phd research burnout

The Savvy Scientist

Experiences of a London PhD student and beyond

PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health

PhDs are renowned for being stressful and when you add a global pandemic into the mix it’s no surprise that many students are struggling with their mental health. Unfortunately this can often lead to PhD fatigue which may eventually lead to burnout.

In this post we’ll explore what academic burnout is and how it comes about, then discuss some tips I picked up for managing mental health during my own PhD.

Please note that I am by no means an expert in this area. I’ve worked in seven different labs before, during and after my PhD so I have a fair idea of research stress but even so, I don’t have all the answers.

If you’re feeling burnt out or depressed and finding the pressure too much, please reach out to friends and family or give the Samaritans a call to talk things through.

Note – This post, and its follow on about maintaining PhD motivation were inspired by a reader who asked for recommendations on dealing with PhD fatigue. I love hearing from all of you, so if you have any ideas for topics which you, or others, could find useful please do let me know either in the comments section below or by getting in contact . Or just pop me a message to say hi. 🙂

This post is part of my PhD mindset series, you can check out the full series below:

• PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health (this part!)
• PhD Motivation: How to Stay Driven From Cover Letter to Completion
• How to Stop Procrastinating and Start Studying

What is PhD Burnout?

Whenever I’ve gone anywhere near social media relating to PhDs I see overwhelmed PhD students who are some combination of overwhelmed, de-energised or depressed.

Specifically I often see Americans talking about the importance of talking through their PhD difficulties with a therapist, which I find a little alarming. It’s great to seek help but even better to avoid the need in the first place.

Sadly, none of this is unusual. As this survey shows, depression is common for PhD students and of note: at higher levels than for working professionals.

All of these feelings can be connected to academic burnout.

The World Health Organisation classifies burnout as a syndrome with symptoms of:

– Feelings of energy depletion or exhaustion; – Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; – Reduced professional efficacy. Symptoms of burnout as classified by the WHO. Source .

This often leads to students falling completely out of love with the topic they decided to spend years of their life researching!

The pandemic has added extra pressures and constraints which can make it even more difficult to have a well balanced and positive PhD experience. Therefore it is more important than ever to take care of yourself, so that not only can you continue to make progress in your project but also ensure you stay healthy.

What are the Stages of Burnout?

Psychologists Herbert Freudenberger and Gail North developed a 12 stage model of burnout. The following graphic by The Present Psychologist does a great job at conveying each of these.

I don’t know about you, but I can personally identify with several of the stages and it’s scary to see how they can potentially lead down a path to complete mental and physical burnout. I also think it’s interesting that neglecting needs (stage 3) happens so early on. If you check in with yourself regularly you can hopefully halt your burnout journey at that point.

PhDs can be tough but burnout isn’t an inevitability. Here are a few suggestions for how you can look after your mental health and avoid academic burnout.

Overcoming PhD Burnout

Manage your energy levels, maintaining energy levels day to day.

• Eat well and eat regularly. Try to avoid nutritionless high sugar foods which can play havoc with your energy levels. Instead aim for low GI food . Maybe I’m just getting old but I really do recommend eating some fruit and veg. My favourite book of 2021, How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reduce Disease , is well worth a read. Not a fan of veggies? Either disguise them or at least eat some fruit such as apples and bananas. Sliced apple with some peanut butter is a delicious and nutritious low GI snack. Check out my series of posts on cooking nutritious meals on a budget.
• Get enough sleep. It doesn’t take PhD-level research to realise that you need to rest properly if you want to avoid becoming exhausted! How much sleep someone needs to feel well-rested varies person to person, so I won’t prescribe that you get a specific amount, but 6-9 hours is the range typically recommended. Personally, I take getting enough sleep very seriously and try to get a minimum of 8 hours.

A side note on caffeine consumption: Do PhD students need caffeine to survive?

In a word, no!

Although a culture of caffeine consumption goes hand in hand with intense work, PhD students certainly don’t need caffeine to survive. How do I know? I didn’t have any at all during my own PhD. In fact, I wrote a whole post about it .

By all means consume as much caffeine as you want, just know that it doesn’t have to be a prerequisite for successfully completing a PhD.

Maintaining energy throughout your whole PhD

• Pace yourself. As I mention later in the post I strongly recommend treating your PhD like a normal full-time job. This means only working 40 hours per week, Monday to Friday. Doing so could help realign your stress, anxiety and depression levels with comparatively less-depressed professional workers . There will of course be times when this isn’t possible and you’ll need to work longer hours to make a certain deadline. But working long hours should not be the norm. It’s good to try and balance the workload as best you can across the whole of your PhD. For instance, I often encourage people to start writing papers earlier than they think as these can later become chapters in your thesis. It’s things like this that can help you avoid excess stress in your final year.
• Take time off to recharge. All work and no play makes for an exhausted PhD student! Make the most of opportunities to get involved with extracurricular activities (often at a discount!). I wrote a whole post about making the most of opportunities during your PhD . PhD students should have time for a social life, again I’ve written about that . Also give yourself permission to take time-off day to day for self care, whether that’s to go for a walk in nature, meet friends or binge-watch a show on Netflix. Even within a single working day I often find I’m far more efficient when I break up my work into chunks and allow myself to take time off in-between. This is also a good way to avoid procrastination!

Reduce Stress and Anxiety

During your PhD there will inevitably be times of stress. Your experiments may not be going as planned, deadlines may be coming up fast or you may find yourself pushed too far outside of your comfort zone. But if you manage your response well you’ll hopefully be able to avoid PhD burnout. I’ll say it again: stress does not need to lead to burnout!

Everyone is unique in terms of what works for them so I’d recommend writing down a list of what you find helpful when you feel stressed, anxious or sad and then you can refer to it when you next experience that feeling.

I’ve created a mental health reminders print-out to refer to when times get tough. It’s available now in the resources library (subscribe for free to get the password!).

Below are a few general suggestions to avoid PhD burnout which work for me and you may find helpful.

• Exercise. When you’re feeling down it can be tough to motivate yourself to go and exercise but I always feel much better for it afterwards. When we exercise it helps our body to adapt at dealing with stress, so getting into a good habit can work wonders for both your mental and physical health. Why not see if your uni has any unusual sports or activities you could try? I tried scuba diving and surfing while at Imperial! But remember, exercise doesn’t need to be difficult. It could just involve going for a walk around the block at lunch or taking the stairs rather than the lift.
• Cook / Bake. I appreciate that for many people cooking can be anything but relaxing, so if you don’t enjoy the pressure of cooking an actual meal perhaps give baking a go. Personally I really enjoy putting a podcast on and making food. Pinterest and Youtube can be great visual places to find new recipes.
• Let your mind relax. Switching off is a skill and I’ve found meditation a great way to help clear my mind. It’s amazing how noticeably different I can feel afterwards, having not previously been aware of how many thoughts were buzzing around! Yoga can also be another good way to relax and be present in the moment. My partner and I have been working our way through 30 Days of Yoga with Adriene on Youtube and I’d recommend it as a good way to ease yourself in. As well as being great for your mind, yoga also ticks the box for exercise!
• Read a book. I’ve previously written about the benefits of reading fiction * and I still believe it’s one of the best ways to relax. Reading allows you to immerse yourself in a different world and it’s a great way to entertain yourself during a commute.

* Wondering how I got something published in Science ? Read my guide here .

Talk It Through

• Meet with your supervisor. Don’t suffer in silence, if you’re finding yourself struggling or burned out raise this with your supervisor and they should be able to work with you to find ways to reduce the pressure. This may involve you taking some time off, delegating some of your workload, suggesting an alternative course of action or signposting you to services your university offers.

Also remember that facing PhD-related challenges can be common. I wrote a whole post about mine in case you want to cheer yourself up! We can’t control everything we encounter, but we can control our response.

A free self-care checklist is also now available in the resources library , providing ideas to stay healthy and avoid PhD burnout.

Top Tips for Avoiding PhD Burnout

On top of everything we’ve covered in the sections above, here are a few overarching tips which I think could help you to avoid PhD burnout:

• Work sensible hours . You shouldn’t feel under pressure from your supervisor or anyone else to be pulling crazy hours on a regular basis. Even if you adore your project it isn’t healthy to be forfeiting other aspects of your life such as food, sleep and friends. As a starting point I suggest treating your PhD as a 9-5 job. About a year into my PhD I shared how many hours I was working .
• Reduce your use of social media. If you feel like social media could be having a negative impact on your mental health, why not try having a break from it?
• Do things outside of your PhD . Bonus points if this includes spending time outdoors, getting exercise or spending time with friends. Basically, make sure the PhD isn’t the only thing occupying both your mental and physical ife.
• Regularly check in on how you’re feeling. If you wait until you’re truly burnt out before seeking help, it is likely to take you a long time to recover and you may even feel that dropping out is your only option. While that can be a completely valid choice I would strongly suggest to check in with yourself on a regular basis and speak to someone early on (be that your supervisor, or a friend or family member) if you find yourself struggling.

I really hope that this post has been useful for you. Nothing is more important than your mental health and PhD burnout can really disrupt that. If you’ve got any comments or suggestions which you think other PhD scholars could find useful please feel free to share them in the comments section below.

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Burnout and engagement among PhD students in medicine: the BEeP study

• Original Article
• Open access
• Published: 07 December 2020
• Volume 10 , pages 110–117, ( 2021 )

Cite this article

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• Rashmi A. Kusurkar   ORCID: orcid.org/0000-0002-9382-0379 1 , 2 ,
• Stéphanie M. E. van der Burgt   ORCID: orcid.org/0000-0001-7188-1827 1 , 3 ,
• Ulviye Isik 1 , 2 ,
• Marianne Mak-van der Vossen   ORCID: orcid.org/0000-0001-7810-6575 1 , 2 ,
• Janneke Wilschut 4 ,
• Anouk Wouters   ORCID: orcid.org/0000-0002-6806-7573 1 , 2 &
• Andries S. Koster 5  

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A Commentary to this article was published on 15 December 2020

Introduction

Using a self-determination theory framework, we investigated burnout and engagement among PhD students in medicine, and their association with motivation, work-life balance and satisfaction or frustration of their basic psychological needs.

This cross-sectional study was conducted among PhD students at a university medical centre ( n  = 990) using an electronic survey on background characteristics and validated burnout, engagement, motivation and basic psychological needs questionnaires. Cluster analysis was performed on the burnout subscale scores to find subgroups within the sample which had similar profiles on burnout. Structural equation modelling was conducted on a hypothesized model of frustration of basic psychological needs and burnout.

The response rate was 47% ( n  = 464). We found three clusters/subgroups which were composed of PhD students with similar burnout profiles within the cluster and different profiles between the clusters. Cluster 1 ( n  = 199, 47%) had low scores on burnout. Clusters 2 ( n  = 168, 40%) and 3 ( n  = 55, 13%) had moderate and high burnout scores, respectively, and were associated with low engagement scores. Cluster 3, with the highest burnout scores, was associated with the lowest motivational, engagement, needs satisfaction and work-life balance scores. We found a good fit for the “basic psychological needs frustration associated with burnout” model.

The most important variables for burnout among PhD students in medicine were lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. These add to the factors found in the literature.

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Burnout has been identified as a global problem among medical students, residents and physicians, and is on the rise [ 1 , 2 , 3 , 4 ]. The percentage of physicians having at least one symptom of burnout in the US increased from 45% to 54% between 2011 and 2014 [ 5 ]. “PhD students in medicine” as a group has been neglected in burnout research. The reason PhD students in medicine (with or without a clinical background) deserve to be treated as a separate group from other PhD students is because this group works in a hospital or clinical setting, may be supervised by physicians with PhDs and may experience elements of the medical culture and hierarchy in ways that may contribute to burnout [ 4 ]. Thus the context is very different from a general university setting. Within PhD students in medicine, PhD students with clinical backgrounds have been reported to have different motivation, financial position and confidence as professionals than those with other scientific backgrounds [ 6 ]. PhD students actively working with patients are also expected to have more workload and conflict in balancing clinical or patient responsibilities along with their PhD research work. The current study therefore aimed to explore burnout and the factors influencing burnout among PhD students in medicine.

“Job burnout is a psychological syndrome that involves a prolonged response to chronic interpersonal stressors on the job” [ 7 ]. The professional consequences of burnout are lower productivity at work, unprofessionalism, increased errors and higher chances of quitting the field of work. In case of health professionals (which would include PhD students in medicine with patient responsibilities), burnout can lead to consequences such as dissatisfied patients, lower patient safety, higher patient mortality and higher cost of inefficiently delivered healthcare [ 8 ].

