ORIGINAL ARTICLE Gouveia PAC et al.

Factors associated with burnout syndrome in medical residents

of a university hospital
Pedro Alves da Cruz Gouveia1*, Maria Hosana Chaves Ribeiro Neta1, Carlos Alberto de Moura Aschoff2, Doris Pires Gomes2,
Nadine Anita Fonseca da Silva2, Helton Alexsandro Firmino Cavalcanti3
1
Internal Medicine Service, Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
2
Medicine Course, Health Sciences Center, UFPE, Recife, PE, Brazil
3
Psychiatry Division, Universidade de Pernambuco (UPE), Recife, PE, Brazil

Summary
Objective: To determine the prevalence of burnout syndrome among resident
physicians of various specialties and to evaluate associated factors.
Method: The Maslach Burnout Inventory questionnaire and a sociodemographic
questionnaire were used to evaluate factors associated with the syndrome. Burnout
was defined as the association of high emotional exhaustion, depersonalization
and low professional achievement. Multivariate analysis was performed after
adjustment of the Poisson model with the identification of risk factors and
calculation of prevalence ratios (PR). Of the 250 resident physicians registered
with Hospital das Clínicas of Pernambuco, 129 participated in the study.
Results: In the three domains that characterize burnout syndrome, we found
a low level of professional achievement in 94.6% of resident physicians inter-
viewed, a high level of depersonalization in 31.8%, and 59.7% with a high level
Study performed at Hospital das Clínicas of emotional exhaustion. The prevalence of burnout was 27.9%. Having suffered
of Universidade Federal de Pernambuco
a stressful event in the last six months (PR: 8.10; 95CI 1.2-57.2) and being a
(HC-UFPE), Recife, PE, Brazil
student of surgical specialty (PR: 1.99; 95CI 1.2-3.3) were independently associ-
Article received: 10/22/2016 ated with burnout.
Accepted for publication: 11/20/2016
Conclusion: The prevalence of burnout found in resident physicians is in accordance
*Correspondence: with previous Brazilian studies. Residents of surgical specialties and those who
Address: Av. Prof. Moraes Rego, 1.235,
Cidade Universitária
suffered some stressful event were identified as susceptible in this study. The early
Recife, PE – Brazil identification of risk factors is fundamental for the implementation of preventive
Postal code: 50670-901
[email protected]
measures against burnout syndrome.

http://dx.doi.org/10.1590/1806-9282.63.06.504 Keywords: burnout, medical residency, medical education.

Introduction sion, decreased empathy, a sense of lack of energy, and

The term burnout was coined by psychologist Herbert worry. Depersonalization is an attempt that a person
Freudenberger in 1974 in an article entitled “Staff Burn- makes to put distance between themselves and the re-
out,” in which he discusses job dissatisfaction caused by cipients of the service, actively ignoring the qualities that
professional stress.1 Although there is no standard defini- make them unique individuals, motivating a sense of
tion for burnout, it is described as a state of physical and alienation and indifference towards others. This makes
mental exhaustion from work when coping methods are working with other people often unpleasant and unwant-
insufficient.2 Burnout syndrome is defined as a triad com- ed. Low professional achievement or low job satisfaction,
posed of three domains: emotional exhaustion, deperson- in turn, can be described as a feeling that very little has
alization and decline in professional achievement.3 been achieved and what is accomplished is worthless.2,4
Emotional exhaustion reflects the stress dimension The consequences of burnout syndrome on health
of burnout and encompasses feelings of hopelessness, include: gastrointestinal disorders, prolonged flu symptoms,
loneliness, depression, anger, impatience, irritability, ten- shortness of breath, hypertension, headache, insomnia,

