A large cross-sectional study of medical residents in Tunisia finds that burnout affects 45.9% of trainees, with monthly on-call shifts more than doubling the odds, while regular physical activity and intrinsic career motivation appear protective.
What they found
Researchers surveyed 320 medical residents aged 25,35 across six Tunisian university hospitals between March 2024 and January 2025. Participants completed validated instruments including the Maslach Burnout Inventory, the Insomnia Severity Index, the Somatic Symptom Scale-8, and the Ricci-Gagnon physical activity questionnaire.
Key figures:
- 45.9% of residents met criteria for burnout, with pathological scores across all three Maslach subscales (emotional exhaustion, depersonalization, reduced personal accomplishment).
- Emotional exhaustion showed strong correlations with somatic symptom burden (r = 0.84) and insomnia severity (r = 0.75), and a strong inverse correlation with physical activity (r =,0.82).
- Each additional monthly on-call shift was associated with 2.72 times higher odds of burnout (p < 0.001).
- Residents who reported intrinsic motivation for choosing medicine had 87% lower odds of burnout (OR = 0.13; p = 0.001).
- Higher somatic symptom scores were associated with increased burnout risk (OR = 1.20 per unit; p = 0.013).
- Regular physical activity was associated with reduced burnout risk (OR = 0.82 per unit; p = 0.001).
Why it matters
Burnout among medical residents is a global concern, not just for the well-being of trainees, but for patient safety, healthcare workforce retention, and the quality of care delivered. This study is among the first from Tunisia to use a multidimensional analytic approach that simultaneously accounts for occupational, psychological, and lifestyle factors. The strong independent associations with insomnia severity and physical activity suggest that sleep health and exercise could be modifiable intervention targets within residency programs, alongside structural reforms to on-call scheduling.
Limits
The study is cross-sectional, so causality cannot be inferred. All measures were self-reported, which may introduce recall or desirability bias. The sample was drawn from a single country (Tunisia), and findings may not generalize to residency programs with different shift structures, cultural contexts, or healthcare systems.
Bottom line
Burnout is highly prevalent among medical residents and is shaped by a combination of on-call overload, poor sleep, somatic distress, and low physical activity. The findings support the case for residency programs to invest in sleep health screening, exercise promotion, and scheduling reforms, alongside efforts to preserve the intrinsic motivation that drew trainees into medicine in the first place.
Source
Henchiri H, Chaabeni A, Znazen H, et al. Burnout in medical residents: the combined influence of on-call burden, somatic symptomatology, insomnia severity, and physical activity. Frontiers in Sports and Active Living. 2026;8:1779677. doi:10.3389/fspor.2026.1779677. PMID: 42293990.