Burnout and associated factors in psychiatry residents: a systematic review

Objectives: This study aimed to systematically review extant data on the prevalence of burnout amongst psychiatry residents, examine the contributory factors, and consider potential ways to manage burnout. Methods: A systematic literature review was conducted on all relevant articles within Pubmed/OVID Medline and ScienceDirect digital databases from January 2000 till March 2019 that investigated burnout in psychiatry residents. Variables of interest included questionnaires used to assess burnout, the prevalence of burnout, and its clinical correlates. Articles were included if they were observational or experimental studies and involved a sample consisting solely of or a subsample of psychiatry residents. The data are summarised and presented as a narrative synthesis. Results: Twenty-two studies were included. The overall prevalence of burnout among psychiatry residents was 33.7%, which was associated with certain demographic (non-parental status), training (juniors years of training, lower priority of psychiatry as career choice, lack of clinical supervision, discontinuation from training), work (high workload, long hours, insufficient rest), and learner factors (more stressors, greater anxiety, and depressive symptoms, low self-efficacy, decreased empathic capacity, poor coping, self-medication, and use of mental health services). Conclusions: These findings suggest that interventions such as refining candidate selection, enforcement of work hour limits, enhancement of support and supervision, and equipping of stress coping skills may ameliorate burnout related to training, work, and learner factors respectively. These findings and suggestions may apply to other residency programs. However, future studies should examine burnout longitudinally and evaluate the effectiveness of different interventions in reducing burnout within psychiatry residents.