Burnout in medical students: a systematic review of experiences in Chinese medical schools

BACKGROUND To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. METHODS Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. RESULTS Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. CONCLUSIONS Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.