Table 1. Characteristics of Studies, Populations, and Outcomes Included in the Review.

Study	Country	Health care setting	Research design	Sample size	Men, %	Mean age, y	Specialties	Working experience	Measure of wellnessa	Categories of stressors identified	Newcastle-Ottawa Scale Score
Abdulghani et al,11 2015	Saudi Arabia	Hospital and primary care	Cross-sectional	318	60	27.9	Multiple	Residency year 1-4	2, Kessler-10 psychological distress instrument	Specialty grade, demographics, poor work-life balance, work demands	4
Abdulghani et al,30 2014	Saudi Arabia	Hospital	Cross-sectional	404	63	Not stated	Multiple	Internship	2, Kessler-10 psychological distress instrument	Demographics, specialty	4
Afzal et al,31 2010	US	Hospital and primary care	Cross-sectional	134	58	Not stated	Multiple	Residency	1, Maslach Burnout Inventory	Specialty, demographics, poor work-life balance	7
Al-Ma'mari et al,32 2016	Canada	Hospital	Cross-sectional	47	13	Not stated	Obstetrics and gynecology	Residents	1, Maslach Burnout Inventory	Poor work environment	5
Antoniou et al,33 2003	Greece	Public hospital, clinics	Cross-sectional	355	54	Age range, 25-42	Not specified	All training grades	2, Occupational Stress Index	Poor career development, poor work-life balance, poor work environment, personal and self-efficacy, concerns about patient care, work demands, financial worries	6
Baer et al,34 2017	US	Public hospital	Cross-sectional	258	21	29	Pediatrics	Residents	1, 2-item burnout measure validated again Maslach Burnout Inventory	Demographics, perceived/reported poor mental or physical health poor work-life balance, work demands, seniority and grade, poor work environment	7
Baldwin et al,35 1997	UK	Hospital	Prospective cohort	142	55	25	Not specified	Senior house officers	2, General Health Questionnaire	Work demands, concerns about patient care	6
Bellolio et al,36 2014	US	Hospital	Cross-sectional	191	53	Not stated	Multiple	Residents	1, 2, Professional Quality of Life Scale which includes measures on burnout	Demographics, specialty, personal and self-efficacy, work demands	2
Blanchard et al,37 2010	France	Hospital	Cross-sectional	204	60	Median, 28	Oncology and hematology	Residents	1, Maslach Burnout Inventory	Work demands, poor career development, concerns about patient care	8
Byrne et al,38 2016	Ireland	Hospital	Cross-sectional	270	39	Not stated	Multiple	Internship	3, General Health Questionnaire	Poor career development, perceived/reported poor mental or physical health, poor work-life balance	5
Cohen and Patten,10 2005	Canada	Hospital	Cross-sectional	415	47	29	Multiple	Residents	2, Sources and amount of perceived stress	Poor work-life balance, financial worries, work demands, poor work environment, perceived/reported poor mental or physical health	4
Cooke et al,39 2013	Australia	Primary care	Cross-sectional	128	33	>20	General practice	Registrar level	1,3, Single-item scale for burnout validated against Maslach Burnout Inventory, professional quality-of-life scale	Concerns about patient care, seniority and grade, poor work environment, demographics, work demands, personal and self-efficacy, poor work-life balance, perceived/reported poor mental or physical health	5
Creed et al,40 2014	Australia	Hospital and primary care	Cross-sectional	355	32	28	Multiple	<4 y of graduation	1,2, Copenhagen Burnout Inventory, 4-item academic stress scale	Work demands, financial worries, poor career development	5
Dyrbye et al,41 2018	US	Hospital and primary care	Cross-sectional	3588	49	Not stated	Multiple	Residents	1, Maslach Burnout Inventory	Specialty, demographics, poor work-life balance, financial worries	8
