Background: Burnout is a common mental problem in medical students. For those who are following medical studies abroad there is a higher risk of suffering this syndrome, due to the combination of academic stress and the stress derived from their new living situation. This study was performed with the purpose of testing the following hypothesis: in medical students enrolled in medical programs abroad, abilities associated with professionalism and family support play a protective role in the prevention of suffering burnout. Methods: A cross-sectional study was performed in the Faculty of Medicine of the University of Zagreb, where a fully English medical program is offered. The general version of the Maslach Burnout Inventory (MBI-GS) was used as a dependent variable, while Jefferson Scales of empathy, teamwork, and physician lifelong learning and the Social and Emotional Loneliness Scale for Adults were used as predictive variables. In addition, information related to sex, country of birth, native language, age, academic achievement, and living situation were collected in a socio-demographic form. Linear regression models were applied to identify predictors of burnout. Results: In a sample composed of 188 medical students (38 Croatians and 144 foreigners from 28 countries), 18% of the global score in the MBI-GS was explained by lifelong learning and family loneliness. A separate analysis for each domain of the MBI-GS allowed the creation of three models: the first model explained 19% of the variance of the “exhaustion” domain by “country of birth”, “living with parents”, “academic year”, and “cynicism”; a second model explained 24% of the variance of the “cynicism” domain by “academic year”, “empathy”, “lifelong learning”, and “exhaustion”; and finally, a third model explained 24% of the variance of the “professional efficacy” domain by “lifelong learning”, “family loneliness”, and “cynicism”. All obtained models presented an effect size between medium and large, as well as matching the required conditions for statistical inference. Conclusions: These findings confirm the important role that family plays as a source of support for medical students. Empathy and lifelong learning, two specific elements of medical professionalism, appear as protective factors in the prevention of burnout in international students.

Background: Burnout and engagement are seen as opposite ends of a continuum. In medical education, engagement reflects motivation and social belonging, while burnout signifies a lack of interest in learning and social detachment. This study aimed to investigate the influence of lifelong learning and loneliness on these dynamics. Methods: A cross-sectional study involving a culture back-translation procedure was performed. Participants were medical students enrolled in a Croatian medical school. The Maslach Burnout Inventory (MBI-GS), Jefferson Scale of Physician lifelong learning (JeffSPLL-MS), and the Scale of Social and Emotional Loneliness Scale for Adults (SELSA-S), were used as main measures. Sex, age, grade point average, and year of study, were collected in a complementary form. Confirmatory Factor Analyses (CFAs), followed by correlation, comparative and multiple linear regression analyses were performed to assess the above-mentioned variables. Results: The sample consisted of 1,371 medical students (872 women), all native Croatian speakers. A model including lifelong learning, loneliness and sex variables accounted for 17% of the variance in the global MBI-GS score. This model showed a medium-to-large effect size and fulfilled conditions required for statistical inference. Additionally, differences by sex appeared in loneliness (p < 0.001), but not in lifelong learning abilities. Furthermore, the Croatian versions of the JeffSPLL-MS and the SELSA-S exhibited good psychometric properties, as confirmed by CFAs. Conclusions: These findings highlight the influence of lifelong learning abilities and loneliness on the burnout-engagement continuum. Additionally, findings indicate that female medical students are at heightened risk of experiencing burnout.