In this study “PhD students in medicine” are students at a university medical centre who have completed their Master’s degree and are undergoing residency/specialization training, or are completing PhD research concurrently with their residency training or professional practice, or have completed a Bachelor’s degree in Medicine and are following an MD-PhD program, or non-medical and/or non-clinical graduates completing their research in a non-clinical or a clinical department.

There are several studies on satisfaction of PhD students, stress and depression, and well-being, but the findings of PhD students in medicine have not been reported separately [ 9 , 10 , 11 ]. In a review of the factors influencing PhD students’ well-being, achievement and PhD completion, it is clear that: a) PhD students in medicine have not been identified as a separate group; b) their findings are not reported separately; c) more factors influencing success in PhD have been investigated than well-being; d) only one of the studies focuses on burnout; and e) no specific theoretical framework has been used for studying burnout and engagement [ 11 ]. (See Table A1 in the Electronic Supplementary Material).

Burnout is described as having three dimensions: exhaustion, cynicism and perceived negative efficacy [ 7 ]. Exhaustion means feeling physically and emotionally exhausted, cynicism involves feelings of detachment from one’s work, and perceived negative efficacy involves a feeling of incompetence in work. Generally, cynicism appears first (it also has the highest score), followed by exhaustion; negative personal efficacy may even be absent [ 12 ]. Since one of our research goals was to provide recommendations for supporting these PhD students, we explored not only burnout and factors influencing it, but also engagement in work and motivation (which is an important driver of performance) and the factors enhancing them. Engagement is defined as “a positive, fulfilling, and work-related state of mind that is characterized by vigour, dedication and absorption” [ 13 ]. We used the framework of Self-Determination Theory (SDT) to investigate this phenomenon because it provides a basis for investigating burnout and engagement through frustration or satisfaction of basic psychological needs, respectively [ 14 ]. Thus, this study aimed to investigate burnout and engagement among PhD students in medicine, and how these variables are associated with the quality of their academic motivation [ 14 ], work-life balance [ 15 ], quality of sleep [ 16 ], perceived conflict in work-related responsibilities and satisfaction or frustration of their basic psychological needs [ 14 ]. (See Table A2 in the Electronic Supplementary Material for descriptions of these variables).

Self-determination theory framework

Self-determination theory (SDT) [ 14 , 17 ] is a macro-theory of human motivation, which puts the fulfilment of three basic psychological needs—autonomy (feeling of choice), competence (feeling of capability) and relatedness (feeling of belonging)—at the epicentre of an individual being autonomously motivated for learning or work, his/her well-being, happiness, creativity and performance. This theory considers the quality of motivation (the why of motivation) more important than the quantity (how much) and describes the quality of motivation as autonomous or controlled. Autonomous motivation is derived out of genuine interest and/or great personal value for learning or work [ 18 ]. Controlled motivation stands for persuasion of learning or work because of internal or external pressure or in the expectation of a reward [ 18 ]. SDT advocates that the more autonomous the motivation, the better the observed outcomes, namely: deep learning, high academic or work performance, better adjustment and positive well-being [ 14 , 17 ]. Satisfaction of the basic psychological needs can move a student from controlled towards autonomous motivation and is also directly associated with engagement. On the contrary, frustration of these needs can move a student from autonomous towards controlled motivation and is also directly associated with burnout.

Our hypothesized model on basic psychological needs frustration-burnout is depicted in Fig.  1 .

Hypothesized model for basic psychological needs frustration and burnout

Our research questions for this study were:

How do PhD students in medicine score on burnout, work engagement, quality of motivation for PhD, work-life balance, conflict in work responsibilities, feeling part of a team and quality of sleep? Can we find patterns in how they score on the burnout subscales?

Are there differences in the burnout scores of males and females, clinical and non-clinical departments, and working with patients, in a lab or in an office?

How do PhD students in medicine score on the satisfaction or frustration of their basic psychological needs of autonomy, competence and relatedness?

How are burnout, quality of motivation for PhD, work-life balance, quality of sleep, conflict in work responsibilities, feeling part of a team, frustration of their basic psychological needs and background variables associated with each other?

This cross-sectional study was conducted at a University Medical Centre in Amsterdam, the Netherlands. PhD training in the Netherlands is generally a 4-year program with training in research skills and other non-cognitive skills (such as presenting in English) interspersed between data collection, analysis, interpretation and publication of about four empirical studies which form the PhD thesis. Thus the PhD is not divided into coursework and thesis phases as in some other parts of the world [ 19 ]. Also PhD students are appointed as employees and receive a salary instead of a stipend. Some PhD students who have a medical degree combine their PhD work with their residency training, while others pursue one at a time. Some PhD students have non-medical backgrounds even though they may be pursuing a PhD in a medical department. All PhD students in medicine registered at the different research institutes in this medical centre ( n  = 990) were invited to fill out an electronic survey using Net Questionnaire. The data were collected from September to November 2018 and two reminders were sent. We obtained ethical approval from the Netherlands Association for Medical Education—Ethical Review Board (Folder no. 2018.5.13).

Background variables

We collected anonymous data after written informed consent, participation was voluntary and no incentives were provided. See Tables A2 and A3 in the Electronic Supplementary Material for the details of the survey and demographic characteristics of the participants, respectively.

Data analyses

Descriptive statistics and Pearson’s correlations for all included variables were computed (research questions 1 and 3). We tested for differences (research question 2) in the variable scores for gender, clinical versus non-clinical departments and work setting using students unpaired t‑tests or ANOVAs, as appropriate. To answer the second part of our research question 1, we performed K‑means cluster analysis using the three burnout subscale scores. We did this because the MBI-SS [ 13 ] does not provide any cut-off scores for classifying burnout as “high”, “moderate” or “low”. Cluster analysis helped us to group PhD students who had similar scores on the three subscales of burnout with each other [ 20 ]. We validated the cluster solution using the random half-splitting method and computing the Cohen’s kappa as a measure of cluster stability. Clustering effectively reduced the within-groups variability of burnout scores by more than 50%, compared with the score variability before clustering. Therefore, clustering was considered effective. Clustering also allowed us to compare the groups with each other for their scores on the dependent variables using multiple analysis of variance (multiple ANOVAs), followed by comparison of group means using Bonferroni adjustments. Cohen’s d was used to characterize the effect size for differences between individual means, whenever statistically significant [ 21 ].

To answer our research question 4, we conducted Structural Equation Modelling analysis using AMOS 18 for testing the hypothesized model depicted in Fig.  1 [ 22 , 23 ]. The indices used for estimating goodness of fit of the model were: Root Mean Square Error of Approximation (RMSEA <0.05), Comparison of Fit Index (CFI >0.95), Tucker Lewis Index (TLI >0.95), and Standardized Root Mean Square Residual (SRMR <0.05) [ 22 , 23 ].

The response rate was 47% ( n  = 464). The majority were 25–34 years old, Dutch females ( n  = 371, 80%), married/in a relationship, and childless. Thirty-three percent had a medicine-related degree, 52% were from clinical departments, 56% worked in an office, 27% in a lab and 17% with patients; 68% worked beyond their contract hours. The demographic characteristics and the Pearson’s correlations between all study variables are depicted in Tables A3 and A4 in the Electronic Supplementary Material.

A limited number of statistically significant differences ( p  < 0.05) between genders, departments, or work settings were found. Concerning gender, we found that work-life balance was significantly better (males: 1.92 ± 0.62, females: 2.07 ± 0.57, p  = 0.038, d  = 0.26) and vigour was significantly poorer (males: 2.22 ± 0.74, females: 1.96 ± 0.74, p  = 0.004, d  = 0.35) in females as compared with males. Concerning clinical versus non-clinical departments, autonomy frustration was significantly higher (clinical: 3.89 ± 1.21, non-clinical: 3.58 ± 1.20, p  = 0.013, d  = 0.26) and conflict between work responsibilities was significantly higher (clinical: 5.10 ± 2.59, non-clinical: 4.22 ± 2.32, p  < 0.001, d  = 0.36) among PhD students from clinical departments. Concerning work setting, work-life balance was significantly better among PhD students who worked in an office (2.16 ± 0.60) as compared to those who worked in a lab (1.89 ± 0.54) or with patients (1.90 ± 0.56): p  < 0.001 in both comparisons ( d  = 0.48 and 0.45, respectively). Conflicts with work responsibilities were significantly higher among PhD students who worked with patients (6.14 ± 2.28) than those who worked in an office (4.61 ± 2.50) or a lab (3.99 ± 2.24): p  < 0.001 in both comparisons ( d   =  0.64 and 0.90, respectively).

When we tried to classify PhD students, based on their burnout scores, three clusters were found with increasing scores on the subscales exhaustion, cynicism and perceived negative efficacy (Tab.  1 ).

Cluster 1 had low scores on burnout. Clusters 2 and 3 with medium and high scores on burnout were associated with low engagement scores. Cluster 3, with high burnout scores, was associated with the lowest autonomous motivation, engagement, needs satisfaction, perception of being part of a team, and feeling refreshed in the morning and the highest controlled motivation, needs frustration and conflict in work responsibilities (Tab.  2 ). Effect sizes for the differences between clusters 1 and 2, and between clusters 2 and 3, of the engagement and basic psychological needs scores were substantial ( d  > 0.8 in many cases); relatedness scores were relatively less affected (see Tab.  2 , and Figure A1 in the Electronic Supplementary Material).

Relationships between basic psychological needs and burnout scores for the sampled PhD students as a whole were investigated using structural equation modelling. We did not find a good fit for the hypothesized model (Fig.  1 ). We therefore removed all the non-significant relationships from the model one by one and finally arrived at the model depicted in Fig.  2 , which had a good fit with our data, RMSEA = 0.044 (<0.06), CFI = 0.986 (>0.95), TLI = 0.976 (>0.95), SRMR = 0.041 (<0.05). Quality of sleep was negatively associated with exhaustion. Work-life balance was negatively associated with basic psychological needs frustration, directly and indirectly with exhaustion, and indirectly with cynicism and perceived negative efficacy. Conflict in work responsibilities was negatively associated only with basic psychological needs frustration, and did not have any direct or indirect effects on the burnout subscale scores. Basic psychological needs frustration was associated with exhaustion, cynicism and perceived negative efficacy.

Structural equation model of BPN frustration and burnout. Indirect effects: Work Life Balance-Basic Psychological Needs Frustration-Exhaustion (*−0.185); Work Life Balance-Basic Psychological Needs Frustration-Cynicism (*−0.213); Work Life Balance-Basic Psychological Needs Frustration-Perceived Negative Efficacy (*−0.154)

As hypothesized, we found that PhD students from clinical departments had a poorer work-life balance and higher conflict between work responsibilities. They also had higher autonomy frustration, which can be expected due to the conflict. A previous study has investigated differences between the motivation and expectations of PhD students with clinical versus science backgrounds [ 6 ]. PhD students with clinical backgrounds were generally older, and found lab work difficult. Although they started their PhD training perceiving themselves as professionals, they were treated by their departments as students. They perceived this as frustrating [ 6 ]. But this study did not investigate burnout among these students [ 6 ]. PhD students working with patients had a poorer work-life balance and higher conflict with work-related responsibilities than those working in a lab or an office. Clinical residents have been reported to have higher burnout scores in an earlier study owing to high patient load, long working hours and low autonomy [ 1 ]. A national study on Dutch residents has reported a high percentage (21%) of burnout [ 3 ]. If PhD work is conducted on top of these circumstances, much worse outcomes can be expected.

We also found three groups based on PhD students’ scores on the burnout subscales: Low, moderate and high . Contrary to the literature, we did not find gender differences between the three burnout subscale scores [ 24 ]. The “high” group had the worst outcomes for engagement and motivation, and basic psychological needs satisfaction and frustration. This finding differs from the study on Dutch residents, in which the authors found that high burnout could be associated with high engagement or low engagement [ 3 ].

We were able to find evidence for a modified model of the relationship between basic psychological needs frustration and burnout than our hypothesized model. Sleep and basic psychological needs frustration have important effects on burnout, while work-life imbalance and conflict in work responsibilities have an important positive effect on basic psychological needs frustration. In addition, work-life balance has an important indirect negative effect on burnout through its effect on basic psychological needs frustration. These findings about basic psychological needs frustration and burnout add to the literature on this topic. Similar results were found in an earlier study among pharmacists, in which basic psychological needs frustration was associated with low vitality [ 25 ]. We could not find evidence for a hypothesized positive relationship between basic psychological needs satisfaction and engagement using structural equation modelling. A similar lack of evidence for a positive relationship between basic psychological needs satisfaction and vitality has been reported earlier by Tjin A Tsoi et al. [ 25 ] We suggest that preventing frustration of basic psychological needs is more important for preventing burnout than ensuring satisfaction of basic psychological needs [ 25 ]. This could be due to the relatively high autonomous motivation for pursuing a PhD project in the sampled population. It can be expected that their perception of autonomy and competence is not so easily changed by external influences. On the other hand, frustration of autonomy and competence by conflicting work requirements and/or inadequate support and guidance can easily lead to a sense of frustration and burnout.