504Rev Assoc Med Bras 2017; 63(6):504-511

Factors associated with burnout syndrome in medical residents of a university hospital

myalgia, pruritus, allergies, hair loss, sexual dysfunction, achievement domain, the classification was made accord-
demotivation, difficulty concentrating and more.5 Also, ing to the following criterion: low (≤ 33 points), moderate
there is a correlation between burnout and suicidal think- (34 to 39 points) and high (≥ 40 points). The criterion
ing.6 Therefore, this is a public health problem with disas- used in our study to define burnout syndrome was the
trous consequences that must be prevented in the workplace. presence of high values for the emotional exhaustion and
Stressors that are associated with or may increase the depersonalization domains, combined with a low score
possibility of burnout among physicians include: excessive for professional achievement.5,12
demands that reduce the quality of care, long working A sociodemographic questionnaire was also used to
hours, numerous work shifts, the need to deal with suf- evaluate factors associated with burnout syndrome. Spe-
fering and death, and more.7 In medical training, resi- cialties considered as “surgical clinic” were: general surgery,
dency is a critical and very stressful period in which con- orthopedics, urology, plastic surgery, surgery of the diges-
stant overloading and sleep deprivation are observed, as tive system, vascular surgery, gynecology and obstetrics,
well as possibly fatigue and fear of making mistakes.8 It ENT, and ophthalmology. The group named “other clin-
is a favorable period for the development of burnout ics” included internal medicine, pediatrics, dermatology,
syndrome, due to its duality of roles (learning and work) radiology, psychiatry, neurology, infectious diseases, ne-
and strong pressure derived from preceptors, society and phrology, cardiology, oncology, endocrinology, rheuma-
the residents themselves.9 Lack of autonomy, competitive- tology, gastroenterology, and family and community
ness, new expectations, inadequate support from supervi- medicine. The following were considered “stressful events”:
sors and irregular work schedules are other problems of personal or family-related health problems, mourning,
residency that correlate with burnout.10 separation, difficult relationship with boss/colleagues/
The objective of our study was to determine the preva- associates/patients, financial problems, relationship prob-
lence of burnout among resident physicians at Hospital das lems with family members. We considered regular physi-
Clínicas – Universidade Federal de Pernambuco (HC-UFPE) cal activity as defined by the World Health Organization:
and to evaluate its associated factors. over 150 weekly minutes of moderate activity (brisk walk-
ing, dancing, active participation in games and sports
Method with children and walking with pets) or over 75 minutes
This is a cross-sectional descriptive study carried out at of intense activity (cycling, aerobic exercises, fast swim-
the HC-UFPE in October and November 2015. The target ming, sports and competitive games).
population was residents enrolled in the medical resi- The data were analyzed using Statistical Package for
dency program that year. Data collection was done Social Sciences – SPSS software version 13.0. In order to
through self-administered questionnaires, and confiden- evaluate the personal and professional profile, habits,
tiality was maintained. All participants signed a free and level of physical activity and living conditions of the
informed consent form. There were 250 registered resi- residents participating in the study, percentages were
dents, of whom 129 participated in the survey. The total calculated and the frequency distributions of the evalu-
number of residents was not reached due to difficulty in ated factors were constructed. Chi-square test was used
approaching some residents in the following situations: to compare proportions.
vacation period, external rotation, working hours at the To evaluate the factors associated (personal and pro-
time of questionnaires, non-return of the questionnaires fessional profile and daily habits of residents) with burn-
and lack of consent to participate in the survey. out syndrome and its subdomains, a contingency table
Burnout syndrome was evaluated based on the was constructed and the Chi-square test for independence
Maslach Burnout Inventory (MBI), a version adapted to was applied. In cases where the assumptions of the Chi-
Brazilian Portuguese11 and structured with 22 questions -square test were not confirmed, Fisher’s exact test was
subdivided into the areas of emotional exhaustion, de- applied. All conclusions were taken considering the sig-
personalization and professional achievement. In order nificance level of 5%. Multivariate analysis for the factors
to classify the emotional exhaustion domain, we used the associated with burnout was done by adjusting the Poisson
following scoring criteria: low (≤ 18 points), moderate (19 model with robust variance, while factor significance was
to 26 points) and high (≥ 27 points). The classification of assessed using Wald statistic. For entry into the model, we
the depersonalization domain was done according to the considered the variables with p<0.2 in the univariate anal-
following score: low (≤ 6 points), moderate (seven to 12 ysis. To retain the variable in the final model, we calcu-
points) and high (≥ 13 points). For the professional lated the prevalence ratios and considered p<0.05.

