Clinical training under movement restriction: checkpoint burden, burnout, and intentions to train abroad among...

BACKGROUND: Medical education in Palestine occurs amid checkpoint-related movement restrictions that may affect well-being and career plans. We assessed burnout, perceived clinical training adequacy, checkpoint burden, and intention to pursue residency abroad among clinical-year medical students. METHODS: We conducted a cross-sectional online survey in 2025 among 4th–6th year medical students from five West Bank medical schools (N = 371). Burnout and perceived training adequacy were assessed using study-specific multi-item Likert composites adapted from previously published instruments and piloted in Arabic for this context. Checkpoint burden was summarized as a standardized index derived from checkpoint-crossing frequency, delayed arrival or missed training time, and missed clinical days. Intention to pursue residency training abroad was coded as yes versus no/unsure. RESULTS: Mean burnout was 3.29 ± 0.83 and perceived training adequacy was 3.18 ± 0.70; 59.3% of respondents intended to pursue residency training abroad. Burnout was negatively correlated with perceived training adequacy (r = − 0.276, p < 0.0001) and positively correlated with checkpoint burden (r = + 0.245, p < 0.00001), whereas perceived training adequacy was not associated with checkpoint burden (r = + 0.022, p = 0.668). In multivariable logistic regression, higher burnout independently predicted intention to pursue residency training abroad (OR 1.57, 95% CI 1.19–2.08; p = 0.0015), and male sex was associated with higher odds (OR 2.18, 95% CI 1.39–3.42; p = 0.0007), whereas higher checkpoint burden (OR 0.68, 95% CI 0.48–0.96; p = 0.029) and East Jerusalem residence (OR 0.26, 95% CI 0.13–0.49; p < 0.0001) were associated with lower odds of intending to train abroad. CONCLUSIONS: Higher burnout was associated with greater checkpoint burden and with intention to pursue residency training abroad. Perceived training adequacy was not associated with checkpoint burden. Given the cross-sectional design and the use of adapted, not formally validated, composite measures, these findings should be interpreted cautiously; nevertheless, they highlight the need for student support and for measures that reduce the educational impact of mobility restrictions.