Syntax Literate: Jurnal Ilmiah Indonesia p–ISSN: 2541-0849

e-ISSN: 2548-1398
Vol. 9, No. 5, Mei 2024

BURNOUT IN MEDICAL STUDENT: LITERATURE REVIEW

Joulanda A. M. Rawis1*, ⁠Andriessanto C. Lengkong2, Inggrid C. Mahama3,

⁠Christopher Lampah4, ⁠Iddo Posangi5
Universitas Negeri Manado, Manado, Indonesia1,2,3,4,5
Email: joulanda_rawis@unima.ac.id1, andriessanto@unsrat.ac.id2,
inggrid2410@yahoo.co.uk3, christopherlampah@gmail.com4,
iddoposangi@gmail.com5

Abstract
Burnout is a condition of emotional exhaustion, depersonalization, and reduced work
performance caused by chronic stress. Burnout can occur in various people, including
medical students. The purpose of this study was to review the literature on burnout in
medical students. This study used a literature research method. Research data were
collected using literature search techniques. Research data were obtained from various
sources, namely journal articles, books, and research reports. The research data were
analyzed using qualitative analysis techniques. The results showed that burnout in medical
students is a serious problem. Burnout can occur in medical students at various levels of
education, ranging from early semester students to final semester students. Factors that can
cause burnout in medical students include high academic loads, demands to be perfect
doctors, and stressful working conditions. The negative impacts of burnout on medical
students include impaired physical and mental health, decreased academic performance and
lower chances of getting a job.
Keywords: Burnout, Medical, Student

Introduction
Burnout is a condition in which a person experiences high levels of emotional
exhaustion, depersonalization, and decreased work performance as a result of continuous
exposure to chronic stress. In this state, individuals can feel emotionally drained, lose a
sense of attachment to their work or surroundings, and experience decreased performance
or achievement in their tasks. Burnout is often associated with excessive demands,
constant pressure, and an imbalance between workload and the ability to cope with the
stress experienced (Maslach & Leiter, 2006).
There are a variety of different instruments to measure burnout symptoms
including: Work-Related Behavior Scale and Patterns of Experience Scale, Oldenburg
Burnout Inventory, Burnout symptoms scale, Hamburg Burnout Inventory Copenhagen
Burnout Inventory and Maslach Burnout Inventory (MBI) with its specific versions:
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) (Erschens et al., 2019).
Burnout can occur in various groups, including medical students. Symptoms of
burnout generally appear early in medical education, and based on research from several
institutions, at least 50% of medical students may experience burnout during their studies
(Chigerwe et al., 2014). Although medical school institutions make every effort to provide
support to students during their education and aim to produce doctors who are
knowledgeable, highly skilled, and professionally ethical, scientific studies show that
medical students face very high levels of personal stress (Fares et al., 2016).
How to cite: Rawis, et al. (2024). Burnout in Medical Student: Literature Review. Syntax Literate. (9)5.
http://dx.doi.org/10.36418/syntax-literate.v9i5
E-ISSN: 2548-1398
Published by: Ridwan Institute
 Burnout in Medical Student: Literature Review

Burnout that occurs in the medical school environment has the potential to
negatively impact students' academic performance and overall well-being. Burnout has
also been identified as a significant predictive factor for suicidal ideation and leaving
medical education (Chunming et al., 2017). Therefore, burnout in medical students
deserves more attention in research and more consideration as a target for prevention and
intervention efforts in the school environment.
Previous research by (Ishak et al., 2013) showed that burnout is prevalent during
medical school, with a large multi-institutional study in the US estimating that at least
half of all medical students may be affected by burnout during their medical education.
Studies show that burnout can continue after graduating from medical school, and is
sometimes associated with psychiatric disorders and suicidal ideation. Various personal
and professional characteristics correlate with burnout. Potential interventions include
school-based and individual-based activities to improve students' overall well-being.
Another study by (Jennings, 2009) showed that cultural factors also facilitate
burnout in medical students who are immersed in clinical environments that foster
excessive detachment from patients and self, undermine self-care, undermine self-
confidence, and hinder the development of a mature and well-integrated professional
identity. The ethical implications of medical student burnout are also discussed. The
purpose of this study was to review the literature on burnout in medical students.