Esan et al,42 2014	Nigeria	Hospital	Cross-sectional	128	73	Not stated	Multiple	Residents	3, General Health Questionnaire	Demographics, financial worries, poor work environment, poor career development, work demands	6
Firth-Cozens,43 1992	UK	Hospital	Cross-sectional	170	Not stated	Not stated	Multiple	Postgraduate year 1	3, General Health Questionnaire	Personal and self-efficacy, demographics, poor work environment, perceived/reported poor mental or physical health	6
Firth-Cozens,44 1990	UK	Hospital	Cross-sectional	70	0	Not stated	Multiple	Postgraduate year 1	3, General Health Questionnaire	Poor work environment, concerns about patient care, poor work-life balance, work demands, poor career development, financial worries	4
Firth Cozens and Morrison,45 1989	UK	Hospital	Cross-sectional	173	57	24.6	Multiple	Postgraduate year 1	3, General Health Questionnaire	Concerns about patient care, poor work environment, work demands	4
Galam et al,46 2013	France	Primary care	Cross-sectional	169	53	25.4	General practice	General practice trainees	1, Maslach Burnout Inventory	Demographics, work demands, poor work environment, poor work-life balance, poor career development	6
Galam et al,47 2017	France	Primary care	Longitudinal	173	31.3	26.4	General practice	General practice trainees	1, Maslach Burnout Inventory	Personal and self-efficacy	6
Gouveia et al,48 2017	Brazil	Hospital	Cross-sectional	129	48	Not stated	Multiple	Residents	1, Maslach Burnout Inventory	Concerns about patient care, specialty	6
Guenette and Smith,49 2017	US	Hospital	Cross-sectional	94	63	Not stated	Radiology	Residents	1, Maslach Burnout Inventory	Poor work-life balance, seniority, demographics	7
Hameed et al,50 2018	Saudi Arabia	Hospital	Cross-sectional	181	41	27.6	Multiple	Residents	1, Maslach Burnout Inventory	Seniority, demographics, specialty	5
Hannan et al,51 2018	Ireland	Hospital	Cross-sectional	101	44	28	Multiple	Interns	1,3, Maslach Burnout inventory and General Health Questionnaire	Poor work environment, poor career development, concerns about patient care, financial worries, perceived/reported poor mental or physical health, work demands	4
Haoka et al,13 2010	Japan	Hospital	Cross-sectional	348	67	Men, 26.2; women, 25.6	Multiple	Residents	3, General Health Questionnaire	Perceived/reported poor mental or physical health, work demands, poor work-life balance, personal and self-efficacy	5
Jex et al,52 1991	US	Hospital	Cross-sectional	1785	70	30	Multiple	Residents	2, General and work-related psychological strain	Work demands, concerns about patient care, perceived/reported poor mental or physical health	7
Kassam et al,53 2015	Canada	University of Calgary trainees	Cross-sectional	317	39	30.9	Multiple	Residents	1,3, Copenhagen Burnout Inventory and work satisfaction	Work demands, personal and self-efficacy, perceived/reported poor mental or physical health	7
Kimo Takayesu et al,542014	US	Residency program	Cross-sectional	218	59	Not stated	Emergency medicine	Residents	1, Maslach Burnout Inventory	Poor work environment, personal and self-efficacy	5
Kshatri et al,55 2017	India	3 Hospitals	Cross-sectional	250	68	29	Multiple	Residents	2, Workplace Stress Scale	Seniority, demographics	4
Maraolo et al,17 2017	Europe	Trainee association -microbiology	Cross-sectional	416	38	32	Microbiology	Residents	1, Own burnout questionnaire	Demographics, poor work environment	4
Ndom and Makanjuola,56 2004	Nigeria	Teaching hospital	Cross-sectional	84	91	33	Multiple	Residents	2, List of stressors	Work demands, poor work environment, personal and self-efficacy, perceived/reported poor mental or physical health, demographics	2
Ochsmann et al57 2011	Germany	Hospital	Cross-sectional	792	44	28.9	Multiple	All training grades	3, Recovery Stress Questionnaire	Work demands, poor work environment	7