Practical applications/recommendations

Using a cluster analysis, which is a person-centred research analysis [ 26 ], for creating groups made of similar characteristics on burnout helped us propose customized recommendations for these different groups. General recommendations, based on Self-Determination Theory, for PhD students, supervisors and organizations, related to the prevention of frustration and support of satisfaction of autonomy, competence and relatedness are summarized in Table A5 in the Electronic Supplementary Material.

Specific recommendations for the three clusters

The low burnout scores cluster seems to have favourable scores on all factors except the three subscales of engagement: vigour, dedication and absorption. We recommend training for the students in this cluster on how to become more engaged in their PhD work. The students in the moderate burnout scores cluster seem to have unfavourable scores on autonomy satisfaction and frustration, engagement—vigour, work-life balance, conflict in work responsibilities, feeling of belongingness to a team and feeling refreshed on waking up. For students in this cluster, we recommend that the supervision team engages in discussion with their students about how to maintain autonomy in work, about reducing the conflict in work responsibilities, and perpetuating team spirit, while the student gets help with organizing his/her schedule, work-life balance and sleep. The high burnout cluster students seem to have low autonomous motivation, very low engagement, low autonomy and competence satisfaction, high autonomy frustration, poor feelings of belongingness to a team, conflict in work responsibilities and do not feel refreshed on waking up. We recommend that research institutes and human resources departments provide training for the students in this cluster on structuring their work, personal and leisure activities, and resolution of problems related to poor supervision and basic psychological needs frustration.

Further research questions

Which other variables are important for burnout and engagement among PhD students in medicine? Can our results be replicated in other countries in similar contexts? In addition, we think that in-depth qualitative research to get more detailed information about the stressors and energizers experienced by students in their PhD work would add to the existing literature.

Limitations

Our study has several limitations. First of all we used self-report measures, which does not give an indication of actual burnout among the PhD students. But this is true for most burnout studies in the literature, and in spite of this we think this study adds important insights to the literature. The cross-sectional design is also a limitation and a longitudinal design would definitely benefit such research. We had a response rate of 47%, which could have created a response bias. We believe this low response rate to be random as we collected data anonymously. In spite of a relatively low response rate, we believe that our results add to the literature on burnout and engagement among PhD students in medicine. We wanted to investigate PhD students particularly with clinical responsibilities, but our sample contained only a small percentage (17%) of such students. We did find evidence that clinical responsibilities can interfere with PhD work. We recommend a similar study with a bigger sample size of PhD students with clinical duties to further explore the differences. Also, this study was conducted at a single medical centre. We recommend multicentre studies in the future in the interest of generalizability. We could have missed important variables influencing burnout and engagement outside of SDT, as we collected data and conducted the analysis using the variables included in the SDT framework. But we expect to have covered all the variables important from the SDT perspective and thus have a strong theoretical foundation for our work. In future studies, more variables beyond the ones in our study could be included.

The most important variables, found in this study, for burnout among PhD students in medicine students are lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. Work-life imbalance and conflict in work responsibilities are associated with basic psychological needs frustration. The model of basic psychological needs frustration being associated with burnout adds to the literature.

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Acknowledgements

We are indebted to the many people who have made this research possible. A full list is available online.

This research study was funded by all 8 Amsterdam UMC Research Institutes (Amsterdam Neuroscience, Amsterdam Gastroenterology & Metabolism, Cancer Center Amsterdam, Amsterdam Reproduction and Development, Amsterdam Infection & Immunity, Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam Movement Sciences) and the Human Resources Department of Amsterdam UMC.

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Rashmi A. Kusurkar, Stéphanie M. E. van der Burgt, Ulviye Isik, Marianne Mak-van der Vossen & Anouk Wouters

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Rashmi A. Kusurkar, Ulviye Isik, Marianne Mak-van der Vossen & Anouk Wouters

Center for Evidence Based Education, location AMC, Amsterdam, The Netherlands

Stéphanie M. E. van der Burgt

Dutch Institute of Clinical Auditing, Leiden, The Netherlands

Janneke Wilschut

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R.A. Kusurkar, S.M.E. van der Burgt, U. Isik, M. Mak-van der Vossen, J. Wilschut, A. Wouters and A.S. Koster declare that they have no competing interests.

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Table A1 Summary of the findings of a review study on factors affecting PhD students well-being, achievement and PhD completion; Table A2 Details of electronic survey; Table A3 Demographic characteristics of the participants; Table A4 Pearson’s correlations between all variables in the study; Table A5 Recommendations related to preventing frustration and supporting satisfaction of autonomy, competence and relatedness

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Kusurkar, R.A., van der Burgt, S.M.E., Isik, U. et al. Burnout and engagement among PhD students in medicine: the BEeP study. Perspect Med Educ 10 , 110–117 (2021). https://doi.org/10.1007/s40037-020-00637-6

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Received : 03 July 2020

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Accepted : 16 November 2020

Published : 07 December 2020

Issue Date : March 2021

DOI : https://doi.org/10.1007/s40037-020-00637-6

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Original Research

Burnout and engagement among phd students in medicine: the beep study.

• Stéphanie M. E. van der Bur
• Ulviye Isik
• Marianne Mak-van der Vossen
• Janneke Wilschut
• Anouk Wouters
• Andries S. Koster
• Stéphanie M. E. van der Bur , Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit; Center for Evidence Based Education, location AMC, Netherlands ORCID
• Ulviye Isik , Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Netherlands
• Marianne Mak-van der Vossen , Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Netherlands ORCID
• Janneke Wilschut , Dutch Institute of Clinical Auditing, Netherlands
• Anouk Wouters , Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Netherlands ORCID
• Andries S. Koster , Department of Pharmaceutical Sciences, Utrecht University,, Netherlands

Introduction Using a self-determination theory framework, we investigated burnout and engagement among PhD students in medicine, and their association with motivation, work-life balance and satisfaction or frustration of their basic psychological needs.

Method This cross-sectional study was conducted among PhD students at a university medical centre ( n  = 990) using an electronic survey on background characteristics and validated burnout, engagement, motivation and basic psychological needs questionnaires. Cluster analysis was performed on the burnout subscale scores to find subgroups within the sample which had similar profiles on burnout. Structural equation modelling was conducted on a hypothesized model of frustration of basic psychological needs and burnout.

Results The response rate was 47% ( n  = 464). We found three clusters/subgroups which were composed of PhD students with similar burnout profiles within the cluster and different profiles between the clusters. Cluster 1 ( n  = 199, 47%) had low scores on burnout. Clusters 2 ( n  = 168, 40%) and 3 ( n  = 55, 13%) had moderate and high burnout scores, respectively, and were associated with low engagement scores. Cluster 3, with the highest burnout scores, was associated with the lowest motivational, engagement, needs satisfaction and work-life balance scores. We found a good fit for the “basic psychological needs frustration associated with burnout” model.

Discussion The most important variables for burnout among PhD students in medicine were lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. These add to the factors found in the literature.

• Page/Article: 110-117
• DOI: 10.1007/S40037-020-00637-6
• Accepted on 16 Nov 2020
• Published on 7 Dec 2020
• Peer Reviewed

Burnout and engagement among PhD students in medicine: the BEeP study

Affiliations.

• 1 Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands. [email protected].
• 2 LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands. [email protected].
• 3 Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
• 4 Center for Evidence Based Education, location AMC, Amsterdam, The Netherlands.
• 5 LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands.
• 6 Dutch Institute of Clinical Auditing, Leiden, The Netherlands.
• 7 Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
• PMID: 33284408
• PMCID: PMC7952475
• DOI: 10.1007/s40037-020-00637-6

Introduction: Using a self-determination theory framework, we investigated burnout and engagement among PhD students in medicine, and their association with motivation, work-life balance and satisfaction or frustration of their basic psychological needs.

Method: This cross-sectional study was conducted among PhD students at a university medical centre (n = 990) using an electronic survey on background characteristics and validated burnout, engagement, motivation and basic psychological needs questionnaires. Cluster analysis was performed on the burnout subscale scores to find subgroups within the sample which had similar profiles on burnout. Structural equation modelling was conducted on a hypothesized model of frustration of basic psychological needs and burnout.

Results: The response rate was 47% (n = 464). We found three clusters/subgroups which were composed of PhD students with similar burnout profiles within the cluster and different profiles between the clusters. Cluster 1 (n = 199, 47%) had low scores on burnout. Clusters 2 (n = 168, 40%) and 3 (n = 55, 13%) had moderate and high burnout scores, respectively, and were associated with low engagement scores. Cluster 3, with the highest burnout scores, was associated with the lowest motivational, engagement, needs satisfaction and work-life balance scores. We found a good fit for the "basic psychological needs frustration associated with burnout" model.

Discussion: The most important variables for burnout among PhD students in medicine were lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. These add to the factors found in the literature.

Keywords: Burnout; Engagement; Medicine; Motivation; PhD students.

Publication types

• Research Support, Non-U.S. Gov't
• Burnout, Professional / psychology*
• Cross-Sectional Studies
• Education, Medical, Graduate / methods
• Education, Medical, Graduate / standards
• Education, Medical, Graduate / statistics & numerical data
• Work Engagement*

PhD Student Burnout

Fmhs-pgsa blog.

Doctoral study is associated with high levels of anxiety and depressive symptomatology, and poor wellbeing overall (1) . Unsurprisingly, the prevalence of burnout is also high among this population (2) . Along with PhD students, nursing and medical students also suffer from disproportionate rates of burnout (3) . This is not a great omen for PhD students in the Faculty of Medical and Health Sciences.

What is burnout?

Burnout is defined as ‘‘ a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy ’’ (4) .

Exhaustion may include fatigue and low energy due to the draining of emotional resources (5) . Cynicism may refer to an attitude of distancing from work or feelings of indifference towards work. Inefficacy refers to lower rates of success at work or reduced accomplishments.

It’s important to note that burnout is not a failure of the individual. While precise definitions of burnout may vary, the core issue is chronic workplace stress due to poor management. Most of all, burnout reflects a failure of the system.

Universities should take note that the experience of burnout is linked to attrition intentions among PhD students (6.7) .

HOW DOES BURNOUT FEEL FOR PHD STUDENTS?

For PhD students, burnout may feel like high levels of chronic stress . PhD students often serve in a variety of roles as teachers, students, and researchers, and this unclear delineation of roles may in itself be a source of burnout stress.

Students experiencing burnout may feel under constant strain, unhappy, and experience depressive symptoms . Students may experience sleeping difficulties due to worries and an inability to overcome difficulties.

Additionally, burnout feels like emotional exhaustion. Students experiencing burnout may feel increasingly irritable and strained. Students might feel resentful, taken for granted, and with nothing left to give. Depersonalization, or a feeling of detachment, may be experienced such that students appear emotionally cold. 

Feelings of worthlessness and lack of accomplishment are typical during episodes of burnout. Students may feel an absence of motivation to complete their work.

Finally, physical symptoms may accompany the psychological symptoms of burnout. Fatigue, exhaustion, headaches, gastrointestinal disturbances, hypertension, colds, and flu are among the physical symptoms associated with burnout (8.9). 

I think I’m getting better at recognising burnout because it’s happened so much and it’s getting quite normal. For me, I just tend to feel tired a lot and start to experience apathy and anhedonia. For me, recovery requires taking long breaks (at least a few days) from work, and finding time to reconnect with the people and things that I love.

What contributes to burnout?

Key predictors of burnout among doctoral students include:

• Chronic stress (9, 10) 
• Low frequency of supervision (7) 
• Lack of satisfaction with supervision (2, 7, 10) 
• Lack of equality among researchers (7) 
• Poor sleep quality (11)
• Bullying by faculty members (12) 
• Feeling a lack of belongingness to a team (13) 
• Conflict in work responsibilities (2, 13) 
• Low autonomy (13) 

Perfectionism, subjective appraisal of employment opportunities, and an existing psychiatric disorder may also increase risk of burnout (6, 14). 

What reduces risk of burnout?

The risk of burnout may be decreased by:

• Doing PhD in hometown (2) 
• Quality supervision- emotional, social, and informational support (7, 10, 15, 16) 
• Equal treatment as part of research community (7) 
• Regular supervisory meetings (7) 
• Sense of belonging (17) 
• Social support (18) 

Of the predictors and risk factors, supervision appears to have a consistent and powerful impact on burnout for doctoral students. Quality supervision has a buffering effect on stress which social support from family/friends cannot match (16) .