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 Gouveia PAC et al.

The research was performed after analysis and ap- About 80% of residents experienced a stressful event in the
proval by the Ethics Committee of the Health Sciences previous six months, 75% had adequate supervision at the
Center of Universidade Federal de Pernambuco (CEP/ medical residency, and the clinics hospital (HC) was the
CCS/UFPE), in accordance with Resolution No. 466/2012 first place they chose to go (64.3%). Most of the participants
on “Research involving Human Beings” of the Ministry do not practice intense physical activity (65.1%) and do
of Health, Opinion No. 49197615.2.0000.5208. drink alcohol (72.7%). As for housing, 50.4% of the residents
are from Recife and 72.9% do not live with their parents.
Results Burnout syndrome was found in 36 of the 129 resi-
In relation to the personal profile of the participants, we dents through the MBI questionnaire, resulting in a
found that most are in the first or second year of residency prevalence of 27.9%. As for the domains of burnout, the
(67.4%), aged up to 28 years (52.9%), female (51.9% ), not majority of the participants presented a high level of emo-
married (66.1%) and do not have children (87.9%). Regard- tional exhaustion (59.7%) and a low level of professional
ing the professional profile of the residents, we found that effectiveness (94.6%). The level of depersonalization was
most of the students do more shifts to supplement their high in 31.8% of the participants.
income (84.5%), work up to an additional 24 hours (76.4%), Table 1 compares residents who met criteria for burn-
performed four or more night shifts in the last month out and those without the syndrome, illustrating the as-
(75.6%) and works more than 60 hours per week (56.6%). sociation with risk factors in the univariate analysis. Area

TABLE 1  Distribution of burnout syndrome according to the personal and professional profile of resident physicians at
Hospital das Clínicas of Universidade Federal de Pernambuco.
Factor assessed Has burnout syndrome p-value
Yes No
Year of residency
1st to 2nd year 23 (26.4%) 64 (73.6%) 0.59*
3 to 5 year
rd th
13 (31.0%) 29 (69.0%)
Age
Up to 28 years 20 (31.7%) 43 (68.3%) 0.71*
Older than 28 years 16 (28.6%) 40 (71.4%)
Sex
Male 17 (27.4%) 45 (72.6%) 0.90*
Female 19 (28.4%) 48 (71.6%)
Marital status
Not married 25 (29.8%) 59 (70.2%) 0.62*
Married 11 (25.6%) 32 (74.4%)
Has children
Yes 4 (26.7%) 11 (73.3%) 1.00†
No 31 (28.4%) 78 (71.6%)
Specialization area
Surgical medicine 16 (44.4%) 20 (55.6%) 0.01*
Other 20 (21.5%) 73 (78.5%)
Extra shifts to supplement income
Yes 31 (28.4%) 78 (71.6%) 0.75*
No 5 (25.0%) 15 (75.0%)
Weekly hours of work
Up to 60 hours 12 (21.4%) 44 (78.6%) 0.15*
More than 60 hours 24 (32.9%) 49 (67.1%)
(Continues)

506Rev Assoc Med Bras 2017; 63(6):504-511

 Factors associated with burnout syndrome in medical residents of a university hospital

