported that 70% of participants experienced burnout syndrome, with 16% demonstrating signs of depression [17]. However, that study was limited to residents from a single geographic emirate, utilized cut-off scores that have since been revised, and did not include medical interns. Studies from neighboring Gulf Cooperation Council (GCC) countries have reported burnout prevalence ranging from 65% to 98% among trainees, though heterogeneity in assessment tools and definitions limits direct comparisons [18, 19]. Despite the growing body of international literature, a comprehensive national assessment of burnout encompassing all accredited training programs, including both residents and interns, has not been undertaken in the UAE. The National Institute for Health Specialties (NIHS), as the accrediting body for postgraduate medical education in the UAE, conducted its inaugural national survey incorporating validated burnout assessments to systematically evaluate trainee well-being. This initiative addresses a critical gap, as many UAE residency programs hold accreditations from multiple regional and international bodies without a unified mechanism for monitoring trainee wellness. To the best of our knowledge, this represents the first nationwide study to assess burnout across all accredited medical training programs in the UAE, encompassing both residents and interns within a single, standardized framework.

This study aimed to determine the prevalence of burnout among trainee doctors enrolled in nationally accredited postgraduate medical education (PGME) programs in the UAE and to identify associated factors, with particular focus on duty hour violations and satisfaction with supervision and teaching.

Methods

Study design

This was a cross-sectional study utilizing data from the annual Trainees Survey conducted by NIHS. The survey was disseminated electronically to all residents and interns who had enrolled in training for at least six months. It collected data on demographics, working conditions, self-reported stressors, and burnout levels.

Burnout assessment tool

Several validated instruments exist for measuring burnout syndrome. The Maslach Burnout Inventory (MBI) remains the most widely used tool and can assess all three dimensions of burnout: emotional exhaustion, depersonalization/cynicism, and lack of personal accomplishment [3, 4]. However, the MBI is a proprietary instrument requiring payment for each use. The Copenhagen Burnout Inventory (CBI) is freely available but measures only the exhaustion dimension of burnout [20]. The Oldenburg Burnout Inventory (OLBI), developed by Demerouti et al. based on the Job Demands-Resources model, is another freely available instrument that measures two core dimensions of burnout: emotional exhaustion and disengagement (depersonalization) [7, 18, 21]. The OLBI has demonstrated comparable validity to the MBI for assessing these two dimensions [5]. Given the large sample size (> 1500 trainees) and funding constraints, we selected the OLBI (English version) to assess burnout in this study. The survey comprised two parts. The first part collected information on demographics (age, gender, nationality), training program details (specialty, year of training), and working conditions including duty hour practices and satisfaction with supervision and teaching. The second part, presented as a “wellbeing survey” to minimize response bias, included the 16-item OLBI questionnaire (English version) to assess emotional exhaustion and disengagement [16]. Participation in the OLBI section was optional.

Data collection

All 1,618 residents and interns enrolled in training programs accredited by NIHS between March 2023 and October 2023 were invited to complete the online confidential survey via the NIHS electronic platform. A total of 653 trainees (40.4%) completed the survey. Post-hoc statistical power calculations confirmed that a minimum sample size of 528 respondents was required to detect a burnout prevalence of 25% compared to an estimated baseline rate of 20% (power 80%, alpha level 0.05, one-sample proportion test); our achieved sample exceeded this threshold.

Inclusion criteria were: (1) enrollment in a nationally accredited residency or internship program, and (2) agreement to participate. The study was approved by the United Arab Emirates University Social Sciences Ethics Committee (approval number ERSC_2023_2948). Electronic informed consent was obtained from all participants. No personally identifiable information was collected, and participant confidentiality was maintained throughout. Data were stored on a secure server within the NIHS platform.

