Unveiling the shadows: A qualitative inquiry into burnout perceptions among pre-clerkship students in Canadian medical education

Emerging evidence indicates that burnout manifests early, even among medical students. The pre-clerkship demographic remains inadequately understood with a notable scarcity of studies examining burnout. To address this gap, this project developed a conceptual model to better understand burnout among pre-clerkship = students. Fifteen second-year medical students participated in interviews exploring their experiences with educational stress and perceptions of burnout. Constructivist Grounded Theory informed data collection and analysis due to the undertheorized nature of burnout in the pre-clerkship setting. Recurring themes encompassed information overload, perceived limited faculty support, anticipatory stress of entering clerkship and social isolation during hybrid learning, highlighting multifaceted stressors that ranged from academic to relational. Participants underscored various personal factors, such as time management, adaptation strategies and focusing on personal strengths, as mitigating burnout. Participants recognized the systemic nature of burnout, suggesting that early clinical exposure, peer mentorship and social connections, and dedicated personal time could serve as protective measures. This study addresses a gap in the literature by presenting a model of how personal characteristics interact with institutional and environmental pressures among pre-clerkship students. The findings prompt reflection on why pre-clerkship students express burnout before entering the clinical setting, advocating for institutional strategies to support junior learners.