I think the key to avoiding burnout during PhD is 1) setting realistic milestones, and 2) making sure you meet them along the way. Often PhD students set unrealistic milestones and feel like a failure if these are not met. The best way around this is to check in with your supervisor and your peers who may have more experience in how long tasks may take. And secondly, three to four years seems like a really long time but it will really be over quite quickly. Therefore students should work consistently throughout the PhD to ensure that these realistic milestones are met. Making progress in small but consistent increments should help avoid overload and risk of burnout. Remember it is a marathon not a sprint!

HOW CAN YOU PROTECT AGAINST BURNOUT?

The prevention of burnout is not an individual responsibility, but a collective one. Universities should identify risk factors for burnout and attempt to mitigate these. These efforts might include specialised training to aid doctoral supervisors in developing constructive and supportive leadership styles; clear and comprehensive information on the roles and responsibilities of doctoral students; and fostering of a cohesive community for doctoral students, faculty, and staff (1, 10, 15, 16, 19).

In the absence of power to drastically change university systems and culture, an individual doctoral student might be able to slightly reduce burnout risk by:

Engaging with peers.

Peer support has been shown to help with motivation, identification of stressful tasks and workloads, and confidence to talk with supervisors about changes that are needed to prevent burnout (20). 

Active involvement in the academic community.

Students are more likely to feel empowered when they actively engage in the research community (17) . Students may attend conferences or participate in academic events or seminars to increase their involvement.

Avoid overload.

It can be difficult for students to say no to extra work due to several factors including the power imbalance between supervisors and students. But if students can cut down on tasks that don’t serve them, this would be beneficial (19). 

Prioritise sleep.

Sleep was frequently mentioned in studies of doctoral student burnout. Better sleep quality and duration is a modifiable factor that may reduce the risk of transitioning from ‘stressed’ to ‘exhausted’ (11). 

• Levecque K, Anseel F, de Beuckelaer A, van der Heyden J, Gisle L. Work organization and mental health problems in PhD students. Research Policy . 2017;46(4):868-879. doi:10.1016/J.RESPOL.2017.02.008
• Sorrel MA, Ángel Martínez-Huertas J, Arconada M. It Must have been Burnout: Prevalence and Related Factors among Spanish PhD Students. The Spanish Journal of Psychology . 2020;23:1-13. doi:10.1017/SJP.2020.31
• Bullock G, Kraft L, Amsden K, … WGC medical, 2017 undefined. The prevalence and effect of burnout on graduate healthcare students. ncbi.nlm.nih.gov . Accessed August 1, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661741/
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• Schaufeli WB, Martínez IM, Pinto AM, Salanova M, Barker AB. Burnout and engagement in university students a cross-national study. Journal of Cross-Cultural Psychology . 2002;33(5):464-481. doi:10.1177/0022022102033005003
• Nagy G, Fang C, Hish A, … LKCS, 2019 undefined. Burnout and mental health problems in biomedical doctoral students. Am Soc Cell Biol . 2019;18(2):1-14. doi:10.1187/cbe.18-09-0198
• Cornér S, Löfström E, Doctoral KPIJ of, 2017 undefined. The relationship between doctoral students’ perceptions of supervision and burnout. helda.helsinki.fi . doi:10.28945/3754
• Symptoms of professional burnout: A review of the empirical evidence.: EBSCOhost. Accessed August 1, 2022. https://web.s.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=0&sid=b9d14b7e-56fe-4370-8d56-049a6bad9a99%40redis
• Meis L de, Velloso A, Lannes D, … MCBJ of, 2003 undefined. The growing competition in Brazilian science: rites of passage, stress and burnout. SciELO Brasil . 36(9):2003. Accessed August 1, 2022. https://www.scielo.br/j/bjmbr/a/X9Fby6spKPD7B9mt4PcSHsF/abstract/?lang=en
• Allen HK, Lilly F, Green KM, Zanjani F, Vincent KB, Arria AM. Graduate Student Burnout: Substance Use, Mental Health, and the Moderating Role of Advisor Satisfaction. International Journal of Mental Health and Addiction . 2022;20(2):1130-1146. doi:10.1007/S11469-020-00431-9/TABLES/3
• Allen HK, Barrall AL, Vincent KB, Arria AM. Stress and Burnout Among Graduate Students: Moderation by Sleep Duration and Quality. International Journal of Behavioral Medicine . 2021;28(1):21-28. doi:10.1007/S12529-020-09867-8/FIGURES/2
• Goodboy A, Martin M, Johnson Z. Communication Research Reports The Relationships Between Workplace Bullying by Graduate Faculty with Graduate Students’ Burnout and Organizational Citizenship Behaviors. doi:10.1080/08824096.2015.1052904
• Kusurkar RA, van der Burgt SME, Isik U, et al. Burnout and engagement among PhD students in medicine: the BEeP study. Perspectives on Medical Education . 2021;10(2):110-117. doi:10.1007/S40037-020-00637-6/FIGURES/2
• Chun KH. 의과대학ㆍ의학전문대학원생의 학업소진 양상과 관련 변인들과의 관계 Relationship between Academic Burnout of Medical and Graduate Students and Related Variables. Korean Medical Education Review . 2014;16(2):77-87. Accessed August 1, 2022. http://www.ysmed.net/kmer
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• Published: 23 March 2023

Academic burnout among master and doctoral students during the COVID-19 pandemic

• Diego Andrade   ORCID: orcid.org/0000-0002-5323-1211 1 ,
• Icaro J. S. Ribeiro   ORCID: orcid.org/0000-0002-4389-7810 2 &
• Orsolya Máté   ORCID: orcid.org/0000-0003-4778-3519 1  

Scientific Reports volume  13 , Article number:  4745 ( 2023 ) Cite this article

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• Public health

The COVID-19 outbreak has had an immense impact on academic life and public health. Graduate students had experienced obligatory curfews and quarantines due to the COVID-19 outbreak directly impacting their mental health and triggering academic burnout. In this cross-sectional study, we address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic. A total of 519 graduate students from master's and Ph.D./DLA degrees across universities in Hungary and other European countries participated in this study. The Copenhagen burnout inventory student version was used to evaluate burnout syndrome as an outcome. Our findings displayed burnout significantly lower among graduate students who had good sleep quality, receive high levels of support from their university, and were satisfied with how their university dealt with the pandemic. The excessive consumption of alcohol, the use of antidepressants, being single, and thinking about dropping out showed as predictive factors of burnout. The results add to emergent evidence on the impact of the COVID-19 pandemic on mental health and the predicted factors of academic burnout among master and doctoral students.

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Introduction.

The COVID-19 pandemic has forced universities worldwide to adopt strong measures through compulsory confinement and social isolation. As a result, a negative impact on many students’ mental health was observed, such as the development of academic burnout 1 , 2 , 3 .

Studies has shown that graduate students are more affected by mental health issues and more likely to present higher levels of stress than undergraduate students and the general population during COVID-19 4 , 5 . With the COVID-19 pandemic, new demands have arisen that directly interfere on students' mental health, such as interruption of learning, uncertainty about prolongation of research duration, laboratory closures, losing part-time teaching job, expiring visas for foreign students, uncertain of funding/grant discontinuation, inadequate mentoring, lack of concentration at home and performing more household chores 1 , 6 , 7 . These academic disruptions combined with significant apprehension about the completion and quality of the work, career concerns, usual high workload even at home, colleagues’ competition, inadequate university support, insufficient supervision, financial issues, low autonomy, emotional suffering, academic dissatisfaction, are examples of factors that predispose to a chronic stress and result in academic burnout 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 .

Burnout is described as a psychological disorder emerged as a response to chronic emotional and interpersonal stressors in the working environment, composed of emotional exhaustion, depersonalization and reduced personal accomplishment 17 . Emotional exhaustion refers to depletion of emotional resources by feeling emotionally overextended, exhausted and drained. Depersonalization is often referring to cynicism, and includes negative attitudes toward other people, like colleagues, patients, or clients. A reduction in personal accomplishment refers to decreased satisfaction and declined feeling of competence and successful achievement 18 . The development of burnout in students is directly related to excessive and prolonged stress caused by piling school work and academic demands combined with drained energy, reduced enthusiasm toward academic tasks, lack of positive attitudes and low academic achievements 19 , 20 .

In addition to all of the academic pressure, graduate students also have had to deal with the COVID-19 outbreak, experiencing curfews, social isolation, and quarantines. In these stressful circumstances, studying and conducting research can have a wide range of effects on mental health, which can lead to academic burnout 16 , 21 , 22 , 23 .

The study of this issue may be of special international interest, considering the recent COVID-19 pandemic, that by itself addresses a critical and unique gap in research concerning the mental status in regard to academic burnout among graduate students in Hungary and some European countries. We aim to address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic.

A total of 519 students (365 women [70.30%]) with a mean age of 31 years (± 7.76) were included in the evaluation. Single individuals (55.3%), from non-European countries (43.4%), from the University of Pécs (49.1%) and with PhD/DLA educational level (56.3%) prevailed (Table 1 ).

Higher averages of burnout were observed in all the dimensions of the CBI for females, with a significant difference for the dimensions CRB (CRB, p  ≤ 0.01). With regard to marital status, all dimensions of the CBI were higher among singles and the difference was significant for all dimensions (PB, p  = 0.04; SRB, p  ≤ 0.01; CRB, p  = 0.02; TRB, p  ≤ 0.01) (Table 2 ). Evaluating aspects related to academic life, those who thought often about dropping out of the course had higher levels of burnout for all dimensions. With regard to how the university dealt with the pandemic, burnout was more frequent among those dissatisfied with the strategies used. Finally, among those who did not feel supported by the university, burnout was also higher (Table 3 ).

Excessive alcohol consumption (CRB, p  ≤ 0.01) and use of antidepressants (CRB, p  ≤ 0.01; TRB, p  = 0.04) were also associated with higher levels of burnout, but only for the CRB and TRB dimensions. With regard to sleep quality, among those who rated it as poor, they had higher levels of burnout for the PB and SRB dimensions (PB, SRB, p  ≤ 0.01) (Table 4 ).

The current study discloses the influence that the COVID-19 pandemic has had on the mental health of graduate students by analysing the factors associated with burnout syndrome. We analysed sociodemographic, academic, health and life habits factors. We found that being single had an effect in all burnout domains and the sex female as well with the colleagues related burnout domain along the sociodemographic characteristics. Among the academic characteristics, we found high levels of academic burnout for all dimensions among those who had university drop-out intentions, were dissatisfied with how the university dealt with the pandemic and also those who did not feel supported by the university during the outbreak. We found high levels of academic burnout among colleagues-related burnout and teacher-related burnout dimensions in the health and life habits characteristics with those who had excessive alcohol consumption and took antidepressants. The personal burnout and studies-related burnout presented a high level among those who had a bad sleep quality.

Sex differences associated with burnout is still without a literature consensus. Some authors suggest that females are more likely suffer from exhaustion and have higher levels of stress than males, while others report no difference between the two sexes regarding exhaustion and stress 9 , 24 . Nonetheless, our study found association between sex and the colleagues-related burnout dimension, corroborating that females are more likely to develop burnout. Studies has been reporting 25 , 26 , 27 that the higher chronic stress level among females is influenced not only by the university environment that includes role conflict, excessive workload, competitive colleagues and considerable mental pressure to publish, but also by inappropriate behaviours, such as harassment, bullying and gender discrimination.

Woolston 28 published a study by the Nature’s survey with 6.296 PhD respondents, one-quarter of who identified as female reported personally experiencing harassment or discrimination compared with 16% of those identifying as men. Moreover, 57% of students who experienced bullying reported fear of personal repercussions if they discuss their situation. This discloses that sex differences associated with burnout exist and being a woman researcher is still a challenge.

We also found that being single was associated with higher burnout scores in all dimensions compared to those with married or other marital status. This result was well reported by Maslach et al. 17 that found higher burnout among those who identified as single rather than married. Among postgraduates, other study also found higher burnout scores in single individuals compared to the married ones 14 . Marriage as a social support may act as a protecting factor from chronic stress and can play a role in reducing academic burnout.

Evaluating aspects related to academic life, we found that many graduate students at some point had considered abandoning their studies. Several studies have reported high rates of university withdrawal intentions, for example, 30–70% of doctorate students will may not complete their PhD degree 8 , 29 , 30 , 31 . Experiences of high stress, anxiety and exhaustion, demonstrated a lack of interest in their studies which appears to influence drop-out intentions 8 , 32 , 33 . In contrast, satisfaction and engagement in research, supervision from several supervisors, integration and networks in the research community has a reverse effect in reducing burnout rates and enhancing success to degree completion 34 , 35 . This reveals that the decision to drop out of studies has a direct influence on burnout experiences, as shown by an association in all four burnout’s dimensions.