TABLE 1  (Cont.) Distribution of burnout syndrome according to the personal and professional profile of resident physicians
at Hospital das Clínicas of Universidade Federal de Pernambuco.
Factor assessed Has burnout syndrome p-value
Yes No
Stressful events in the previous 6 months
Yes 35 (33.7%) 69 (66.3%) <0.01*
No 1 (4.0%) 24 (96.0%)
Adequate supervision during residency
Yes 24 (25.0%) 72 (75.0%) 0.17*
No 12 (37.5%) 20 (62.5%)
Regular physical activity
Yes 9 (20.0%) 36 (80.0%) 0.14*
No 27 (32.1%) 57 (67.9%)
Use of alcoholic beverages
Yes 29 (31.2%) 64 (68.8%) 0.21*
No 7 (20.0%) 28 (80.0%)
Place of origin
Greater Recife area 21 (32.3%) 44 (67.7%) 0.26*
Other locations 15 (23.4%) 49 (76.6%)
Lives with
Parents 14 (40.0%) 21 (60.0%) 0.06*
Other relatives, friends or alone 22 (23.4%) 72 (76.6%)
* p-value of the Chi-square test for independence; † p-value of Fisher’s exact test.

of specialization, stress event in the previous 6 months, cialty residency was the only factor that was associated with
supervision of residency, workload, physical activity and high depersonalization in the multivariate analysis. No
living with parents, friends or alone were the variables factor was independently associated with low achievement.
yielding p<0.2 and thus submitted to multivariate analysis.
Table 2 shows the association between the resident Discussion
profile and the MBI questionnaire domains. For the emo- The prevalence of burnout in medical residency, according
tional exhaustion domain, the variables submitted to mul- to the international literature, ranges from 27 to 75%,
tivariate analysis due to p<0.2 were specialization area, hav- depending on the specialty.13 Brazilian studies, on the
ing children, performing supplementary shifts to increase other hand, reveal a prevalence between 20 and 50%, using
income, stress event in the previous six months, supervision the same instrument adopted by us in this study: the MBI
at the residency and place of origin. In the depersonaliza- questionnaire. Half of the residents of internal medicine
tion domain, the variables submitted to multivariate anal- at a philanthropic hospital in São Paulo met the criteria
ysis were area of specialization, stress event in the last six for burnout in 2012.14 In a study performed in 2004 at
months, physical activity and living with parents, friends Hospital de Clínicas of Universidade Federal de Uberlân-
or alone. For the professional achievement domain, the dia, the authors found a prevalence of 20.8% of burnout
variables were marital status, having children, stress event in residents from several specialties,9 similar to the figure
in the previous six months and use of alcoholic beverage. found in 2009 at Hospital das Clínicas of Universidade
Table 3 shows the final model with the factors that Federal de Goiás, which was 18%.6 A study with oncology
remained independently associated with p<0.05. Burnout residents only, from several centers in Brazil, identified a
was about twice as prevalent in surgical residents (PR: 1.99; high prevalence of burnout (76%). However, using as a
95CI 1.20-3.29), and eight times more frequent in those criterion the presence of the three dimensions of the
who experienced stressful event in the previous six months syndrome, this value drops to less than 36%.15 Our study
(PR: 8.10; 95CI 1.15-57.16) after control for other covariates. demonstrated a prevalence of 27.9% of burnout syndrome
These same factors were independently associated with in HC-UFPE residents, which is compatible with the aver-
high emotional exhaustion, while being in a surgical spe- age of other studies conducted in Brazil.

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 Gouveia PAC et al.

