Medical school students often experience emotional difficulties when handling the challenges of their formation, occasionally leading to burnout. In this study, we measured the prevalence of burnout and its relationships with perceived stress, perceived social support, and alexithymia in medical students from the largest academic medical community in Romania. A cross-sectional survey was administered to a randomized sample of 299 preclinical medical students at the University of Medicine in Bucharest. Participants completed four standardized questionnaires. In addition to the assessment of burnout prevalence, stepwise backward regression was used to establish which variables had the highest correlation to burnout components. Further, t-tests were run to assess gender-related differences. Overall, burnout prevalence was 15.05%. Perceived stress was found to be the strongest predictor of emotional exhaustion and lack of accomplishment, while the strongest predictors of depersonalization were low perceived social support (in women) and alexithymia (in men). Women appear to be more vulnerable to two of the components of burnout (emotional exhaustion and low personal accomplishment) and associate higher perceived stress and alexithymia. These results suggest that interventions addressing academic burnout could benefit from being gender-specific, with focus on key elements, such as perceived stress and alexithymia.

This study aimed to highlight the contribution of self-efficacy, optimism, resilience and perceived stress on academic performance (GPA) at medical undergraduate students. Additionally, we investigated the relationship established between abovementioned variables, gender and position in the academic cycle and the factors associated with satisfaction regarding own academic results. 118 students (25 men, 93 women, mean age 22.863, SD = 1.763) participated in the study. They were administered the General Self-Efficacy Scale (G-SES), the Revised Life Orientation test (LOT-R), the Brief Resilience Scale (BRS) and the Perceived Stress Scale (PSS). t, Wilcoxon-Mann-Whitney, chi-square tests, and linear regressions were performed, in order to test the strength of the hypothesized associations. Data analysis demonstrates a significant association between low optimism, low resilience, high perceived stress and poor academic performance. Even though preclinical students displayed greater perceived stress, it negatively correlated to GPA only in clinical students, this indicating a possible accumulation of stress-related effects. No gender differences were met for the studied variables. Students in clinical cycle were significantly less satisfied about their own performance. These results indicate solid associations between psychosocial variables and academic performance, and differences in the subjective evaluation of own performance, suggesting key points to address, when designing interventions against academic stress.

Physicians working with palliative patients have a substantial risk of emotional exhaustion because of their daily confrontation with suffering and death. Common concerns include alexithymia, high stress, low perceived social support and a greater burnout risk. This longitudinal study aimed to evaluate the effectiveness of Balint training in preventing the development of these symptoms in these medical professionals. The design of the study was longitudinal. A group of 69 physicians working with palliative patients from 5 county hospitals in Romania (33 men, 36 women) participated in the study. Out of them, 31 joined and systematically attended a local Balint group whereas the others did not participate in such a group, either during the study or previously. They were given, both at the beginning (2015) and at the end of the study (2017), 4 psychometric instruments assessing alexithymia (Bagby's Toronto Alexithymia Scale), perceived stress (Cohen and Williamson's Perceived Stress Scale), social support (Duke-UNC Functional Social Support Questionnaire) and burnout (Maslach Burnout Inventory). A split-plot ANOVA analysis was used for evaluating the significance of Balint groups participation, with gender and age considered as auxiliary variables. In the study group, Balint training significantly improved the scores of global burnout (F(1, 64) = 25.104, p < 0.0001), 2 of its components (emotional exhaustion (F(1, 64) = 18.390, p < 0.0001) and depersonalization (F(1, 64) = 10.957, p < 0.002), alexithymia (F(1, 64) = 3.461, p < 0.0001) and perceived social support (F(1, 64) = 57.883, p < 0.0001), but not the scores of perceived stress and low personal accomplishment. Gender had an additional contribution in decreasing alexithymia (F(1, 64) = 7.436, p < 0.009) and increasing perceived social support (F(1, 64) = 15.426, p < 0.0001), with higher effects in men. This study points to the potential usefulness of Balint training in addressing alexithymia and burnout, and in improving perceived social support among physicians working with palliative patients. As the Balint method is easily understood and does not require special investments, it could represent a cost-effective instrument of addressing job-related psychological risks. Int J Occup Med Environ Health. 2019;32(1):53-63.