Furthermore, relating to the academic life, we found that the feeling of not being supported by the university during the COVID-19 outbreak had an association with all burnout dimensions. The academic support that graduate students receive from their department, faculty or university is essential to develop the sense of belonging and fitting in the educational environment. The lack of this perceived organizational support can increase the risk of experiencing exhaustion and the dissatisfaction with the doctoral studies, leading to academic burnout and consequences such as the intention to leave the degree 8 , 36 , 37 . The dissatisfaction with how the university dealt with the pandemic was another result found associated with the dimensions studies-related burnout, colleague-related burnout and teacher-related burnout, showing the direct influence of the institution, work environment and supervision on student satisfaction and well-being 37 , 38 , 39 . Particularly, the perceived organizational support and satisfaction with the institution can be decreased when the graduate students need to deal with the lack of transparency, undefined career prospects, unclear expectations during an outbreak such the COVID-19, thus the aforementioned factors can raise the risk for developing burnout.

Analysing the health and life habits characteristics we found that a bad sleep quality is associated with two burnout dimensions, personal burnout and studies-related burnout. Allen et al. also found in their study with graduate students that sleep quality has more consistent relationship with burnout and might be more important than sleep duration in order to reduce burnout levels 40 . It is already known that a poor sleep quality is associated with higher levels of fatigue and exhaustion, and when it comes to graduate students, this can impact directly and negatively the student’s personal life and academic productivity 41 , 42 . Given that together with prolonged and chronic stress, the lack of energy and motivation can make students less interested in their studies and more prone to develop academic burnout.

Moreover, with regards to the health and life habits factors related to academic burnout, we found that self-reported excessive alcohol consumption and use of antidepressants are both associated with colleague-related burnout and teacher-related burnout. The association between burnout syndrome and the consumption of alcohol has been widely reported, although a limited number of studies have examined this relationship among graduate students. The vulnerable situations of the students, emotional conflicts in the academia environment, excess of activities and competitiveness are pointed as the most contributing factors in the development of high levels of stress and alcohol misuse. This excessive alcohol consumption may be viewed as a dysfunctional coping mechanism, since the students may abuse alcohol as a strategy for regulating tension and stressful situations in the academia 43 , 44 , 45 , 46 .

The use of antidepressants can be also observed as a way of coping with adversity in the academia. It is already known that the academic stressors are related to stress, anxiety, depression, and when combined with extra load on studying as well as the need to enhance performance and concentration, students may resort to the use of antidepressants to avoid episodes of social anxiety and depressive behaviour. This finding is consistent with other studies, that reported students who use antidepressants, present high levels of burnout 47 , 48 , 49 . The misuse of alcohol and/or other substances are linked with burnout, and by neglecting that, it can lead to serious consequences.

1 Limitations

Our study has some important limitations. The cross-sectional study design limited our ability to establish causality between the associations. The online assessment to collect data during the COVID-19 outbreak may carry response bias and are less reliable. Therefore, we have used screening tools in this study and our findings should be interpreted carefully, since it is not a clinical psychiatric diagnostic instrument.

Conclusion and implications

This study analysed a number of factors thought to influence graduate students to develop academic burnout during the COVID-19 pandemic. Burnout showed significantly lower among graduate students who receive high levels of support from their university, were satisfied with how their university dealt with the pandemic and had a good sleep quality. The excessive consumption of alcohol, the use of antidepressants, being single and thinking about abandoning the university had a negative impact academic success and were predictory to burnout. We believe that these findings can offer patterns and predictors for future graduate students and university administrators to identify, promote and implement changes to help those who are facing the academic burnout and prevent other graduate students from develop it.

Study design and data collection

This current study is a cross-sectional analytical research. Data were collected through an online survey between September 2021 and March 2022. We tested a pilot of our preliminary instrument to ensure question clarity, and confirm completion of the survey in approximately 15 min. Data collection was done by virtual distribution over the Google Forms platform, along a close co-operation with international associations of graduate students and university departments. The form was disseminated through emails and included an invitation to participate, social media channels from communities for graduate students, and by asking participants to pass along the survey link to other eligible participants. The survey was designed and carried out in accordance with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) 50 (Supplementary Table S1).

Participation was anonymous and voluntary throughout the entire study period, and they were informed about the research and goal before giving their consent. We were unable to assess how many people viewed the online invitation, and therefore we could not determine the response rate of the study. Altogether, 542 students participated in the study. After eliminating incomplete answers, the final sample consisted of 519 graduate students which yielded a 95.75% completion rate.

Inclusion criteria were graduate students at master or Ph.D./DLA level by voluntary participation. Exclusion criteria were incomplete questionnaires and those who did not wish to participate in the research. The pilot test data and incomplete questionnaires with missing responses were excluded from the study.

The dependent variable was academic burnout syndrome, which was evaluated through the Copenhagen burnout inventory—student version 51 . The CBI was developed by Kristensen et al. 51 , and adapted for students by Campos et al. 52 . This scale consists of 25 items that represent 4 subscales: Personal Burnout (PB), Studies-related Burnout (SRB), Colleague-related Burnout (CRB), and Teacher-related Burnout (TRB). The answers are quantifying as 100, 75, 50, 25, and 0% respectively, with a reverse scoring for item 10. We used the Kristensen’s criteria of burnout score, 50–74 is consider moderate, 75–99 is high, and a score of 100 consider as severe burnout 53 . In the current study, the Cronbach’s alpha for the CBI-S scale was 0.93, indicating good internal reliability.

All the other selected variables were classified according to sociodemographic, academic and health status by self-reported answers.

Sociodemographic variables: age, sex (male, female, prefer not to mention), marital status (single, married, other), education level (PhD/DLA, master’s), and origin country (Hungary, European, non-European).

Academic variables: university of origin, study year, university’s drop-out intention (3-point scale ranging from: frequently; sometimes; never), university’s satisfaction during COVID-19 pandemic (5-point scale ranging from: strongly disagreed; disagree; neutral; agreed; strongly agreed), university’s support during COVID-19 pandemic (5-point scale ranging from: strongly disagreed; disagree; neutral; agreed; strongly agreed).

Health status and life habits variables: alcohol consumption (excessively; moderately; no consumption), antidepressant medications in use (yes; no), and quality of sleep (4-point scale ranging from: poor; regular; good; very good).

Statistical analysis

Statistical analysis was performed using initially the Microsoft Excel for Microsoft 365 (Microsoft Corp., Redmond, WA, USA). A p value of 0.05 (two-tailed) was considered to be statistically significant. Descriptive statistics were performed with the calculation of the mean (M) and standard deviation (SD) for quantitative variables, and percentages were calculated for qualitative variables.

In order to verify the difference between the means of the CBI dimensions and the independent variables, the t test (two groups) and the ANOVA (more than two groups) were applied, given the normality of the data attested by the Kolmogorov Smirnov test. All analyses were performed using the Stata statistical package version 12 (Stata Corp., College Station, TX, USA), with a significance level of 5%.

Ethical considerations

The study was approved Ethical Committee from the University of Pécs approved the study, under protocol number 8471, and also respected the Helsinki guidelines at all times. All participants statement an informed consent before becoming part of this study.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge the study participants who took their valuable time to participate in this research. The Stipendium Hungaricum scholarship program held by Tempus Foundation. And Dr Viktor Farkas for all great contributions.

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D.A. had the idea for the article. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by D.A., I.R. and O.M. The first draft of the manuscript was written by D.A. I.R. and O.M. critically revised the work. All authors read and approved the final manuscript.

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Andrade, D., Ribeiro, I.J.S. & Máté, O. Academic burnout among master and doctoral students during the COVID-19 pandemic. Sci Rep 13 , 4745 (2023). https://doi.org/10.1038/s41598-023-31852-w

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Rollins Research Review: WASH-Related Recommendations, Equity in PrEP Uptake, and the Effects of COVID-19 on Health Care Workers’ and Black Men’s Wellbeing

By Shelby Crosier

Last month, Rollins researchers authored papers on a wealth of public health topics. Find summaries of a few highlights below.

Title:  Priority gender-specific indicators for WASH monitoring under SDG targets 6.1 and 6.2: Recommendations for National and Global Monitoring

Organization: The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP)

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Important Takeaways:

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Title:  Equity of PrEP Uptake by Race, Ethnicity, Sex and Region in the United States in the First Decade of PrEP: A Population-Based Analysis

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Title:  Systemic Effects of the COVID Pandemic on Rural Black American Men’s Interpersonal Relationships: A Phenomenological Examination

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Rollins Author: Michael Curtis, PhD

• Studies have shown that the psychological and economic effects of the COVID-19 pandemic disproportionately affected Black men living in the rural South, but not much research has been done about the effects on their social networks.
• In this study, researchers interviewed 17 Black men in rural Georgia to learn about how the pandemic affected their interpersonal relationships.
• All men reported that the pandemic majorly impacted their relationships—often allowing them to improve relationships with family members but causing distress in romantic relationships. Many participants also felt disconnected from their communities during the pandemic.
• These findings highlight the importance of considering men’s relational health in pandemic recovery efforts.

Title:  Providing Trauma-Informed Care During a Pandemic: How Health Care Workers at Ryan White-Funded Clinics in the Southeastern United States Responded to COVID-19 and Its Effects on Their Well-Being

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• Health Disparities
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The top 5 books these mental health experts say will help you combat burnout at work and build healthy habits

Work stress is a pervasive problem. A 2022 Zippia report found that 83% of U.S. workers suffer from work-related stress, with 25% saying their job is the top stressor in their lives. Unrelenting stress has mental and physical consequences, raising your risk for chronic conditions like heart disease . 

Whether you’re struggling with the symptoms of burnout , such as fatigue, agitation, and a loss of motivation, are stressed about the dynamic between you and your boss, or are wrestling with a lack purpose , it may be time to do some light reading to build a healthier relationship with work .

Fortune asked a range of mental health and workplace culture experts to recommend their go-to books that can help you reframe work stress, combat burnout, and feel happier. 

Here are their top five.

Connected by Nicholas Christakis and James Fowler 

“The authors demonstrate through research results, the broad and lasting impact our friends and family members, both immediate and those more distant from our inner circle, play on our physical and emotional health,” says Dr. Richard Safeer , the chief medical director of employee health and well-being at Johns Hopkins Medicine and author of A Cure for the Common Company. “This book opened my mind to the idea that the stress (and other emotions) of those around me at work was impacting my own stress levels. In part due to this book (and my mindfulness practice), I’m much more acutely aware of how the emotions of others might impact me.  However, now I am much less likely to let the negative emotions cause me to feel the same.” 

The Upside of Stress by Kelly McGonigal

“When we think of stress, we usually think of it as being a negative thing, but Kelly McGongial speaks to the benefits of stress and how we can channel this energy for good,” says Dora Kamau, a mindfulness and meditation instructor at Headspace. 

Burnout: The Secret to Unlocking the Stress Cycle by Emily Nagoski and Amelia Nagoski 

“This book gives readers a good sense of how to better mitigate the pervasive experience of stress in our lives,” says Naomi Ben-Ami , a psychologist with the Williamsburg Therapy Group. 

The Power of Habit: Why We Do What We Do In Life and Business by Charles Duhigg

“I refer to this book often when talking to clients about making habit changes in their lives. This book uses easily accessible language to describe the research and evidence behind why we get stuck in certain habits even when we know they are bad for us, and how to make real, lasting changes,” says Jenny Maenpaa, a social worker and founder of Forward in Heels , a platform to empower women at work. 

Burn Rate by Andy Dunn  

“ Andy Dunn ‘s Burn Rate was the most honest, raw depiction of a founder’s journey I’ve read. It put my relationship with work in greater perspective and resulted in me taking my own mental health more seriously,” says Ariela Safira, CEO of Zeera, a workplace mental health platform. “Reading Burn Rate has motivated me, to this day, to pay attention to my own signs of burnout and mental health decline; and it has compelled me to actually make a change when I notice those signs.”

For more on workplace wellness: 

• Workplace health benefits don’t move the needle on improving employee happiness and well-being. With one exception
• Gen Z wants psychological safety at work—and here’s why it’s good for companies and employees
• American workers are overwhelmed with uncertainty, which can lead to burnout. Here’s a way to manage the nerves
• We know, it’s lonely at work. Here’s how you can feel more connected in just 10 minutes a day

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ORIGINAL RESEARCH article

Study engagement and burnout of the phd candidates in medicine: a person-centered approach.

