Burnout in medical residents: the combined influence of on-call burden, somatic symptomatology, insomnia severity, and physical activity

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Introduction Burnout has emerged as a critical threat to healthcare systems, particularly among medical residents who face intense workloads, recurrent night shifts, and emotionally demanding clinical environments. In Tunisia, evidence on the interplay between occupational, psychological, and lifestyle determinants of burnout remains limited. This study aimed to determine the prevalence of burnout among Tunisian medical residents and to identify key predictors, including on-call burden, somatic symptomatology, insomnia severity, substance use, and physical activity, using a multidimensional analytic approach. Methods A multi-center cross-sectional study was conducted across six Tunisian university hospitals from March 2024 to January 2025. Medical residents aged 25–35 years completed validated instruments, including the Maslach Burnout Inventory–Human Services Survey (MBI-HSS), Insomnia Severity Index, Somatic Symptom Scale-8, and Ricci–Gagnon physical activity questionnaire. Sociodemographic, professional, and behavioral factors were also collected. Pearson correlation analyses and multivariate logistic regression were performed to identify factors associated with burnout. Results Among 320 residents, burnout prevalence was 45.9%, with pathological mean scores across all MBI-HSS subscales. Emotional exhaustion strongly correlated with somatic symptom burden ( r = 0.84), insomnia severity ( r = 0.75), and inversely with physical activity ( r = −0.82). Logistic regression revealed that the number of monthly on-call shifts was associated with burnout (OR = 2.72; p < 0.001). Intrinsic motivation for choosing medicine was associated with lower odds of burnout (OR = 0.13; p = 0.001). Higher somatic symptoms were associated with burnout risk (OR = 1.20; p = 0.013), whereas physical activity may reduce it (OR = 0.82; p = 0.001). Conclusions Burnout is highly prevalent among Tunisian medical residents and is shaped by a combination of occupational strain, psychosomatic distress, and lifestyle behaviors. On-call overload, somatic symptoms, and poor sleep were associated with the increase of burnout risk, while regular physical activity and intrinsic career motivation may serve as protective factors. These findings support the implementation of targeted preventive strategies and early screening tools within residency training programs.

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