Statistical analysis

Statistical analysis was performed using IBM SPSS Statistics version 29 (IBM Corp., Armonk, NY, USA). Descriptive statistics were presented as frequencies and percentages for categorical variables, and means with standard deviations (SD) for continuous variables. Burnout was assessed using the OLBI, which comprises 16 items scored on a 4-point Likert scale (1 = strongly agree to 4 = strongly disagree), with eight items measuring exhaustion and eight measuring disengagement. Following reverse-scoring of positively worded items, mean scores were calculated for each subscale. High burnout was defined using validated cut-off scores derived from occupational studies which is ≥ 2.85 for exhaustion and ≥ 2.6 for disengagement [24]. Participants scoring above the cut-off on either subscale were classified as having burnout; those exceeding both cut-offs were classified as having severe burnout (burnout in both dimensions).

A composite Duty Hours Violations Score was calculated as the mean of Likert-scale ratings (1 = never to 5 = extremely often) for five items assessing frequency of exceeding: 80-hour weekly limit, one day off per week, 1-in-3 on-call frequency, 10-hour inter-shift rest, and 24-hour continuous duty limit. A satisfaction with Supervision and Teaching Score was calculated as the mean of three items assessing supervision frequency and satisfaction with supervision and teaching.

Bivariate associations between categorical variables were assessed using chi-square tests; comparisons of continuous variables between two groups used independent samples t-tests. Correlations between continuous variables were assessed using Pearson’s correlation coefficient. P-values reported in Table 1 represent chi-square tests comparing distributions between male and female respondents. To address potential non-response bias given the 40.4% response rate, respondent demographics were compared to the total population registry where possible, though full non-response analysis was limited by data privacy constraints.

Table 1.

Characteristics of study participants (N = 653 trainee doctors)

		Gender
		Males		Females		Total
		N	%	N	%		p-value
Year of training	Intern	66	31.1%	146	68.9%	212
	PGY 1	36	26.1%	102	73.9%	138
	PGY 2	33	32.4%	69	67.6%	102
	PGY 3	17	18.7%	74	81.3%	91	0.045
	PGY 4	18	22.8%	61	77.2%	79
Intern or resident	Interns	66	31.1%	146	68.9%	212
	Residents	113	25.7%	327	74.3%	440
Nationality		2	50.0%	2	50.0%	4	< 0.001
	Emirati	31	15.4%	170	84.6%	201
	Non-Emirati	147	32.8%	301	67.2%	448
High disengagement	Normal	144	29.0%	353	71.0%	497
	Disengaged	36	23.4%	118	76.6%	154
High exhaustion	Normal	116	32.1%	245	67.9%	361	0.005
	Exhausted	64	22.1%	225	77.9%	289
High in either Disengagement OR Exhaustion)	No	112	32.7%	231	67.3%	343	0.003
	Yes	68	22.1%	240	77.9%	308
High in both Disengagement AND Exhaustion)	All others including those with only one	148	28.7%	367	71.3%	515
	Both disengaged AND exhausted	32	23.7%	103	76.3%	135
Specialty	Anesthesia	4	21.1%	15	78.9%	19
	Dermatology	0	0.0%	8	100.0%	8
	Emergency Medicine	23	40.4%	34	59.6%	57
	ENT	0	0.0%	6	100.0%	6
	Family Medicine	14	19.7%	57	80.3%	71
	General Surgery	8	42.1%	11	57.9%	19
	Internal Medicine	20	28.2%	51	71.8%	71
	Medical Internship	37	27.4%	98	72.6%	135
	Obstetrics and Gynecology	0	0.0%	16	100.0%	16
	Ophthalmology	0	0.0%	3	100.0%	3
	Orthodontics	1	11.1%	8	88.9%	9
	Orthopedics	8	80.0%	2	20.0%	10
	Pediatrics	17	16.5%	86	83.5%	103
	Prosthodontics	1	14.3%	6	85.7%	7
	Psychiatry	6	24.0%	19	76.0%	25
	Radiology	3	37.5%	5	62.5%	8
	Urology	9	100.0%	0	0.0%	9

p-values are for comparison of frequencies between males and females

Multivariate binary logistic regression was performed to identify independent predictors of burnout (defined as elevated score on either subscale), with results expressed as adjusted odds ratios (OR) and 95% confidence intervals (CI). Linear regression was used to identify predictors of continuous exhaustion and disengagement scores, with results expressed as standardized beta coefficients. A stepwise selection method was employed for model building. Statistical significance was set at p < 0.05 (two-tailed).

