Burnout and psychological distress across U.S. postgraduate trainees, fellows, and students: A comprehensive meta-analysis

Objective: This meta-analysis explored the relationship between burnout and psychological distress across different academic disciplines, measurement tools, institutional contexts, and the pandemic. Method: We synthesized 76 effect sizes from 29 studies involving 20,037 students, residents, and fellows in the United States. Results: The correlation between burnout and psychological distress was (r = 0.44), with stress showing the strongest correlation (r = 0.48). Notably, the correlations were higher during the pandemic (r = 0.46) compared to pre-pandemic (r = 0.44). Our subgroup analysis indicated that medical students exhibited a stronger association (r = 0.5) than fellows and residents. Additionally, samples from a multiple organization yielded higher correlations (r = 0.46). Conclusions: Among the dimensions of burnout, emotional exhaustion demonstrated a stronger correlation with psychological distress. Meta-regression confirmed that the students’ disciplines, sample locations, and COVID-19 moderated the overall effect size. Findings highlight the urgent need for targeted interventions to address environmental stressors within medical training.