This study assessed the learning perception of undergraduate medical students on three types of teaching (classical/online/hybrid), in relation to coping strategies, stress, and social support, in the context of the SARS-CoV-2 pandemic. Additionally, we explored gender differences and the perceived usefulness of teaching. 201 students (48 men, 153 women; mean age = 22.900, SD = 2.830) participated in the study. They answered a Multidimensional Scale of Perceived Social Support, a Brief Cope Scale, a Student-life Stress Inventory, a visual analog scale for usefulness, and a survey collecting their perceptions about learning across teaching types. Results point out a preference for classical teaching, followed by the hybrid and online formats. Online teaching was identified as more advantageous in terms of time management and seeking information. Denial and substance use were statistically associated with poor communication, bad time using, and impaired learning. Both stress and social support had ambivalent associations with learning perceptions. Gender differences were limited to behavioral disengagement and higher social support perceived by women. Although classical teaching was globally perceived as the most useful, online teaching was considered desirable by male urban respondents. These data may contribute to the strategic growth and refinement of web-based teaching methods in medical universities.

This study aimed to assess the extent of burnout in Romanian and Moldavian academic physicians and to determine the predictive value of emotional intelligence (EI), coping strategies, work motivation (WM), perceived organizational support (POS), and the socio-demographic characteristics of burnout. Two hundred physicians (40% men, 60% women, mean age = 43.02, SD = 9.91) participated in the study. They were administered the Maslach Burnout Inventory−General Survey, Brief COPE Scale, Multidimensional Work Motivation Scale, Schutte’s Self-Report Emotional Intelligence Test, and Perceived Organizational Support Scale. Mann−Whitney U tests were used to assess the significance of intercountry differences, while hierarchical regressions were performed to investigate the predictive value of the independent variables on burnout. Moldavian participants had significantly lower scores in burnout and amotivation (p < 0.001) and higher scores in EI, POS, and WM (p < 0.001). The main burnout predictors were amotivation (β = 0.388, p < 0.001) and low POS (β = −0.313, p< 0.001) in Moldavian respondents, and WM (intrinsic: β = −0.620, p < 0.001; extrinsic: β = 0.406, p < 0.001) in Romanian participants. Moldavian respondents displayed better adjustment to academic stress. The distribution of burnout predictors suggests better sensitivity of respondents to organizational interventions in Moldova and to individual therapy in Romania. This data could serve to better tailor Public Health interventions addressing burnout in the academic environment.

Stress exposure can take a toll on the adjustment of young individuals, including students. The aim of this study was to investigate the impact of burnout and impostor syndrome (IS) on self-esteem and academic performance in medical students. The participants were 331 undergraduate medical students (102 men, 229 women; 89.7% native, 12,1% international; mean age = 21.18, SD = 2.338). The study instruments included the Copenhagen Burnout Inventory for Students (CBI-S), Clance Impostor Phenomenon Scale (CIPS), and Rosenberg’s Self-Esteem Scale, while academic performance (AP) was reported as received GPA (objective AP) and expected GPA (subjective AP). The statistical analysis comprised independent t-tests, MANOVA, ANOVA, and correlational and mediational analyses. The results showed that native students had lower self-esteem and higher scores of personal burnout and IS. Irrespective of cultural differences, women scored higher than men in IS and in personal burnout, while men had higher self-esteem than women. Burnout and IS were correlated with a decrease in self-esteem (adj. R² = 0.531) in the overall sample, whereas in native students, IS was correlated with a difference between subjective and objective self-assessments of AP (adj. R² = 0.027). Burnout and impostor syndrome, despite not directly impacting academic performance, may significantly influence self-esteem, making them a target for preventive or interventional measures.