Ogundipe et al,58 2014	Nigeria	Hospital setting	Cross-sectional	204	58	33.4	Multiple	Residents	1,3, General Health Questionnaire and Maslach Burnout Inventory	Work demands, personal and self-efficacy, demographics, poor work environment	7
Ogunsemi et al,12 2010	Nigeria	Hospital	Cross-sectional	58	74	35.7	Multiple	Residents	2,3, Measured perception and sources of stress and perception of well-being		3
										Demographics, poor career development, personal and self-efficacy, poor work environment, concerns about patient care, work demands, financial worries, perceived/reported poor mental or physical health
Okpozo et al,59 2017	US	3 Teaching hospitals	Cross-sectional	203	52	Not stated	Multiple	Residents	1, Maslach Burnout Inventory	Personal and self-efficacy, poor work environment	4
Pan et al,60 2017	Australia	Hospital	Cross-sectional	540	40	Not stated	Multiple	Postgraduate Year 1-3	2, Perception of stress	Work demands, poor career development, personal and self-efficacy, poor work environment, concerns about patient care	8
Prins et al,61 2010	Holland	Hospital	Cross-sectional	2115	39	31.5	Multiple	Residents	1, Maslach Burnout Inventory	Demographics, poor work-life balance, specialty	8
Saini et al,62 2010	India	Hospital	Cross-sectional	721	53	27.5	Multiple	Residents	2,3, Depression Anxiety Stress Scale	Seniority, specialty, work demands, poor career development, personal and self-efficacy	5
Sochos et al,63 2012	UK	Hospital and primary care	Cross-sectional	184	40	30.6	Multiple	All training grades	1, Maslach Burnout Inventory	Personal and self-efficacy, poor work environment, perceived/reported poor mental or physical health	4
Stucky et al,4 2009	US	Hospital	Prospective study	144	36	Interns, 27.9; residents, 29.4	Pediatric and internal medicine	Interns and residents	3, Measuring emotional state every 90 min throughout each duty shift	Seniority, demographics, work demands, poor health	5
Taylor-East et al,64 2013	Malta	Hospital	Cross-sectional	117	53	Not stated	Multiple	Foundation years 1 and 2	3, General Health Questionnaire	Seniority, demographics, personal and self-efficacy, poor career development	7
Toral-Villanueva et al,65 2009	Mexico	Hospital	Cross-sectional survey	312	57	28	Multiple	All training grades	1, Maslach Burnout Inventory	Concerns about patient care, perceived/reported poor mental or physical health, work demands, seniority	8
Tyssen et al,662005	Norway	Hospital	Longitudinal	371	58	29	Multiple	Interns	2, Modified version of Cooper Job Stress Questionnaire	Demographics, personal and self-efficacy, work demands, poor work environment	7
Verweij et al,67 2017	Holland	Hospital	Cross-sectional	2115	39	31.5	Multiple	Residents	1, Maslach Burnout Inventory	Work demands, personal and self-efficacy, demographics, poor career development	8
West et al,68 2011	US	Hospital	Cross-sectional	16394	55.7	Not stated	Multiple	Residents	1, Maslach Burnout Inventory	Demographics, financial worries, seniority	8
Woodside et al,69 2008	US	Hospital and primary care	Cross-sectional	155	57	35	Family medicine and psychiatry	Residents	1, Maslach Burnout Inventory	Demographics, poor work-life balance, specialty	4
Zis et al,702015	Greece	Hospital	Cross-sectional	116	45	34.5	Neurology	Residents	1, Maslach Burnout Inventory	Demographics, work demands, poor work-life balance, poor career development	7
Zubairi and Noordin,71 2016	Pakistan	Hospital	Cross-sectional	110	54	Not stated	Multiple	Residents	1, Maslach Burnout Inventory	Work demands, poor work environment	4

^aCode for measure of wellness: 1, burnout (eg, Maslach Burnout Inventory); 2, stress (eg, Kessler-10 psychological distress instrument); and 3, other measures (eg, General Health Questionnaire).