TABLE 2  Distribution of the emotional exhaustion, depersonalization and professional achievement domains, according to
the personal and professional profile of resident physicians at Hospital das Clínicas of Universidade Federal de Pernambuco.
Factor assessed Emotional exhaustion Depersonalization Professional achievement
Low/ High p-value Low/ High p-value Low Moderate p-value
Moderate Moderate
Year of residency
1st to 2nd year 33 (37.9%) 54 (62.1%) 0.43* 60 (69.0%) 27 (31.0%) 0.79* 82 (94.3%) 5 (5.7%) 1.00†
3rd to 5th year 19 (45.2%) 23 (54.8%) 28 (66.7%) 14 (33.3%) 40 (95.2%) 2 (4.8%)
Age
Up to 28 years 23 (36.5%) 40 (63.5%) 0.27* 38 (60.3%) 25 (39.7%) 0.20* 61 (96.8%) 2 (3.2%) 0.25†
Older than 28 years 26 (46.4%) 30 (53.6%) 40 (71.4%) 16 (28.6%) 51 (91.1%) 5 (8.9%)
Sex
Male 28 (45.2%) 34 (54.8%) 0.28* 42 (67.7%) 20 (32.3%) 0.91* 57 (91.9%) 5 (8.1%) 0.26†
Female 24 (35.8%) 43 (64.2%) 46 (68.7%) 21 (31.3%) 65 (97.0%) 2 (3.0%)
Marital status
Not married 31 (36.9%) 53 (63.1%) 0.43* 55 (65.5%) 29 (34.5%) 0.45* 82 (97.6%) 2 (2.4%) 0.04†
Married 19 (44.2%) 24 (55.8%) 31 (72.1%) 12 (27.9%) 38 (88.4%) 5 (11.6%)
Has children
Yes 9 (60.0%) 6 (40.0%) 0.10* 10 (66.7%) 5 (33.3%) 1.00* 12 (80.0%) 3 (20.0%) 0.04†
No 41 (37.6%) 68 (62.4%) 74 (67.9%) 35 (32.1%) 105 (96.3%) 4 (3.7%)
Specialization area
Surgical medicine 9 (25.0%) 27 (75.0%) 0.03* 20 (55.6%) 16 (44.4%) 0.06* 34 (94.4%) 2 (5.6%) 1.00†
Other 43 (46.2%) 50 (53.8%) 68 (73.1%) 25 (26.9%) 88 (94.6%) 5 (5.4%)
Extra shifts to supplement income
Yes 41 (37.6%) 68 (62.4%) 0.14* 75 (68.8%) 34 (31.2%) 0.74* 103 (94.5%) 6 (5.5%) 1.00†
No 11 (55.0%) 9 (45.0%) 13 (65.0%) 7 (35.0%) 19 (95.0%) 1 (5.0%)
Weekly hours of work
Up to 60 hours 25 (44.6%) 31 (55.4%) 0.38* 41 (73.2%) 15 (26.8%) 0.29* 52 (92.9%) 4 (7.1%) 0.47†
More than 60 hours 27 (37.0%) 46 (63.0%) 47 (64.4%) 26 (35.6%) 70 (95.9%) 3 (4.1%)
Stressful events in the previous 6 months
Yes 31 (29.8%) 73 (70.2%) <0.01* 66 (63.5%) 38 (36.5%) 0.02* 100 (96.2%) 4 (3.8%) 0.13†
No 21 (84.0%) 4 (16.0%) 22 (88.0%) 3 (12.0%) 22 (88.0%) 3 (12.0%)
Adequate supervision during residency
Yes 43 (44.8%) 53 (55.2%) 0.04* 68 (70.8%) 28 (29.2%) 0.23* 91 (94.8%) 5 (5.2%) 1.00†
No 8 (25.0%) 24 (75.0%) 19 (59.4%) 13 (40.6%) 30 (93.8%) 2 (6.3%)
Regular physical activity
Yes 20 (44.4%) 25 (55.6%) 0.48* 35 (77.8%) 10 (22.2%) 0.09* 41 (91.1%) 4 (8.9%) 0.24†
No 32 (38.1%) 52 (61.9%) 53 (63.1%) 31 (36.9%) 81 (96.4%) 3 (3.6%)
Use of alcoholic beverages
Yes 35 (37.6%) 58 (62.4%) 0.26* 61 (65.6%) 32 (34.4%) 0.35* 90 (96.8%) 3 (3.2%) 0.09†
No 17 (48.6%) 18 (51.4%) 26 (74.3%) 9 (25.7%) 31 (88.6%) 4 (11.4%)
Place of origin
Greater Recife area 21 (32.3%) 44 (67.7%) 0.06* 42 (64.6%) 23 (35.4%) 0.38* 63 (96.9%) 2 (3.1%) 0.27†
Other locations 31 (48.4%) 33 (51.6%) 46 (71.9%) 18 (28.1%) 59 (92.2%) 5 (7.8%)
Lives with
Parents 11 (31.4%) 24 (68.6%) 0.21* 20 (57.1%) 15 (42.9%) 0.10* 34 (97.1%) 1 (2.9%) 0.67†
Other relatives, friends 41 (43.6%) 53 (56.4%) 68 (72.3%) 26 (27.7%) 88 (93.6%) 6 (6.4%)
or alone
* p-value of the Chi-square test for independence; † p-value of Fisher’s exact test.

