BURNOUT AND MORAL INJURY AMONG RESIDENTS AND EARLY-CAREER PHYSICIANS: AN INTERNATIONAL REVIEW OF OBSERVATIONAL EVIDENCE

Abstract

Background. Burnout among healthcare workers is now recognised as a public-health concern in its own right, with residents and early-career physicians disproportionately affected. The construct of moral injury — distress arising when clinicians cannot act in accordance with their professional values because of system-level constraints — has been proposed as a complement to the classical burnout framework. Aim. To synthesise contemporary observational evidence on the epidemiology of burnout, its principal risk factors, and the role of moral injury among residents and early-career physicians, with particular attention to the Polish context. Methods. A literature review of observational studies published between 2009 and 2025 was conducted in PubMed, Scopus, and Web of Science, following the STROBE statement for reporting. Because of methodological heterogeneity, no quantitative meta-analysis was attempted; findings were integrated through qualitative narrative synthesis. Results. Burnout prevalence in this population ranged from approximately 30% to over 60%, depending on geography, specialty, and measurement instrument [11,12]. Dominant risk factors were organisational: excessive workload, administrative load, restricted professional autonomy, and impaired work–life balance. Personal attributes rarely operated as independent predictors but appeared to modify risk. Moral injury emerged as a meaningful complement to burnout, capturing the value-conflict dimension that burnout scales tend to miss [8,9]. Conclusions. Burnout and moral injury together pose a serious challenge to healthcare systems. Prevention strategies that focus exclusively on individual resilience are unlikely to succeed; the evidence points instead to structural and organisational reform [31].