• 1 Centre for University Teaching and Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
• 2 School of Applied Educational Science and Teacher Education, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
• 3 Faculty of Education, University of Oulu, Oulu, Finland
• 4 Behavioral Informatics Team, Health Informatics Centre, Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
• 5 Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden

This study focused on exploring individual variations in doctoral candidates’ well-being, in terms of experienced research engagement and burnout by using a person-centered approach. In addition, the associations between well-being profiles and gender, country of origin, study status (full-time or part-time), research group status and drop-out intentions were explored. The participants were 692 PhD candidates in the field of medicine. Latent profile analysis was employed to identify the well-being profiles. Four distinct profiles were identified: high engagement–low burnout, high engagement–moderate burnout, moderate engagement–moderate burnout , and moderate engagement–high burnout. Working in a clinical unit or hospital and working in a research group seemed to be related to increased engagement and reduced risk for suffering burnout, while the intentions to quit one’s doctoral studies were more frequently reported in profiles with moderate levels of engagement. The findings imply that although a significant number of PhD candidates in medicine had an increased risk for developing burnout, for most of the PhD candidates research education is an engaging experience.

Introduction

Undertaking a doctoral degree provides both highs and lows, potentially significantly reducing or increasing PhD candidates’ well-being (e.g., Stubb et al., 2011 ; Divaris et al., 2012 ; Caesens et al., 2014 ; Hunter and Devine, 2016 ; Swords and Ellis, 2017 ). Yet, previous research on the topic has focused heavily on the negative attributes such as stress (e.g., Oswalt and Riddock, 2007 ; Pappa et al., 2020 ), depression (e.g. Peluso et al., 2011 ; Levecque et al., 2017 ), anxiety (e.g., Barry et al., 2018 ; Liu et al., 2019 ), and exhaustion (e.g., Hunter and Devine, 2016 ), while positive aspects of PhD experience have been studied to a lesser extent ( Barnes and Randall, 2012 ; Sverdlik et al., 2018 ; Pyhältö et al., 2019 ). In particular, the number of studies exploring the combination or co-existence of positive and negative attributes of PhD candidates’ well-being is limited (for an exception, see Stubb et al., 2011 ), although PhD candidate’s well-being cannot be reduced simply to an absence of negative experiences ( Schmidt and Hansson, 2018 ).

A large body of research has indicated that the risk of burnout among physicians and other health care workers is high ( van Vendeloo et al., 2018 ; Dyrbye et al., 2020 ; Woo et al., 2020 ). The COVID-19-pandemic has further increased the risk of burnout among health care workers ( Chirico et al., 2021 ; Magnavita et al., 2021 ). In contrast, we know little about the well-being of research-active employees in the medical fields. Based on the literature on doctoral education, PhD candidates working in the medical context have rarely been studied. The medical research context is affected by the culture and hierarchy of the wider organizational culture of health care and hospital hierarchy, likely affecting PhD candidates’ well-being ( Kusurkar et al., 2021 ). Furthermore, there are at least two distinct subgroups of PhD students in these contexts ( Naylor et al., 2016 ): those who also work clinically and those working in the basic sciences. These two groups of PhD candidates often work under very different conditions, within the same medical university setting ( Naylor et al., 2016 ). More context-specific studies into PhD candidates in medical research education and the differing subgroups of PhD candidates in medicine have been called for ( Naylor et al., 2016 ; Kusurkar et al., 2021 ).

In this study, we aimed to explore the individual variation in well-being among PhD candidates in medicine by employing a person-centered approach. We focused on identifying burnout-engagement profiles employed by PhD candidates in the medical fields, and how they are related to working in a clinical unit or hospital, study status (full-time or part-time), research group status, and drop-out intentions. Also, differences between international and native (Swedish) PhDs candidates, and men and women were examined.

PhD Candidates’ Well-Being

PhD candidates’ study well-being is a multidimensional construct referring to a combination of positive mental states, such as satisfaction, self-efficacy or/and study engagement, and absence of extensive and severe negative ones such as burnout or strain related to doctoral studies, further contributing to a candidates ability to pursue their study goals ( Korhonen et al., 2014 ; Widlund et al., 2018 ). Study well-being is constructed in an interplay between demands and resources of the PhD. candidate and their doctoral study environment (see on study well-being among undergraduates Salmela-Aro and Upadyaya, 2014 ). In this study, we explore PhD. candidates’ study well-being in terms of study engagement and burnout. It has been suggested that s tudy engagement is a symbol of an optimal PhD experience, characterized by vigor, dedication, and absorption ( Schaufeli et al., 2002b ; Salmela-Aro and Upadyaya, 2012 ). Among PhD candidates, engagement is typically manifested as high levels of energy and mental resilience while working with one’s doctoral research, a strong willingness to invest effort in the doctorate, a sense of significance, enthusiasm, and inspiration, and being fully focused on one’s work, whereby time passes quickly ( Virtanen and Pyhältö, 2012 ; Vekkaila et al., 2013 , 2014 ). Engagement in doctoral study has been shown to be positively related to study progress and negatively to drop-out intentions ( Castelló et al., 2016 ).

Study burnout , in turn, refers to a negative study experience that is characterized by two core symptoms, exhaustion and cynicism, resulting from prolonged stress ( Schaufeli et al., 2002a ; Salmela-Aro et al., 2009 ). Exhaustion refers to lack of emotional energy and chronic fatigue ( Maslach and Jackson, 1981 ), and cynicism refers to alienation from one’s studying, perceiving them as meaningless and losing interest in them ( Maslach, 2003 ). Burnout during doctoral study has been shown to be related to delaying doctoral study and intending to quit them ( Pyhältö et al., 2012 ; Anttila et al., 2015 ; Hunter and Devine, 2016 ; Cornér et al., 2017 ; Barry et al., 2018 ).

In variable-based studies, study engagement and burnout have typically been found to be negatively related to each other ( Schaufeli et al., 2002a ; González-Romá et al., 2006 ; Salmela-Aro and Upadyaya, 2012 ; Swords and Ellis, 2017 ). This means that the PhD candidates experiencing high levels of study engagement are likely to experience low levels of study burnout and vice versa. However, various combinations of study engagement and burnout are also possible ( Tuominen-Soini and Salmela-Aro, 2014 ; Salmela-Aro and Read, 2017 ). For example, a PhD candidate can be highly engaged in their doctorate, but simultaneously experience high levels of exhaustion. A reason for this might the gradual development of burnout: burnout typically begins with exhaustion, and then, if working conditions remain the same, also the levels of cynicism increase ( Maslach and Leiter, 2016 ). Studies using a person-centered approach to explore PhD candidates’ study engagement and burnout simultaneously are scarce, resulting in a lack of knowledge about individual variations in the study well-being of PhD candidates in medicine. In addition, it is not known how different study well-being profiles are related to individual and contextual factors.

Antecedents of PhD Students’ Study Well-Being

Research has identified several individual and contextual antecedents of PhD candidates’ well-being. For instance, gender has been shown to be associated with study well-being, yet the evidence is mixed: although there is some evidence showing that female PhD students experience more stress and exhaustion than males ( Toews et al., 1997 ; McAlpine et al., 2020 ), there is also evidence of male postgraduates being more likely to experience increased levels of exhaustion than their female colleagues. Hunter and Devine (2016) , on the other hand, showed that PhD students’ gender was not associated with their experiences of exhaustion. The mixed findings imply that gendered impact may be dependent on the socio-cultural or disciplinary practices.

Some differences between international and native PhD candidates have also been reported. It has also been suggested that international PhD candidates are more career-oriented and more satisfied with their doctoral studies, which might make them more likely to experience research engagement compared to native PhD candidates ( Harman, 2003 ; Sakurai et al., 2017 ). However, international PhD candidates have also been shown to experience stress due to a lack of a supportive network ( Pappa et al., 2020 ), which increases their risk of burnout. Yet, evidence concerning the differences between domestic and international PhD candidates’ well-being is particularly limited.

Working conditions can be expected to have an impact on the well-being of PhD candidates in the medical fields. First, it has been suggested that the PhD candidates who are involved in clinical work experience high work strain due to constant balancing with their clinical or patient responsibilities and PhD research ( Kusurkar et al., 2021 ), which makes them prone to burnout experiences. On the other hand, there is also evidence that real work-life experiences such as clinical work can inspire candidates in their doctoral studies, and thus contribute to increased engagement (see Vekkaila et al., 2013 ). In a qualitative case study, comparing clinically active and basic science PhD candidates in the same context, Naylor and others (2016) showed that clinical doctoral candidates were initially less competent in basic research skills than candidates who had learned these skills at earlier stages of their basic science education. An adjustment from an established position at the clinic to being a junior researcher in the laboratory was challenging. On the other hand, financial stress characterized the experience of the science candidates more than that of the clinicians. Clinical PhD candidates also saw research education as being more clearly connected to career opportunities in the future than their basic science counterparts in the same setting did. Perceived employment opportunities have been associated with lower burnout levels in biomedical PhD candidates ( Nagy et al., 2019 ). Differences in the working conditions of medical PhD candidates may thus affect the levels of burnout and engagement in differing ways.

Research group status, i.e., whether the PhD candidate is undertaking their doctoral research within a research group or alone, can be assumed to have impact on study well-being. Research group has been shown to be an important source of social support to PhD candidates, and hence, working in a research group can be assumed to increase the experienced engagement ( Stubb et al., 2011 ; Peltonen et al., 2017 ). However, it has also been found that working within a research group can be a source of stress ( Stubb et al., 2011 ). Moreover, study status, i.e., whether the PhD candidate is undertaking their degree part-time vs. full-time, may have an impact on their study well-being. Yet, the evidence in this regard is partly contradictory. While those who work full-time are shown to be more satisfied with their supervision and perceive the scholarly community as empowering compared to those who work part-time ( Stubb et al., 2011 ; Pyhältö et al., 2016 ), candidates working part-time are shown to be more satisfied with their mental health and friendships ( Isohätälä et al., 2017 ).

Aim of the Study

The aim of the study was to understand the individual differences in study well-being among PhD candidates in medicine. More specifically, we explored the PhD candidates’ study engagement–burnout profiles and their associations with background variables that have previously shown to be associated with PhD candidates’ well-being [i.e., gender, country of origin, and study status (i.e., whether they were completing their doctorate full-time or part-time], and research group status). We also explored whether PhD candidates classified into different study well-being profiles differed in their intensions to drop out from doctoral studies. The following general hypotheses were formulated:

H1 : Different study engagement–burnout profiles can be detected among PhD candidates in medicine, ranging from profiles with high levels of burnout and low levels of engagement to profiles with low levels of burnout and high levels of engagement. H2 : The PhD candidates in the different study well-being profiles differ from each other in terms of gender, country of origin (i.e., domestic/international), and whether they are completing their doctorate full-time or part-time, and whether they work in hospital/clinical unit or not, and whether they worked with their doctorate alone or as a part of a research group (i.e., research group status). H3 : The PhD candidates with different study well-being profiles differ in their intentions to quit the doctoral studying, i.e., the students with high levels of burnout and low level of engagement are more likely to consider dropping out from the doctorate than those with low levels of burnout and high levels of engagement.

Materials and Methods

Research context.

This study had a cross-sectional design. The data were collected during 2015–2016 through a web-based survey using a secure platform (Artologik). The survey was conducted in English. All PhD candidates at Karolinska Institutet with an activity rate of more than 10% 1 received an invitation to participate in the survey. Karolinska Institutet is a research-oriented medical university with more than 2000 PhD candidates enrolled. “Medical” is understood as an umbrella term encompassing a wide array of fields with a connection to medicine: From clinical research to a wide variety of basic research topics in microbiological and life sciences. Several allied health sciences, behavioral and medical social sciences, such as nursing, physiotherapy, occupational therapy, psychology, medical ethics, and management are also represented.

All participants were enrolled in the same university-wide research education program and have the same overall formal requirements for their training, regarding the number of credits required from research education courses, general criteria for quality of research work, and basic structures of supervision and quality control of the research education process. However, within that universal organizational framework there is great variation in terms of the topics investigated, practices of individual research groups and supervisors and departmental structures.

There are clinical and basic science PhD candidates at Karolinska Institutet. The clinical PhD candidates typically work within two organizations: The hospital clinic or another health care organization (the manager or supervisor of the clinical work being the person the clinician reports to) and another one in the research group on the university side (the main doctoral supervisor most often being the candidate’s responsible manager). The basic science PhD candidates only work within one organization, the university, and have their main supervisor in doctoral education.

In Sweden, all PhD candidates are fully financed, meaning that they get a monthly salary. Their salary level depends on a variety of factors, mainly the source of finance (for example, grants from abroad, external competitive research funding, research funding from medical industry, or funding provided by the healthcare system for their employees). Clinical PhD candidates typically have considerably higher salaries than their basic science counterparts.

The context of the current study is similar to many other natural science contexts in that much of the research work is done within a research group, and a collaborative “teamwork research training structure” ( Chiang, 2003 ) is prevalent. However, there is considerable variation in this regard. At least two co-supervisors in addition to a main supervisor is an organizational norm.