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Factors associated with burnout syndrome in medical residents of a university hospital

TABLE 3  Multivariate analysis of burnout syndrome and associated factors in resident physicians at Hospital das Clínicas of
Universidade Federal de Pernambuco.
Factor assessed PR 95CI p–value*
Burnout syndrome Specialty
Surgical medicine 1.99 1.20-3.29 0.008
Other 1.00 – –
Stressful event in the previous 6 months
Yes 8.10 1.15-57.16 0.036
No 1.00 – –
Emotional exhaustion Specialty
Surgical medicine 1.35 1.04-1.74 0.022
Other 1.00 – –
Stressful event in the previous 6 months
Yes 4.32 1.78-10.46 0.001
No 1.00 – –
Depersonalization Specialty
Surgical medicine 1.65 1.007-2.71 0.047
Other 1.00 – –
PR: prevalence ratio; 95CI: 95% confidence interval; *p-value of the Wald test.

As for Brazilian studies including physicians after enced in the Unified Health System also contribute to the
completion of residency, the prevalence of burnout is feeling of low professional achievement. The current study
lower. A prevalence of 7.4% was found in 297 intensive was conducted in a hospital linked to the public health
care physicians in the city of Salvador.16 The prevalence system, whose resident physicians performed a small
was also low (5.1%) among pediatricians and obstetricians/ strike with temporary cessation of care in the period
gynecologists of a teaching hospital in Pernambuco.12 prior to data collection, due to the lack of basic conditions
This difference in prevalence can be explained by the char- for professional practice. This event may have influenced
acteristics of residents and medical residency. Resident the low professional achievement observed in our study
physicians, in addition to experiencing stressing factors and reflects the interference of the work environment in
that are inherent to the medical profession, are under the the personal satisfaction of the professional. According
pressure of medical residency (training nature and edu- to Malasch, the lack of professional effectiveness seems
cational structure) and face conflicts that are common to emerge more clearly from the lack of relevant resourc-
to young professionals (seeking independence and au- es, while emotional exhaustion seems to emerge from the
tonomy, conflict between work and leisure).8 Comparing presence of work overload.2
the level of psychological stress among resident and non- In the multivariate analysis, burnout was associated
resident physicians of Brazilian university hospitals, with surgical specialties. Thus, the risk of residents as-
greater vulnerability to work stress was demonstrated in sociated with surgical specialties developing burnout was
residents.17 In addition, they are less able to cope with twice as high as the risk of residents of other specialties
stress and feel less confident in accomplishing their tasks. (p=0.008). Previous studies have found that resident sur-
Regarding the domains of burnout, the high preva- geons live under more stress than other medical profes-
lence of low level of professional achievement is worth sionals.18,19 A Mexican study found that burnout is more
noting in our work (94.6%). This prevalence was much prevalent in residents who work over 80 hours per week,
lower in other studies with physicians living in Brazil, being statistically more frequent in those with surgical
ranging from 17.6 to 33.3%.6,9,15 The exception was a study specialties.20 Justifications for the association between
by Fabichak that found 70.8% of the residents with low burnout and surgical specialties were not determined in
level of professional achievement.14 In our study, this can our study. One possible explanation would be the fact
be explained by the period of data collection at the end that surgical medicine is an area that demands more
of a school year, between October and November. Never- workload and has more demanding instructors. The influ-
theless, the physical and managerial difficulties experi- ence of supervisors’ behavior on the prevalence of burnout