Results

A total of 653 respondents out of 1,618 invited trainees (40.4%) completed the burnout questionnaire (Table 1). The majority were female (473; 72.4%) with 180 males (27.6%). There were 201 (30.8%) Emirati nationals and 448 (68.6%) non-Emirati physicians. In terms of training stage, there were 212 (37.8%) interns and 440 (61.1%) residents. The most common specialties were Pediatrics (103 respondents; 15.8%), Internal Medicine (71; 10.9%), and Family Medicine (71; 10.3%).

Burnout scales categorized into high and normal levels

Using pre-specified cut-off levels for OLBI (≥ 2.6 for disengagement; ≥2.85 for exhaustion) [25], burnout scores were categorized into high and normal subgroups. On the disengagement scale, 79 (12.1%) respondents scored above the threshold, indicating a cynicism profile of burnout. On the exhaustion scale, 113 (17.3%) reported high exhaustion levels, indicating an overextended profile. Burnout syndrome, defined as scoring above the cut-off on either dimension, was identified in 136 (20.8%) respondents. Severe burnout, defined as elevated scores on both dimensions, was present in 56 (8.6%) respondents (Table 2).

Table 2.

Burnout levels among respondents

Characteristics		Disengagement		Exhaustion		Both
		N	%	N	%	N	%
Gender	Males	36	20.0%	64	35.6%	32	17.8%
	Females	118	25.1%	225	47.9%	103	21.9%
Year of training	Intern	58	27.5%	100	47.4%	51	24.1%
	PGY 1	34	24.6%	74	54.0%	30	21.9%
	PGY 2	17	16.7%	37	36.3%	16	15.7%
	PGY 3	18	20.0%	32	35.2%	15	16.7%
	PGY 4	16	20.3%	29	37.2%	13	16.7%
Intern or resident	Interns	58	27.5%	100	47.4%	51	24.1%
	Residents	96	21.9%	188	42.9%	84	19.2%
Specialty	Anesthesia	6	31.6%	9	47.4%	6	31.6%
	Dental Internship	17	22.1%	27	35.5%	13	16.9%
	Dermatology	2	25.0%	3	37.5%	2	25.0%
	Emergency Medicine	10	17.5%	16	28.1%	7	12.3%
	ENT	0	0.0%	2	33.3%	0	0.0%
	Family Medicine	13	18.6%	36	51.4%	12	17.4%
	General Surgery	3	15.8%	6	31.6%	3	15.8%
	Internal Medicine	20	28.2%	37	52.1%	19	26.8%
	Medical Internship	41	30.6%	73	54.1%	38	28.1%
	Gynecology	5	31.3%	8	50.0%	5	31.3%
	Ophthalmology	0	0.0%	1	33.3%	0	0.0%
	Orthodontics	2	22.2%	4	44.4%	2	22.2%
	Orthopedics	0	0.0%	2	20.0%	0	0.0%
	Pediatrics	26	25.2%	46	45.1%	20	19.6%
	Prosthodontics	2	28.6%	2	28.6%	2	28.6%
	Psychiatry	2	8.0%	11	44.0%	2	8.0%
	Radiology	0	0.0%	0	0.0%	0	0.0%
	Urology	5	55.6%	6	66.7%	4	44.4%

N = 653 physicians

Burnout scores

The mean disengagement score was 2.04 (SD 0.48; range 1.0–3.75), while the mean exhaustion score was 2.37 (SD 0.52; range 1.0–4.0). The two subscales were strongly correlated (r = 0.759, p < 0.001).