Participants

In total, 2044 PhD candidates were invited and 692 responded to the survey (response rate 34%). PhD candidates were all in the medical fields. Of the participants, 61.3% were females and 36.6% males. The age of the participants ranged from 24 to 88, the mean being 35years. Forty six percent of the participants ( n =320) were Swedish and 53% ( n =366) were from another country. Of the participants, 67.2% ( n =465) reported that they were completing their doctorate full-time and 32.7% part-time. Nearly one-third (32.7%, n =226) of the participants were working in a hospital or a clinical unit. The proportion of those working mainly on their own with their doctorate was 54.8% ( n =379), and 44.4% ( n =307) of the participants reported that they were working in a research team.

Participants were informed that participation was completely voluntary and that they may withdraw from the study at any time without providing any explanation. They were also informed that all of the data which they provided would be strictly anonymous and treated confidentially, responses to the survey would not be linked to any other personal data and that analyses would be made at the group level. Before completing the survey, participants indicated that they had read and understood the information provided above and whether they agreed to participate in the study. The research was approved by the Swedish Central Ethical Review Board (Ref. No#2015/1626-31/5).

The participants completed the cross-country doctoral experience (C-DES) survey (see C-DES manual Pyhältö et al., 2018 ; Castelló et al., 2018 ). In this study, we used the following C-DES-scales to study PhD students’ study well-being: (1) research engagement (5 items) and (2) burnout in studying consisting of two factors: (a) exhaustion (4 items) and (b) cynicism (5 items). All items were rated on seven-point scales (1=not at all, 2=very rarely, 3=rarely, 4=sometimes, 5=often, 6=very often, 7=all the time; See Appendix 1 for the items). Mean variables were formed to represent research engagement, exhaustion, and cynicism in studying. The Cronbach alpha reliability and descriptive statistics of the subscales are shown in Table 1 .

Table 1 . Descriptive statistics and correlations of the study variables.

Data Analyses

A latent profile analysis (LPA) was used to identify subgroups of individuals based on their experiences of study engagement and burnout. LPA is a person-centered approach that involves grouping individuals into latent classes based on their observed response patterns on specific variables instead of exploring the relationships between the variables ( Berlin et al., 2014 ). LPA provides statistical criteria for model comparisons in selecting the best-fitting number of latent classes and opportunity to include predictors and outcomes compared to other clustering approaches (e.g., Vermunt and Magidson, 2002 ; Morin et al., 2018 ). The analyses were carried out using Mplus version 8.6 and MLR estimator that produces maximum likelihood estimates with standard errors and χ 2 test statistics that are robust to non-normality ( Muthén and Muthén, 1998–2017 ). Within-class variances were held constant across classes. We used several statistical criteria to choose the best fitting model: The Akaike (AIC), the Bayesian (BIC), adjusted Bayesian (aBIC) information-based measures of fit, and a Vuong-Lo-Mendell-Rubin (VLMR) and Lo-Mendell-Rubin (aLRT), and bootstrapped (BLRT) likelihood ratio tests ( Nylund et al., 2007 ; Berlin et al., 2014 ). In addition, the theoretical meaningfulness of the profile solution was emphasized in selecting the number of profiles. The average latent class probabilities and entropy values were used to evaluate the clarity of different profile solutions.

To explore whether the PhD candidates with different study well-being profiles differed from each other in terms of background variables (gender, country of origin, working in clinical unit or hospital, study status (full-time or part-time), research group status), we used auxiliary Mplus command ( Muthén and Muthén, 1998–2017 ). The background variables were included as antecedents of the latent class variable while accounting for the measurement error in classification ( Asparouhov and Muthén, 2014 ). This analysis was carried out with the R3STEP procedure of Mplus that performs a multinomial logistic regression and provides the odds ratios describing the effect of background variables on the likelihood of membership in each of the latent profiles compared to other profiles ( McLarnon and O’Neill, 2018 ). DCAT procedure for Mplus was used for examining whether candidates in different profiles differed from each other in terms of their intentions to quit studying for their doctorate.

The Study Well-Being Profiles

LPAs were run with 1–6 classes ( Table 2 ). According to VLMR and aLRT likelihood ratio tests, adding a subsequent class increased the model fit all the way to six classes, while the information criteria (AIC, BIC, and aBIC) showed that adding a new latent profile enhanced the model fit all the way to five profiles. However, the elbow plot ( Figure 1 ) showed that the BIC and aBIC values clearly decreased from one to four profiles, after which the decline levelled off. Therefore, the four-profile solution was selected. The four-profile solution was also considered to be the most parsimonious model, had a clear theoretical interpretation, and included profiles with sufficiently large memberships (i.e., >5% of the cases). The entropy value (0.80) and latent class probabilities (>0.80) also showed sufficient separation between the profiles in the four-profile solution showed sufficient separation between the profiles.

Table 2 . Information criteria values for different profile solutions in LPAs.

Figure 1 . Elbow plot of information criteria for different profile solutions.

Four well-being profiles were identified ( Figure 2 ). The first study well-being profile was high engagement–low burnout profile (see Table 3 ). It was the second most common profile among the participants with a 32.7 percent share ( n =226). The PhD candidates in this profile reported rather high levels of study engagement meaning that they often felt enthusiastic and inspired by their doctoral work. They reported low levels of cynicism, but moderate levels of exhaustion. However, when compared to other profiles, the exhaustion levels were lowest in this profile.

Figure 2 . Study well-being profiles of the PhD candidates in medicine.

Table 3 . Profile means and standard deviations.

The second profile was high engagement–moderate burnout profile, and it was the most common profile among the participants with a 33.2 percent share ( n =230). The PhD candidates within this profile reported moderate levels of both exhaustion and cynicism, and high levels of study engagement. The third profile was moderate engagement–moderate burnout profile. It represented 25.1 percent of the participants ( n =174). The PhD candidates with this profile demonstrated moderate levels of study engagement, exhaustion, and cynicism. This means that although the PhD candidates within this profile felt rather inspired and enthusiastic about their doctoral studies, they also sometimes felt overwhelmed by the doctoral study related workload and perceived their doctoral studies as meaningless. The fourth profile was moderate engagement–high burnout profile. The PhD candidates with this profile reported high levels of both exhaustion and cynicism. The candidates’ high levels of study burnout were combined with moderate levels of study engagement. This profile represented 9.0 percent of the participants ( n =62) being the least common profile.

The profiles differed statistically significantly ( p <0.01) from each other in all study variables, research engagement, exhaustion, and cynicism.

The Antecedents of Study Well-Being Profiles

Gender and country of origin did not have statistically significant relationships with study well-being profiles. Whether the PhD candidates were completing their doctorate full-time or part-time did not predict the profile membership either.

The PhD candidates who reported that they were working alone with their doctoral thesis had higher odds of belonging to moderate engagement–high burnout profile than to high engagement–moderate burnout profile ( b =0.98, SE=0.38, p =0.011, OR=2.86, 95%CI[1.25–5.64]) or high engagement–low burnout profile ( b =1.35, SE=0.38, p <0.001, OR=4.22, 95%CI[1.83–8.11]) compared to those who were completing their doctorate in a research group. In addition, the PhD candidates who reported that they were working alone with their doctorate had higher odds of belonging to the moderate engagement–moderate burnout profile than to the high engagement—low burnout profile ( b =0.83, SE=0.25, p =0.001, OR=2.28, 95%CI[1.39–3.75]) compared to those working in research groups.

The PhD candidates who were working in a clinical unit or hospital had higher odds of belonging to high engagement–low burnout profile than to moderate burnout–moderate engagement ( b =0.61, SE=0.29, p =0.037, OR = 1.85, 95%CI[1.04–3.25]) or moderate engagement–high burnout ( b =1.30, SE=0.52, p =0.012, OR=3.56, 95%CI[1.30–9.72]) profiles compared to those who reported that they were not working in a clinical unit or hospital. Those working in hospital or clinical unit also had higher odds of belonging to high engagement–moderate burnout ( b =1.23, SE=0.50, p =0.015, OR=3.66, 95%CI[1.33–10.10]) profile than to moderate engagement–high burnout profile than those who were not working in a clinical unit or hospital.

Taken together, the PhD candidates who reported that they were working alone with their doctorate had higher odds of belonging to profiles displaying lower levels of engagement and higher levels of burnout compared to those working in a research group. In turn, the PhD candidates who reported working in a clinical unit or hospital had higher odds of belonging to profiles displaying higher levels of engagement and lower levels of burnout compared to those who were not at a clinical unit or hospital.

Differences Between PhD Candidates in Different Profiles in Their Dropout Intentions

The PhD candidates in various profiles differed statistically significantly from each other in terms of their dropout intentions [ χ 2 (3, N =690)=147.6, p <0.001]. The intentions to interrupt one’s doctoral studies were most frequently reported in the following profiles: moderate engagement–high burnout profile (74.7%) of the PhD candidates with this profile had considered dropping out) and moderate engagement–moderate burnout profile (53.4%). However, the candidates with profiles characterized by high study engagement reported less intentions to interrupt their doctoral studies: 7.2% of the PhD candidates with high engagement–low burnout profile and 16.6% with the high engagement–moderate burnout profile had considered dropping out.

Findings in the Light of the Literature

In this study, we explored PhD candidates’ research engagement–burnout profiles. Adopting a person-centered approach allowed us to explore individual variation in PhD candidates’ study well-being by considering both positive and negative attributes of well-being at the same time rather than concentrating on the negative ones which has been the focus of several previous studies (e.g., Oswalt and Riddock, 2007 ; Peluso et al., 2011 ; Levecque et al., 2017 ; Pappa et al., 2020 ). Four distinct profiles among the PhD candidates in the field of medicine were identified: high engagement–low burnout, high engagement–moderate burnout, moderate engagement–moderate burnout, and moderate engagement–high burnout. The person-oriented approach complements variable-based studies showing a negative association between engagement and burnout ( Schaufeli et al., 2002a ; González-Romá et al., 2006 ; Salmela-Aro and Upadyaya, 2012 ; Swords and Ellis, 2017 ) by indicating that there are individual differences in how exhaustion, cynicism, and engagement can combine within a person. Our findings supported the bivariant approach on burnout and engagement, positing that burnout and engagement present two distinct, yet related dimensions of the individual’s affective study related experiences ( Shraga and Shirom, 2009 ; Larsen and McGraw, 2011 ; Shirom, 2011 ).

The results showed that the levels of research engagement were high or moderate in all the profiles and the most common profiles were those displaying high levels of engagement. Thus, the results indicate that undertaking doctoral studies in the field of medicine is a highly engaging experience. However, the results also showed that the risk of experiencing study burnout was also elevated (i.e., moderate or high) among most of the PhD candidates. These results are in line with earlier findings ( Kusurkar et al., 2021 ) suggesting an increased risk of burnout in medical researcher education.

The results also showed that those PhD candidates who reported working alone with their doctoral studying were more likely to belong to the profiles displaying moderate levels of engagement and higher levels of burnout. This implies that engaging in researcher group provides a potential resource for cultivating not only study progress but also the candidate’s well-being, identified also in previous studies ( Pyhältö et al., 2009 ; Stubb et al., 2011 ; Peltonen et al., 2017 ). Interestingly, although medicine presents typical group-based discipline, i.e., the basic unit for conducting research is a research group providing the platform for researcher education, according to our results only about half of the candidates reported that they were engaged in a research group. This implies that formal research group structure does not automatically guarantee an experience of membership or a well-functioning collaboration with the research group.

The results showed that the PhD candidates who were working in a hospital or clinical unit had lower risk of experiencing burnout and were more likely to experience high levels of study engagement than others. This means that undertaking one’s doctoral degree when having clinical responsibilities might protect the PhD candidates from study burnout and support their study engagement. On the contrary, Kusurkar et al. (2021) found that candidates in clinical departments had lower autonomy and higher levels of conflict between work responsibilities, especially among those PhD candidates who were working with patients. A variety of factors may explain our finding. The relevance of the research itself and doctoral studies in general might become apparent in the clinical work and hence, be a source of research engagement (see also Vekkaila et al., 2013 ). On the other hand, the candidates engaging in clinical work might have more extensive support networks to draw from as a resource for their studying and recovery when needed. They might be also less stressed by their career prospects after completing the PhD degree or they might be aiming for a non-academic career to reduce the stress caused by the doctoral studies (see Nagy et al., 2019 ). In addition, financial security may explain the differences in burnout levels: Clinical PhD candidates typically receive a much higher salary than PhD candidates who do not have clinical training or employment. In addition, basic science researchers will typically rely on external, competitive funding not only for the research work itself but even for maintaining a position at the university, thereby having much lower job security than their clinically active counterparts, who always have the chance of increasing the proportion of clinical work, should funding for research be scarce.

