Burnout origins and psychological training needs of medical students and junior doctors: Mixed methods study

Introduction Burnout continues to proliferate in medicine, with reductions in demands failing to reduce rates of burnout or distress, particularly affecting junior doctors and medical students. A broader understanding of antecedents are needed to understand how effective support can be offered. This study aimed to delineate rates of burnout in a sample of junior doctors and medical students in the wake of COVID-19, identify clinical challenges and training needs for these groups, and explore contemporary workplace origins of distress and burnout, with implications for similar cohorts internationally.Methods A mixed method design explored the perspective and needs of medical students and junior doctors through a cross-sectional online survey (early 2023, recruitment via social media and networks) and interviews. Those who had experienced distress were deliberately sought. 102 participants completed demographic and survey measures (junior doctors n = 50; medical students n = 52). The Maslach Burnout Scale-2 measured burnout; Depression, Anxiety and Stress Scale-21 measured psychological distress. Semi-structured interviews were conducted with a subset of survey participants (junior doctors n = 7; medical students n = 6). Interviews were analysed using Framework Method thematic analysis.Results Rates of burnout were high compared to previously published data; 98% of junior doctors and 75% of medical students identified as burnt out, reflecting our recruitment aim. Qualitative analysis foregrounded disconnections between university ideals and clinical realities and challenges associated with hierarchical dysfunction, perfectionism and narrow coping beliefs.Discussion Rates of burnout remain persistently high in medical students and junior doctors. Qualitative findings indicated burnout and distress may reflect dysfunctional clinical cultures and limited psychological coping techniques, highlighting why reductions in practical demands may not improve wellbeing for these groups. This research has implications for training and professional development of medical practitioners, the identification and treatment of burnout, and calls for a greater depth and variety of psychological skills and support.