Female respondents had higher disengagement scores (2.08 vs. 1.95; p = 0.003) and higher exhaustion scores (2.43 vs. 2.23; p < 0.001) compared to males.

Association with working conditions

Higher satisfaction with supervision and teaching was observed in programs with fewer duty hour violations (r = -0.302, p < 0.001). Both burnout subscales correlated positively with duty hour violations (disengagement: r = 0.268; exhaustion: r = 0.312; both p < 0.001) and negatively with satisfaction (disengagement: r = -0.525; exhaustion: r = -0.450; both p < 0.001). Figure 1 illustrates the frequency of duty hour violations and satisfaction levels reported by respondents.

Fig. 1.

Burnout syndrome among trainee doctors in different specialties* *Notes: sorted in decreasing order based on mean scores for female respondents. N = 653 trainee physicians

Faculty engagement in educational activities was strongly associated with burnout. Among respondents who reported low faculty interest in their learning, 18.9% met criteria for burnout (either dimension), compared with only 4.5% among those reporting high faculty interest (p < 0.001; Table 3).

Table 3.

Association between faculty interest in education and resident burnout

Oldenburg Burnout Inventory Results	Faculty’s interest in education (as per trainees)
	High		Low		p-value
Burnout dimension identified	N	%	N	%
Disengagement	69	44.8%	85	55.2%	< 0.001
Exhaustion	158	54.7%	131	45.3%	< 0.001
Both Exhaustion AND Disengagement	53	39.3%	82	60.7%	< 0.001

N = 651 physicians in training. Percentages are across rows. P based on chi-square test

Multivariate analysis

Using binary logistic regression, statistically significant predictors of burnout (elevated score on either subscale) included higher duty hour violations (adjusted OR 1.42) and lower satisfaction with supervision and teaching (adjusted OR 0.31). The model demonstrated acceptable fit (Nagelkerke R² = 0.188; 80% correctly classified; stepwise forward selection). Gender, clinical specialty, and year of training were not significant predictors in the final model.

Two additional multivariate analyses examined predictors of each burnout dimension separately. Using linear regression, predictors of disengagement included lower satisfaction with supervision and teaching (β = -0.49; p < 0.001) and higher duty hour violations (β = 0.12; p < 0.001) (adjusted R² = 0.28). Predictors of exhaustion included lower satisfaction with supervision and teaching (β = -0.38; p < 0.001), higher duty hour violations (β = 0.19; p < 0.001), and female gender (β = 0.09; p = 0.01) (adjusted R² = 0.24; N = 619).

Discussion

Our study is the first to estimate the prevalence of burnout syndrome among all trainees conducted by NIHS as part of its national accreditation efforts. The three commonly used validated inventories for measuring burnout are MBI, OLBI, and CBI [3, 4, 20]. Since using MBI would have required significant funding to survey > 1500 current trainees, we opted to use the OLBI (free to use) to capture both dimensions of burnout in interns and residents. Burnout has been previously reported amongst nearly two-thirds of UAE resident trainee doctors in 2018, which recommended implementing work hour regulations as advocated by the Accreditation Council for Graduate Medical Education (ACGME) [17]. ACGME recommends capping the limit of resident working hours at an average of 80 h per week amongst other working regulations for residents and emphasizes closely monitoring and improving well-being among trainees [22]. Our study, conducted five years later, shows that duty hour violations are still reported despite the implementation of these work hour regulations, with nearly 40% of residents admitting to breaking the rule at least once and over 10% reporting breaking it on a frequent basis (Fig. 2). The frequency of duty hour violations correlated directly with the presence of burnout.

Fig. 2.