Research Methods
This research uses the literature research method. Literature review is a systematic
process in a research that involves the identification, collection, evaluation, and synthesis
of relevant text sources related to a particular research topic or problem. This process
involves an in-depth review of literature or published works, such as books, scientific
journals, articles, theses, research reports, and other sources relevant to the subject or
topic of research (Van Lange et al., 2015). Research data were collected using literature
search techniques obtained from Google Schoolar. The type of data in this study is
secondary data. Research data were obtained from various sources, namely journal
articles, books, and research reports. The research data were analyzed using qualitative
analysis techniques.

Results and Discussion

The medical study program is a study program that aims to produce professional
doctors. Medicine is one of the favorite majors in demand in Indonesia. The strict
selection carried out in the admission of new prospective students is based on efforts to
select new prospective students who have high academic ability to follow and complete
education in higher education in accordance with the predetermined time limit. The high
educational load and process as well as the high learning outcomes that are adjusted to
the competency standards of doctors that must be achieved affect the readiness of students
in undergoing the educational process (Trisnasari & Sulthany, 2023).
Medical education is not easy and requires strong motivation to complete (Dewi et
al, 2015). Although the doctor's study program is a major that is in demand. However, the
medical study program is also one of the most difficult majors in the world. The long and
arduous learning process and high competition make the medical study program a
challenging study program with various exams that must be passed (Gibran, 2023).
Individual failure to make adjustments in the field of education can cause
individuals to experience psychological disorders, one of which is feeling stress (Maulina

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Joulanda A. M. Rawis, ⁠Andriessanto C. Lengkong, Inggrid C. Mahama, ⁠Christopher
Lampah, ⁠Iddo Posangi

& Sari, 2018). The American College Health Association (2013) states that in the field of
education, the problem often faced by students is stress. Students experience stress as a
demand for academic life that must be lived. Stress is a universal phenomenon that occurs
in daily life and will be experienced by everyone. Stress has a total impact on individuals
such as physical, social, intellectual, psychological and spiritual impacts. Stress can come
from individuals, family environment, residential environment, work environment and
education (Hediaty et al, 2022).
Stress can reduce concentration, decrease attention, hinder the decision-making
process, and reduce students' ability to build good relationships with patients, which can
result in incompetence and patient dissatisfaction with clinical practice in the future
(Rahmayani et al, 2019). A form of stress that is often found in the field of education is
academic stress. Academic stress also includes students' perceptions of the amount of
knowledge that must be mastered. Another factor that can cause academic stress in
students is confidence. Belief in one's ability to complete academic tasks can increase
efforts to achieve goals but can also be an obstacle in achieving goals. Self-efficacy is an
ability to organize and carry out part of the activities needed to achieve the desired goals
(Avianti et al, 2021).
Academic stress over a long period of time results in physical and psychological
burnout in students. Burnout appears accompanied by feelings of fatigue, frustration,
helplessness, and cynicism (Firdaus et al, 2021). This unaddressed and ongoing stress can
have a negative impact and can lead to burnout (Aliftitah, 2015). Burnout is a condition
of a person who experiences physical and psychological fatigue due to work and
emotional demands. If burnout continues to occur, it can have a negative impact on life
satisfaction among students and health professionals (Lutfia et al, 2021). Burnout can
interfere with the professional development of medical students in training, put patients
at risk, and result in a variety of personal consequences, including suicidal thoughts.
(Shanafelt et al., 2016).
Burnout syndrome is a syndrome that includes three dimensions, namely emotional
exhaustion, depersonalization, and reduced satisfaction with personal achievement. The
main component is emotional exhaustion which is synonymous with the experience of
fatigue and loss of interest in work.
Emotional exhaustion, also known as emotional exhaustion, comes from burnout,
which is an emotional condition in which a person feels mentally or physically tired and
saturated as a result of increased work demands and feels exhausted, loses passion for
work and is indifferent (Ahsyari, 2014). Emotional exhaustion arises due to excessive
stress, and is difficult to overcome which can lead individuals to a worse state where
apathy, cynicism, and frustration appear. Sources of emotional exhaustion can arise in
individuals who have perfectionist personality tendencies or want perfection in every job
(Santika & Sudibia, 2017). Emotional exhaustion affects learning achievement, so that to
be able to attend lectures sometimes less able to understand lecture material and tired
physical conditions make them less able to concentrate properly (Putri & Budiani, 2012).
Depersonalization is defined as an attempt to create distance between oneself and
the service recipient by ignoring their own special qualities and neglecting to please
others. This dimension is considered the defensive element of the syndrome. It is
characterized by a negative and uncaring attitude towards the patient (Sutoyo et al, 2018).
Cynicism (depersonalization) indicates the appearance of tension with other individuals
and loss of motivation. This component shows a loss of cognitive and emotional

