The association between burnout and empathy in intern medical doctors rotating at Steve Biko Academic Hospital in Pretoria, South Africa

Abstract

BACKGROUND : Burnout, a state of mental and physical exhaustion from chronic work stress, affects approximately one in three doctors. Burnout is associated with substance use, suicidality and impaired doctor-patient relationships. It also contributes to reduced quality of care, increased medical errors and malpractice claims. Empathy is the cognitive ability to understand and respond to a patient’s experiences. This study explored the relationship between burnout and empathy among South African intern doctors. METHODS : This cross-sectional quantitative study used consecutive sampling. Self-administered questionnaires were completed by 95 interns. Data were analysed using descriptive statistics, as well as bivariate and multivariable analyses. RESULTS : The median age of interns was 26 years. Over 70% were overextended or burnt out. About one-third (33.68%) of participants had a diagnosed mental illness, and over half reported worsening illness during their internship. Lack of awareness of counselling services (83.16%) was associated with higher burnout (p = 0.020). Age was associated with burnout profile (p < 0.001), with younger interns more likely to be burnt out. Empathy scores were significantly lower in the burnt out, overextended and ineffective interns (p = 0.002), even after adjustment for demographic, clinical and work-related factors. CONCLUSION : The high prevalence of burnout among intern doctors and its inverse association with empathy underscore the need for systemic, evidence-based interventions to reduce burnout and enhance empathy, supporting the delivery of quality patient care. Contribution: This study offers novel insights into the challenges faced by South African intern doctors, providing a foundation for future research and targeted institutional reform.