The hidden cost of specialization: a mixed-methods study on burnout, mental health, and financial ınstability in...

Burnout is a significant issue in postgraduate dental education, exacerbated by demanding clinical duties, academic pressures, and insufficient resources. This cross-sectional survey incorporated an embedded qualitative component analyzed using inductive thematic analysis.

This cross-sectional survey incorporated an embedded qualitative component analyzed using inductive thematic analysis. Participants filled out validated tests for burnout (OLBI-SS), mental health symptoms (PHQ-4), perceived stress (PSS-4), resilience (BRS), and perceived institutional and supervisory support. We used multiple linear regression to find factors that could lead to burnout. Inductive content analysis was used to put qualitative data from open-ended responses into context with quantitative findings. This study aimed to determine the prevalence of burnout and to examine its individual, supervisory, and institutional correlates among postgraduate dental trainees, using a cross-sectional design with an embedded qualitative component.

Based on a mean OLBI-SS item score ≥3.0, the prevalence of high burnout was 75.4% among postgraduate dental trainees. Burnout levels were high, accompanied by elevated rates of positive screening for anxiety (53.3%) and depressive symptoms (50.0%). In the multivariable model, higher mental health symptoms (β = +1.25, p = 0.001) and lower institutional support (β = -3.15, p = 0.002) significantly predicted burnout. While gender was not significant in bivariate analysis, male gender emerged as a strong independent predictor (β = +3.61, p = 0.041) after controlling for anxiety and depressive symptoms, indicating a suppressor effect where general distress masked specific risks in male trainees. Qualitative analysis revealed four major stressors: financial instability, institutional uncertainty, advisor communication difficulties, and conflicts between clinical and academic responsibilities.

Burnout among dental trainees is caused by a combination of mental health problems, lack of support, and stressors in their environment. Our findings indicate that the quality of the educational environment and the frequency of advisor meetings are more significant determinants of well-being than clinical workload volume alone. Interventions should prioritize organized supervision, clear organization, and financial help.