Issues in training programs according to respondents depicting frequencies of exceeding duty limits. Note: items listed in decreasing order of frequency

Our study estimated the prevalence of burnout syndrome among trainee doctors to be 20.8%, which is notably lower than the rates reported in the previous 2018 UAE study (70%) and international estimates (51%) [6, 17]. This difference should be interpreted with caution, as the studies employed different assessment tools and cut-off criteria. The 2018 study relied on Maslach Burnout Inventory (MBI) third edition and used cut-off scores of ≥ 27 and/or ≥ 10 to identify high emotional exhaustion and high depersonalization respectively, which were adapted from the 3rd edition of MBI published in 1996 [23]. The fourth edition of MBI, published in 2016, acknowledged that these cut-off scores should not be used for diagnosing burnout as they are arbitrary and removed these old cut-offs from all MBI materials due to risks of overestimation and miscalculation [24]. The MBI 2016 edition recommended using standardized (z) values for various populations to identify burnout [24], but the 2018 study did not use these values, which may have caused an overestimation of burnout syndrome [17, 19]. Our study used validated and current OLBI cut-off values as recommended by Demerouti et al. for identifying high burnout in working employees: ≥2.85 for exhaustion and ≥ 2.6 for disengagement [25]. This methodological difference may explain the variation in reported burnout frequency in UAE residents over the last five years.

Burnout syndrome has been diagnosed amongst residents and trainee doctors of various specialties across different healthcare systems, with up to 57.5% of Diabetes Specialist Registrars in England, Scotland and Wales experiencing burnout, a rate that has only increased after the pandemic [26, 27]. Our study showed that interns and first-year residents experience significantly more emotional exhaustion (but not disengagement) than residents in their final two years of training (p < 0.01, Fig. 3). This may indicate lack of resilience and limited exposure to clinical duties/responsibilities at the start of internship and residency programs, which may improve over time during training.

Fig. 3.

Burnout with advancing years of training (n = 620 trainee physicians). Notes: statistically significant differences for Exhausted, p = 0.01 on chi-square test but not for Disengaged (p = 0.22)

Our study also showed that trainee doctors who reported high levels of faculty engagement in their learning activities had substantially lower burnout rates (4.5%) compared to those reporting low faculty interest (18.9%), a statistically significant difference (p < 0.001, Table 3). These results indicate the need for more faculty engagement and interaction with trainees to support their clinical learning, which may help prevent trainee burnout. Another study assessing burnout and stress in residents in Abu Dhabi emirate in 2016 identified burnout in more than 65% of participants; however, a non-validated de novo tool was used for assessing burnout, which may affect accurate estimation [28]. Studies from neighboring countries have indicated burnout syndrome to be as high as 88.5% in registrars working in Saudi Arabia using MBI [29], and 92.2% in Oman and 97.8% in Kuwait amongst trainee residents using Copenhagen Burnout Inventory (CBI) indicating work-related burnout [30]. These results may not be fully comparable due to use of different tools to measure burnout syndrome, which creates heterogeneity, but they are indicative of the magnitude of this problem in healthcare professionals. A recent systematic review assessing the burden of burnout amongst various healthcare providers (physicians, nurses, and allied health) in the Middle East estimated burnout prevalence ranging between 40% and 60%, indicating the need for identification, prevention, and intervention at personal, institutional, and national levels [31]. Recent literature from Leiter and Maslach defines five possible personal profiles among working populations with reference to three burnout dimensions: exhaustion, disengagement, and low efficacy [32]. These five profiles are: (1) Engaged (low exhaustion, low depersonalization, high personal accomplishment); (2) Ineffective (only low personal accomplishment); (3) Overextended (high exhaustion only); (4) Disengaged (high depersonalization only); and (5) Burnout profile (both high exhaustion and high depersonalization) [32]. Applying this profile classification to our trainee doctors in the UAE shows that 12.1% fit the disengaged profile (cynicism only), 17.3% correspond to the overextended profile (exhaustion only), and 8.6% meet criteria for the burnout profile (both dimensions elevated). The strategies for intervention differ by profile: overextended residents experiencing exhaustion may benefit from workload reduction, while disengaged residents with high cynicism and problematic relationships with coworkers and/or organizational values require a different engaging approach. The burnout profile represents the most distressing form, found in approximately 9% of our trainees, which can present a significant challenge to address.

