Non-linear Burnout Trajectory and Academic Motivation Across Training Stages in Obstetrics and Gynecology Residency

Abstract

Background: Burnout is prevalent among postgraduate medical trainees, yet stage-stratified data in obstetrics and gynecology (Ob-Gyn) residency remain sparse. The relationship between burnout domains and academic motivation has not been examined in this population. Objectives: To map burnout prevalence and domain severity across four stages of an Ob-Gyn residency program and examine associations between burnout domains and academic motivation subtypes. Methods: This cross-sectional study enrolled 94 Ob-Gyn residents (semesters 2–9) from the Faculty of Medicine, Universitas Airlangga, undergoing clinical training at a major tertiary teaching hospital in Surabaya, Indonesia. Instruments included the Maslach-Trisni Burnout Inventory and Academic Motivation Scale. Results: Overall burnout prevalence was 25.5%, varying markedly across stages: 44.0% (Stage I), 28.0% (Stage II), 7.4% (Stage III), and 23.5% (Stage IV) (p=0.026), forming a non-linear, U-shaped trajectory. Stage I exhibited significantly higher emotional exhaustion than Stage III (p=0.033). Personal accomplishment (PA) positively correlated with all intrinsic motivation subtypes and introjected/identified regulation and negatively with amotivation (p<0.05). External regulation declined from Stage I to IV (p=0.032), independently of burnout. Conclusions: Burnout concentrates at early and late training stages rather than accumulating uniformly. PA co-occurs with autonomous motivation, suggesting a protective resource-like role. Stage-specific interventions and reinforcement of residents’ clinical competence are warranted.