Clinical training under movement restriction: checkpoint burden, burnout, and intentions to train abroad among medical students in Palestine

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. 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. 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. 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.