Contributors to stress and burnout in junior doctors during the COVID-19 pandemic

IntroductionJunior doctors have previously reported high levels of burnout;and additional stressors have likely emerged from the COVID-19 pandemic may further accelerate burnout. There is a need to identify which particular stressors are most likely to lead to burnout in junior doctors in order to develop appropriate interventions. Objectives1) To develop a comprehensive list of stressors that are relevant to junior doctors, which includes general work and non-work related stressors as well as stressors that have specifically emerged with the pandemic. 2) To assess which of these stressors are most strongly associated with burnout.MethodsAn anonymous online questionnaire was sent to 1000 randomly selected junior doctors in the North West of England between 10/07/20 to 04/08/20. It included 37 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory (MBI) Health Services Survey. Stepwise regression analyses were undertaken to assess associations between stressors and burnout.ResultsIn total, 326 responses were collected (response rate=33%). Of the top 10 stressors rated by junior doctors, 60% were related to the pandemic. Multiple stressors were found to be associated with the burnout dimensions. Fatigue (β=0.43), pandemic-related workload increase (β=0.33) and feeling isolated (β=0.24) had the strongest associations with Emotional Exhaustion, whereas fatigue (β=0.24), uncertainty around COVID-19 information (β=0.22) and doing unproductive tasks (β =0.22) had the strongest associations with Depersonalisation.ConclusionJunior doctors experience a combination of general stressors and additional stressors emerging from the pandemic which significantly to impact on burnout. Monitoring these stressors and targeting them as part of interventions could help mitigating burnout in junior doctors.