Understanding burnout and engagement during medical residency: a multifactorial and longitudinal approach

Abstract

Background The residency period constitutes a critical phase of medical training, during which increasing clinical and professional responsibilities influence residents' well-being. Grounded in the Job Demands-Resources model, this study investigates how burnout and engagement evolve during this period and examines their associations with specific demands, resources, and personality traits.Methods Between 2021 and 2025, data were collected annually via an online survey administered to medical residents from five Belgian universities (n = 1068). Burnout dimensions (i.e., emotional exhaustion, cynicism and reduced professional efficacy) and engagement were assessed alongside their associations with demands, resources, and personality traits. Linear mixed-effects models estimated the relationships between independent and dependent variables.Results The findings show that emotional exhaustion and cynicism modestly but gradually increased over time, while engagement slightly declined and professional efficacy remained stable. Work-home conflict showed the strongest association with the outcomes, while meaningfulness was identified as the most prominent resource and neuroticism as the strongest personal factor consistently linked to all outcome variables.Conclusions These findings highlight the urgent need for structural interventions within residency programs to address key demands and strengthen meaningful work, while recognizing neuroticism as a vulnerability factor in protecting residents' well-being.Clinical trial number Not applicable.