Burnout among Syrian medical residents: A cross-sectional study using the burnout assessment tool (BAT)

Abstract

Introduction Burnout syndrome, described by Herbert Freudenberger in 1974, is a psychological condition caused by chronic workplace stress, particularly in healthcare. It is characterized by emotional exhaustion, depersonalization, and a reduced sense of achievement. Burnout has become prevalent among healthcare workers, especially physicians and residents, with rates often exceeding 50%. In Syria, ongoing conflict has further stressed the healthcare system, exacerbating burnout among medical residents. This study aims to assess the prevalence and contributing factors of burnout among Syrian medical residents using the Burnout Assessment Tool (BAT), a more precise evaluation tool than traditional measures. Methods A cross-sectional study was conducted from April 18 to May 1, 2025, among resident physicians in hospitals across six Syrian governorates. Licensed physicians with at least one year of clinical experience were eligible. Data were collected via an online questionnaire (KoboToolbox) assessing demographics, work conditions, burnout symptoms (BAT-23), job satisfaction, coping strategies, and workplace challenges. The minimum required sample size was 373. SPSS v25 was used for analysis. Non-parametric tests were applied due to non-normal data distribution. Results A total of 550 medical residents participated, with the majority being female and in their early residency years. Participants primarily worked in governmental hospitals. Using the BAT23, 50% of participants were in the high-risk (Red) zone, with exhaustion being the most prevalent (76.7%). Cognitive impairment and emotional impairment were also common. Specialties like internal medicine and surgery showed higher burnout rates, with factors like workload, training, and work environment strongly linked to burnout. No significant differences were found based on Sex, age, or marital status. Discussion The BAT provided a comprehensive assessment of burnout, highlighting exhaustion as the main driver, while mental health was less impacted. Mid-level residents (years 2–4) faced the highest burnout rates due to increased responsibilities without senior mentorship. High-stress specialties like internal medicine, surgery, pulmonology, and anesthesia were more vulnerable to burnout. The study underscores the need for systemic reforms, including improved workload distribution, better training, and mental health support. Conclusion The study reveals high levels of burnout among Syrian medical residents, particularly in exhaustion and cognitive impairment. The highest rates were seen in mid-level residents and high-stress specialties. Structural reforms, such as better work conditions, training, and mental health support, are essential for mitigating burnout and ensuring the sustainability of Syria’s healthcare system.