Syntax Literate, Vol. 9, No. 5, Mei 2024 3136

 Burnout in Medical Student: Literature Review

engagement and a negative response to work. Decreased achievement is another

component of burnout that shows the self-evaluation of burnout sufferers (Islami, 2019).
Burnout syndrome is a special type of tension that reflects a belief that several
sources for coping with stressful conditions will cause a person to experience
hopelessness, fatigue and cognitive fatigue (Putri et al, 2023). According to Korunka et
al in Santi et al (2019), the general characteristics of burnout, namely:
1) Physical pain is characterized as headaches, fever, back pain, tension in the neck and
shoulder muscles, frequent colds, insomnia, chronic fatigue.
2) Emotional exhaustion is characterized as boredom, irritability, cynicism, anger,
anxiety, despair, sadness, depression, helplessness.
3) Mental fatigue is characterized as indifference to the environment, negative attitude
towards others, low self-concept, hopelessness with life path, feeling worthless.
Christy et al (2020) revealed an alarming, yet unsurprising, prevalence rate of
burnout among medical students. Burnout in medical students has several negative effects
on their mental health, with increased rates of depression, poor sleep, suicidal ideation,
and substance abuse. Burnout in this special population can also have far-reaching effects
on learning, causing career regret and thoughts of quitting, as well as impacting future
patient care as medical students enter the workforce. We suggest the need for consensus
on the definition and measurement of burnout to allow for better international
comparisons of burnout prevalence rates in different settings (Almutairi et al, 2022).
The incidence of burnout in students can be related to academic problems and poor
stress coping in students in dealing with these problems (7,13,14), so interventions need
to be made to increase student resilience in dealing with stress during medical education
(Putri et al, 2019). Burnout that is not properly addressed can also affect the
professionalism of medical graduates when they become doctors (Wolf & Rosenstock,
2016). Prolonged burnout has been shown to impair performance and decrease an
individual's interest in further education (Walburg, 2014). Thus, health-related study
programs have a long and strenuous education time. This is what causes burnout in
medical students. Especially in medical students burnout is a common thing to
experience.

Conclusion
Burnout in medical students is a serious problem that requires deep attention.
Burnout can arise at various stages of education, including early semester students to the
final stage. There are several factors that trigger burnout in medical students, including a
very high academic load, pressure to achieve standards of perfection as a doctor, and a
work environment that tends to cause stress. The negative impact of burnout on medical
students is significant. These include impaired physical and mental health, decreased
academic performance, and decreased chances of getting a better job in the future.
Overburdening and constant pressure can have a serious impact on the overall well-being
of medical students. Therefore, the need for concrete and appropriate measures to prevent
and address burnout among medical students is urgent.

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Joulanda A. M. Rawis, ⁠Andriessanto C. Lengkong, Inggrid C. Mahama, ⁠Christopher
Lampah, ⁠Iddo Posangi

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3139 Syntax Literate, Vol. 9, No. 5, Mei 2024

Joulanda A. M. Rawis, ⁠Andriessanto C. Lengkong, Inggrid C. Mahama, ⁠Christopher
Lampah, ⁠Iddo Posangi

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Joulanda A. M. Rawis, ⁠Andriessanto C. Lengkong, Inggrid C. Mahama, ⁠Christopher
Lampah, ⁠Iddo Posangi (2024)

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