Rev Assoc Med Bras 2017; 63(6):504-511 509

 Gouveia PAC et al.

is known, so that residents who perceive themselves unap- can contribute to the elaboration and consolidation of
preciated by their teams are at greater risk of developing preventive and therapeutic measures in this population.
this condition.21
Being a resident of surgical areas was also indepen- Resumo
dently associated with greater emotional exhaustion and
depersonalization. A study from Uberlândia also showed Fatores associados à síndrome de burnout em médicos
that residents belonging to surgical areas presented great- residentes de um hospital universitário 
er depersonalization than those belonging to clinical
areas.9 Emotional exhaustion was recognized as a problem Objetivo: Determinar a prevalência da síndrome de burn-
by surgical residents in South Korea, but directly explored out entre médicos residentes de várias especialidades e
in those programs.18 This shows that although residents avaliar os fatores associados.
perceive the difficulties, Medical Residency Committees Método: Foram aplicados o questionário Maslach Burnout
and preceptors do not generally recognize the profession- Inventory e um questionário sócio-demográfico para
als’ susceptibility to burnout. avaliar fatores associados à síndrome. Burnout foi defini-
The other factor associated with burnout in the mul- do pela associação de alto desgaste emocional e desper-
tivariate analysis was having suffered a stress event in the sonalização e baixa realização profissional. Análise mul-
previous six months. These individuals were eight times tivariada foi realizada por meio do ajuste do modelo de
more likely to develop burnout compared to those who Poisson com a identificação dos fatores de risco e calcu-
did not experience a stressful event (p=0.036). Stressful ladas as razões de prevalência (RP). Dos 250 médicos re-
events affect the physician in training in a negative way sidentes cadastrados no Hospital das Clínicas de Pernam-
and can cause burnout.22 Stressors inside and outside the buco, 129 participaram do estudo.
scope of medicine are able to deplete the personal resourc- Resultados: Nos três domínios que caracterizam a sín-
es of residents.10 In a Canadian study, the main sources of drome de burnout, encontramos um baixo nível de reali-
stress were tests and evaluations (38.9%), financial problems zação profissional em 94,6% dos médicos residentes en-
(25.5%) and family problems (7.4%).22 We were unable to trevistados, alto nível de despersonalização em 31,8% e
identify which type of stress event was most common in 59,7% com alto nível de desgaste emocional. A prevalên-
our sample. Nevertheless, we found that the burnout do- cia de burnout encontrada foi de 27,9%. Ter sofrido even-
main most often implicated was emotional exhaustion. to estressante nos seis meses anteriores (RP: 8,10; IC 95%
It is important that residents who are vulnerable to 1,2-57,2) e cursar especialidade cirúrgica (RP: 1,99; IC
developing burnout syndrome seek psychological counsel- 95% 1,2-3,3) estiveram associados de forma independen-
ing. Resident physicians sought the psychological assistance te ao burnout.
group of the University of São Paulo more in the first year Conclusão: A prevalência de burnout encontrada em mé-
and due to factors related to adaptive crises.23 Early iden- dicos residentes está de acordo com estudos brasileiros
tification of residents susceptible to burnout would be prévios. Residentes de especialidades cirúrgicas e aqueles
important in resolving this type of assistance. In addition, que sofreram evento estressor foram identificados como
Pereira-Lima and Loureiro identified the presence of high- susceptíveis neste estudo. A identificação precoce dos fato-
er scores for social skills in residents without burnout and res de risco é fundamental para a implementação de medi-
mental health problems. Since social skills such as com- das preventivas para o não desenvolvimento da síndrome.
munication, empathy and ability to work as a team can be
learned, it is important to develop these skills during Palavras-chave: burnout, residência médica, educação
medical residency training in order to improve practice.24 médica.

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