Various management strategies for reducing burnout syndromes in physicians have been utilized in the literature, including employee-based interventions like changing work patterns, developing coping skills, promoting good physical and mental health, and employing relaxation strategies and mindfulness; however, no proven efficacy of any individual intervention is currently established [33, 34]. Physician coaching, self-compassion programs, and yoga-based techniques may improve mental health and resilience [35, 36]. Another concept in preventing burnout, with more success than individual-based strategies, is organization-based changes that enable better understanding of employers to adapt work conditions by imparting specific healthcare leadership training [37]. Educators and clinicians with specialized communication and psychological skills can also help improve the wellbeing of medical students and doctors in training [38]. Similarly, innovative teaching strategies that combine didactic and participatory approaches may be useful in supporting trainees in distress, while stress emanating from clinical uncertainty during clinical care can be partly alleviated using probabilistic reasoning [39, 40]. Clinical supervisors who emphasize teaching a holistic approach to patient care may help trainees find more meaning in their clinical work and improve sense of personal efficacy [41]. These trainee and educator-specific interventions may be considered in our setting, given that trainee doctors reported higher burnout rates when their clinical education faculty were less interested in their learning.

As part of a broader quality improvement initiative, NIHS has shared individual program reports with designated institutional officials (DIOs) and program directors, requesting action plans to address burnout-related concerns. This process will serve as a mechanism for ensuring accountability and promoting well-being across training institutions. Burnout mitigation strategies can be categorized into individual and institutional approaches. While physician self-care programs (such as mindfulness training and resilience workshops) offer some benefits; organizational-level changes like enhanced faculty engagement, workload adjustments, and structured mentorship programs have demonstrated more sustained improvements in reducing burnout rates [42].

Limitations

This study had several limitations. First, the use of OLBI rather than MBI, necessitated by funding constraints, meant we could only identify two dimensions and three profiles of burnout rather than all three dimensions and five profiles. Second, the 40.4% response rate, while sufficient for statistical analysis, introduces potential non-response bias; however, respondent demographics were broadly consistent with the overall trainee population. Third, certain personal factors potentially associated with burnout; such as history of smoking, alcohol or illicit drug use, detailed medical/psychiatric history, or screening for depression and/or anxiety disorders; which could not be assessed due to confidentiality concerns and survey length constraints.

Conclusion

This study underscores the importance of systemic efforts in addressing burnout among medical trainees. As the national accrediting body, NIHS has taken a pioneering step by integrating burnout assessments into its annual Trainees Survey. Moving forward, structured interventions and continuous monitoring will be essential to improving trainee well-being and ensuring a sustainable, supportive medical education environment. Personal, departmental and institutional interventions may be required to address the prevalence of burnout in residents/interns as this may lead to decreased organizational productivity, personal health problems, increased absenteeism, increased medical errors and decreased patient care. Future large scale prospective interventional studies using MBI are suggested to help identify the best interventions to reduce physician burnout.

Authors’ contributions

M. AH.: Administrative support, collection and assembly of data, manuscript drafting, manuscript review, and final approval. M.J.H.: Manuscript drafting, critical analysis, manuscript review, and final approval. E.A: Conception, manuscript drafting, manuscript review, and final approval. A.A: Design, conception, manuscript drafting, collection and assembly of data, manuscript drafting, manuscript review, and final approval.

Funding

Unfunded study.

Data availability

The author confirms that all data generated or analyzed during this study are included in this published article.

Declarations

Ethics approval and consent to participate

The study was approved by United Arab Emirates University Social Sciences Ethics Committee with approval number ERSC_2023_2948. An electronic informed consent was obtained from all of the participants in the study. No participant personal identifiable information was included in this study and participant confidentiality was maintained. All research was carried out in compliance with the Helsinki Declaration.

Competing interests

The authors declare no competing interests.