[Workload, institutional recognition, and sleep: A survey of burnout among French internists]

To estimate the prevalence of burnout among internists practicing in France, identify its determinants, and describe their professional experience based on free-text comments.

A national cross-sectional online survey was conducted at the end of 2024 through the French National Society of Internal Medicine (SNFMI). The questionnaire included a modified burnout inventory (mMBI) and contextual items related to work organization, sleep, and mental health. Severe burnout was defined by a high emotional exhaustion (EE) score≥27 or a high depersonalization (DP) score≥10. "Triple impairment" was defined as the combination of high EE, high DP, and low personal accomplishment (PA≤33). Analyses included comparisons across professional profiles and multivariable logistic regressions. A thematic analysis of free-text comments complemented the quantitative findings.

Among 434 respondents (123 residents, 244 attending physicians, 67 academic staff), 58% met criteria for severe burnout and 19% for triple impairment. In the adjusted model, severe burnout was associated with≥55 working hours per week (aOR 1.82; P=0.018), insufficient recognition (aOR 3.24; P<0.001), altered sleep (aOR 4.37; P<0.001), and psychotropic medication use (aOR 2.56; P=0.014). Over 70% of participants provided at least one free-text comment, most often describing emotional fatigue, loss of meaning, bureaucratization, and lack of consideration, while also emphasizing a strong sense of vocation, teamwork, and commitment to patients.

Burnout among French internists is frequent and multifaceted, primarily driven by organizational factors. Simplifying medical work, enhancing institutional recognition, and strengthening professional autonomy appear to be the key levers.