Triggering and protective factors of burnout in medical resident physicians in a lower-middle-income country: A cross-sectional study

Saad bin Zafar Mahmood, Aqusa Zahid, Noreen Nasir, Munaim Tahir, Uzma Ghouri, Aysha Almas

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1 Citation (Scopus)


Background: Residents and interns are prone to emotional and physical exhaustion, also known as burnout. Burnout has not been studied much in physicians working in lower-middle income countries. We conducted this study to determine the burden of burnout among internal medicine residents and to identify triggering and protective factors associated with burnout. Materials and methods: A cross-sectional study was conducted at two institutes in Karachi from 2018 to 2019. All residents registered in the internal medicine program for at least 6 months were invited to participate via an online survey. An abbreviated version of the Maslach Burnout scale was used to measure burnout, and protective and triggering factors were recorded according to known factors. Results: A total of 71 out of 92 (77%) residents participated. The mean (SD) age of the participants was 28 (3.1) years, 51 (71.8%) were females and 51 (71.8%) were junior residents. A total of 33 (46.5%) residents had burnout. Burnout and emotional exhaustion were more in female residents (p < 0.05). None of the triggering factors attained statistical significance. The protective factors for burnout which showed significant association were good relationship with friends (OR 0.1–95% CI 0.0, 0.6), exercise and extra-curricular activities (OR 0.2–95% CI 0.0, 0.7), celebrating accomplishments (OR 0.2–95% CI 0.0, 0.7), having enough money (OR 0.2–95% CI 0.0, 0.4), and ability to plan for future (OR 0.1–95% CI 0.0, 0.6). Conclusion: More than a third of medicine residents suffered from burnout. We need to focus on rejuvenating activities for medicine residents to decrease burnout among them. If not addressed adequately this may result in a compromise in the quality of care being provided to patients.

Original languageEnglish
Article number102500
JournalAnnals of Medicine and Surgery
Publication statusPublished - Jul 2021


  • Burnout
  • Medicine
  • Pakistan
  • Residents


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