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Job burnout among medical interns: a mixed-methods study of current status, associated factors, and experiential
Zhiyong Sun1, Zhao Yin1,2, Zheng Li1
1Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background:
Burnout during clinical internships may affect medical students' learning, professional development, and career choices. We examined the current status, associated factors, and experiential characteristics of burnout among medical interns.
Methods:
This study was conducted at a large tertiary hospital in central China. During the quantitative phase, an online cross-sectional questionnaire survey was conducted using the Maslach Burnout Inventory to assess burnout among medical interns and identify factors associated with the total burnout score. During the qualitative phase, semi-structured interviews were conducted to explore the specific manifestations of burnout among medical interns. All interviewees were recruited using purposive sampling; we selected interns whose total burnout scores were at or above the 75th percentile, and the interview data were analyzed using thematic analysis. Finally, the quantitative and qualitative findings were integrated.
Results:
A total of 1,054 medical interns participated, and 23 interns were enrolled for semi-structured interviews. The mean total burnout score was 64.40 ± 18.52, while the mean scores for emotional exhaustion, depersonalization, and reduced personal accomplishment were 20.57 ± 9.46, 7.75 ± 5.65, and 36.08 ± 8.71, respectively. All three dimensions were significantly positively correlated with the total burnout score, with emotional exhaustion showing the strongest correlation (r = 0.849, p < 0.01). Multiple linear regression analysis showed that institutional level, scholarship experience, having a fixed clinical preceptor during the internship, having clearly defined career goals, and experience of medical disputes were significantly associated with the total burnout score. Having clearly defined career goals had the largest standardized regression coefficient (β = -0.241, p < 0.001). The qualitative findings showed that emotional exhaustion was mainly manifested as physical fatigue, mental depletion, prolonged periods on duty, and insufficient rest. Depersonalization was mainly manifested as a limited understanding of patients, emotional detachment, and indifference toward clinical tasks. Reduced personal accomplishment was mainly manifested as repetitive work, a diminished sense of work-related value, and inadequate opportunities for professional growth.
Conclusion:
Burnout among medical interns is distinctly multidimensional, involving physical and mental depletion, emotional detachment, and a diminished sense of professional value. Burnout is associated not only with individual and academic characteristics but also with career planning, preceptor support, and clinical experiences.