Burnout and its Associated Factors in Medical Students of Lahore, Pakistan

Abstract

Introduction:Burnout is a widely known phenomenon. It is defined as a state of prolonged physical and psychological exhaustion and is experienced virtually by every medical student due to the highly demanding nature of medical education. This study probes into the prevalence and psychosocial determinants of burnout in Pakistani medical students.Methods:A descriptive, cross-sectional study design and convenience (non-probability) sampling technique were employed in undergraduate medical students from years 1-5. A total of 777 medical students from two medical colleges were included in the study from May-August, 2014. An English version of the Copenhagen Burnout Inventory (CBI) and a series of demographic questions, intermixed with questions from other topics, were included in the questionnaire. Data was analysed by using SPSS ver.21.Results:The majority of students were females and enrolled in the third year of MBBS. Of the medical students involved, 30.6% were found to have high/very high levels of burnout (Kristenson’s burnout scoring). Although 38.7% of students said that they did not feel burned out after reading the definition of burnout given in the questionnaire, 35.9% out of these students actually had high levels of burnout according to CBI. According to the multiple regression analysis, burnout in medical students was significantly associated with age, gender, doctor parents, no help or no supportive resources (e.g., from colleagues), lack of time off, lack of belief in what you do, fear of big consequences of failure, family responsibilities, and uncertain future. Perception of teachers lacking leadership skills and doing too much study with little balance was associated with low burnout scores.Conclusion:There is a high prevalence of burnout in Pakistani medical students. The present study identifies several factors associated with burnout in Pakistani medical students. Although these factors are a part of daily life of medical students, their identification should prompt the use of effective coping strategies and skills, thus, minimising their burnout levels.

Mental Morbidity among Medical Students in India

“…The results are supported by study Muzafar et al [34] and Shah et al [38] in which medical students reported stressors to be of academic in nature including lack of sleep, lack of time off, high frequency of tests, fear of failure and high parental expectations. Similarly, Sreeramareddy et al [37] found the vastness of syllabus, tests/exams, high parental expectations, and lack of time and facilities for entertainment as major stressors in undergraduate Nepalese medical students With similar results by Imran et al 2015, the most frequently occurring sources of stressors were broadness of academic syllabus, increased frequency of exams, tough routine, lack of guidance from seniors, living away from home, lack of guidance from faculty, poor living conditions in dormitory, fear of failing exams and high family expectations.…”

“…The reason for this discordance might be that the latter studies had more female subjects recruited and being an Arab country, females would be facing different socio-cultural barriers, the reason of increased prevalence of psychiatric morbidity quoted in their study also. It was also found that day-scholar medical entrants had more psychiatric morbidity than hostler, which could be due to proper personality development of hostler which included several factors of adequate social exposure and development of interpersonal relationship among peers with similar results by Muzafar et al in 2015 [34] . It might be possible that day scholar had additional burden to travelling each day and facing day to day family issues.…”

“…Females may also have positive self-concept and self-esteem due to their entrance to glorious job of medicine and thus remaining free from social role of housewife, while males may feel more social obligation of being sole bread earner. The results of this study is in contradiction with studies by Mahroon et al in 2017 [33] and Muzafar et al in 2015 [34] where females had more prevalence as compared to males. The reason for this discordance might be that the latter studies had more female subjects recruited and being an Arab country, females would be facing different socio-cultural barriers, the reason of increased prevalence of psychiatric morbidity quoted in their study also.…”

“…Similar results were obtained by Mahroon et al in 2017 in which the prevalence rate of approximately 40% was observed in students of medical university of Bahrain with higher prevalence of disorder in initial part of the education like year 1 as compared to later years (Year 5) [33] . Another study by Muzafar et al in 2015 reported burnout of 35.9% according to Copenhagen Burnout Inventory in Lahore, Pakistan [34] . However, the study by Almojaliet al in 2017 reported a higher prevalence of 53.2% of all types of stress by medical students of Saudi Arabia.…”

“…Such medical students may find it difficult to meet the demands of medical education on the one hand and the financial and emotional support of their families on the other. Thus, the combined demands of medical education, family, and the stress arising from occasional conflicts between these demands can exhaust the students to the level that they become burnt out [34] .…”