International PhD candidates did not differ in their likelihood of belonging to any subgroup. As previous studies have suggested that although international students might be prone to experience stress ( Pappa et al., 2020 ), they are also likely to be motivated and satisfied with their studying ( Harman, 2003 ; Sakurai et al., 2017 ), and thus be likely to experience research engagement. To our knowledge, no earlier study has looked at engagement and burnout of international doctoral students specifically in the medical research education, a context that tends to be extremely international and intercultural. Based on this finding, it seems that there were no distinctive differences between the international and native PhD candidates regard to their engagement-burnout-profiles. Accordingly, this suggests that the international PhD candidates in the field of medicine are highly heterogeneous group in terms of study well-being, not primarily determined by their status as international students. For example, it might be that whether they experienced working alone or within a research group or were clinical vs. basic science medical PhD candidates, were more significant in terms of their well-being than being an international PhD student.

The PhD candidates within the profiles displaying moderate levels of engagement and moderate or high levels of burnout symptoms more often reported intention to quit the doctoral degree than those with high levels of engagement, which was in line with previous findings ( Anttila et al., 2015 ; Cornér et al., 2017 ). Hence, in addition to having mental health benefits, high levels of experienced engagement are related to study progress among PhD candidates in the field of medicine. Accordingly, investing in developing engaging doctoral education environments has potentially significant individual and organizational benefits, considering that according to previous studies, drop-out rates among the PhD candidates typically range from 25 to 60% (e.g., Council of Graduate Schools, 2004 ; Golde, 2005 ; McAlpine and Norton, 2006 ; Gardner, 2009 ).

Limitations of the Study

There are some methodological limitations in the study that need to be considered when interpreting the results. First, the criteria for selecting the number of profiles were ambiguous ( Nylund et al., 2007 ), and hence, further studies exploring whether similar profiles can be found among other groups of PhD candidates are needed. For example, models for how profiles can be reproduced in new samples are being developed and may be helpful in exploring the well-being of PhD candidates across different medical research contexts (e.g., Gillet et al., 2021 ). Second, it is important to note that due to cross-sectional design, causal or process-related conclusions between study well-being and dropping out cannot be drawn. Third, the survey was sent to all doctoral students at the university simultaneously. Although the number of students who responded is sufficient for the analyses conducted, the sample only represents 36% of all doctoral students enrolled in the program. This should be kept in mind when generalizing, as we do not know whether self-selection might have affected the results. Fourth, the study was carried out in a specific social-cultural country context and in health sciences, accordingly one should be careful in drawing conclusions based on the results, across the doctoral education systems or disciplines. Last, it is important to note that data were collected before the COVID-19-pandemic. The pandemic has affected both the clinical and basic-science doctoral students in many ways. Further studies are needed to explore how stress, engagement and well-being of doctoral students working in the medical context have been affected by the pandemic at its different phases and afterwards.

Undertaking a PhD in medical fields is an engaging experience for most of the PhD candidates. However, the results suggested that there are several PhD candidates with high or increased risk of burnout. Thus, it seems that individual differences occur between PhD candidates in terms of their well-being. For individuβals displaying a higher risk of burnout, it was more common to experience studying alone in their PhD compared to those with lower burnout risk. In addition, the lower risk of burnout was related to working in a clinical unit or hospital. Therefore, it can be concluded that in the field of medicine, working in research group, and in a clinical unit or hospital during their PhD can help buffering study burnout and provide sources of research engagement.

Practical Implications

The results of the present study can be used by educational developers and staff trainers working with doctoral education. The stressors experienced by basic science PhD candidates in the highly competitive, externally funded research universities need to be taken into consideration by supervisors and policymakers. Particular attention should be paid to the candidates who experience that they are studying alone. Supervisors should be encouraged to be particularly careful in mapping out the actual support networks of their PhD candidates, instead of just formal connections to officially defined research groups. Moreover, the similarities and differences between the conditions of the clinical and non-clinical PhD candidates are worth discussing, as they work in the same general setting. The positive news for medical universities is that despite the pressures and competing responsibilities, the medical research setting is often experienced as engaging and does not automatically lead to burnout, a message worth spreading in this community engaged with cutting-edge, life-saving academic research. The study also has implications for policymakers: the findings highlight the importance of surveillance of the occupational health within the hospitals to check the psychosocial risk factors for staff undergoing research education, not merely that of residents and other health care workers.

The results also provide directions for future research on PhD candidates’ well-being. Our findings suggested that although an official membership in a research group is common in medical university, over half of the participants in this study reported that they were working alone. Working alone instead of within a research group was more common in profiles with higher burnout levels and lower levels of engagement. Therefore, reasons for the finding that most of the participants experienced working alone needs to be studied further. For example, investigation is needed to see if working alone is an active choice of a candidate or whether it represents a failure of the research education system in ensuring a supportive setting for doctoral students. In such further investigations, special attention should be paid to the actual networks, communities of practice and support. Also, factors involved in medical doctoral students’ engagement and burnout warrant closer investigation. As engagement may be more of a day-to-day experience, while burnout takes more time to develop ( Sonnentag, 2017 ), it might be useful to look more closely at the sources of engagement for both the clinically active and the basic science subgroups of medical PhD candidates, both to identify them more precisely and to investigate the variability and trajectory of them. Given the highly competitive, high-pressure nature of research-oriented medical contexts, it might also be useful to look at experiences of exhaustion as separate from fully developed burnout, as recent research indicates that weariness does not necessarily develop into more serious burnout ( Gustavsson et al., 2010 ; Gillet et al., 2021 ). For PhD candidates, supervisors, and decision-makers in these competitive environments, where high workload is more the norm than the exception, a more detailed understanding of these processes would be invaluable in terms of identifying high-risk situations and individuals in urgent need of help.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The research was approved by the Swedish Central Ethical Review Board (Ref. No#2015/1626-31/5). The participants provided their written informed consent to participate in this study.

Author Contributions

LT, KP, AB, and JN have contributed to writing the original draft and editing it. AB has contributed to data collection and project administration. LT has contributed to conducting the analyses. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.727746/full#supplementary-material

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Keywords: burnout, drop-out, PhD candidate, research engagement, well-being

Citation: Tikkanen L, Pyhältö K, Bujacz A and Nieminen J (2021) Study Engagement and Burnout of the PhD Candidates in Medicine: A Person-Centered Approach. Front. Psychol . 12:727746. doi: 10.3389/fpsyg.2021.727746

Received: 19 June 2021; Accepted: 28 October 2021; Published: 23 November 2021.

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Copyright © 2021 Tikkanen, Pyhältö, Bujacz and Nieminen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lotta Tikkanen, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Laurence Willemet remembers countless family dinners where curious faces turned to her with shades of the same question: “What is it, exactly, that you do with robots?”

It’s a familiar scenario for MIT students exploring topics outside of their family’s scope of knowledge — distilling complex concepts without slides or jargon, plumbing the depths with nothing but lay terms. “It was during these moments,” Willemet says, “that I realized the importance of clear communication and the power of storytelling.”

Participating in the MIT Research Slam, then, felt like one of her family dinners.

The finalists in the 2024 MIT Research Slam competition met head-to-head on Wednesday, April 17 at a live, in-person showcase event. Four PhD candidates and four postdoc finalists demonstrated their topic mastery and storytelling skills by conveying complex ideas in only 180 seconds to an educated audience unfamiliar with the field or project at hand.

The Research Slam follows the format of the 3-Minute Thesis competition, which takes place annually at over 200 universities around the world. Both an exciting competition and a rigorous professional development training opportunity, the event serves an opportunity to learn for everyone involved.

One of this year’s competitors, Bhavish Dinakar, explains it this way: “Participating in the Research Slam was a fantastic opportunity to bring my research from the lab into the real world. In addition to being a helpful exercise in public speaking and communication, the three-minute time limit forces us to learn the art of distilling years of detailed experiments into a digestible story that non-experts can understand.”

Leading up to the event, participants joined training workshops on pitch content and delivery, and had the opportunity to work one-on-one with educators from the Writing and Communication Center, English Language Studies, Career Advising and Professional Development, and the Engineering Communication Labs, all of which co-sponsored and co-produced the event. This interdepartmental team offered support for the full arc of the competition, from early story development to one-on-one practice sessions.

The showcase was jovially emceed by Eric Grunwald, director of English language learning. He shared his thoughts on the night: “I was thrilled with the enthusiasm and skill shown by all the presenters in sharing their work in this context. I was also delighted by the crowd’s enthusiasm and their many insightful questions. All in all, another very successful slam.”

A panel of accomplished judges with distinct perspectives on research communication gave feedback after each of the talks: Deborah Blum, director of the Knight Science Journalism Program at MIT; Denzil Streete, senior associate dean and director of graduate education; and Emma Yee, scientific editor at the journal Cell .

Deborah Blum aptly summed up her experience: “It was a pleasure as a science journalist to be a judge and to listen to this smart group of MIT grad students and postdocs explain their research with such style, humor, and intelligence. It was a reminder of the importance the university places on the value of scientists who communicate. And this matters. We need more scientists who can explain their work clearly, explain science to the public, and help us build a science-literate world.”

After all the talks, the judges provided constructive and substantive feedback for the contestants. It was a close competition, but in the end, Bhavish Dinakar was the judges’ choice for first place, and the audience agreed, awarding him the Audience Choice award. Omar Rutledge’s strong performance earned him the runner-up position. Among the postdoc competitors, Laurence Willemet won first place and Audience Choice, with Most Kaniz Moriam earning the runner-up award.

Postdoc Kaniz Mariam noted that she felt privileged to participate in the showcase. “This experience has enhanced my ability to communicate research effectively and boosted my confidence in sharing my work with a broader audience. I am eager to apply the lessons learned from this enriching experience to future endeavors and continue contributing to MIT's dynamic research community. The MIT Research Slam Showcase wasn't just about winning; it was about the thrill of sharing knowledge and inspiring others. Special thanks to Chris Featherman and Elena Kallestinova from the MIT Communication Lab for their guidance in practical communication skills. ”

Double winner Laurence Willemet related the competition to experiences in her daily life. Her interest in the Research Slam was rooted in countless family dinners filled with curiosity. “‘What is it exactly that you do with robots?’ they would ask, prompting me to unravel the complexities of my research in layman’s terms. Each time, I found myself grappling with the task of distilling intricate concepts into digestible nuggets of information, relying solely on words to convey the depth of my work. It was during these moments, stripped of slides and scientific jargon, that I realized the importance of clear communication and the power of storytelling. And so, when the opportunity arose to participate in the Research Slam, it felt akin to one of those family dinners for me.”

The first place finishers received a $600 cash prize, while the runners-up and audience choice winners each received $300.

Last year’s winner in the PhD category, Neha Bokil, candidate in biology working on her dissertation in the lab of David Page, is set to represent MIT at the Three Minute Thesis Northeast Regional Competition later this month, which is organized by the Northeastern Association of Graduate Schools.

A full list of slam finalists and the titles of their talks is below.

  PhD Contestants: 

• Pradeep Natarajan, Chemical Engineering (ChemE), “What can coffee-brewing teach us about brain disease?”
• Omar Rutledge, Brain and Cognitive Sciences, “Investigating the effects of cannabidiol (CBD) on social anxiety disorder”
• Bhavish Dinakar, ChemE, “A boost from batteries: making chemical reactions faster”
• Sydney Dolan, Aeronautics and Astronautics, “Creating traffic signals for space”

  Postdocs: 

• Augusto Gandia, Architecture and Planning, “Cyber modeling — computational morphogenesis via ‘smart’ models”
• Laurence Willemet, Computer Science and Artificial Intelligence Laboratory, “Remote touch for teleoperation”
• Most Kaniz Moriam, Mechanical Engineering, “Improving recyclability of cellulose-based textile wastes”
• Mohammed Aatif Shahab, ChemE, “Eye-based human engineering for enhanced industrial safety” 

Research Slam organizers included Diana Chien, director of MIT School of Engineering Communication Lab ; Elena Kallestinova, director of MIT Writing and Communication Center ; Alexis Boyer, assistant director, Graduate Career Services, Career Advising and Professional Development (CAPD); Amanda Cornwall, associate director, Graduate Student Professional Development, CAPD; and Eric Grunwald, director of English Language Studies. This event was sponsored by the Office of Graduate Education, the Office of Postdoctoral Services, the Writing and Communication Center, MIT Career Advising and Professional Development , English Language Studies, and the MIT School of Engineering Communication Labs.

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Here’s How Bad Burnout Has Become at Work

For Kaitlin Howes, the topic of burnout at work hits close to home.

Howes, an HR business partner at Reward Gateway, said that at a previous employer, she was “trapped in a rigid role without a lot of flexibility,” where innovation felt out of reach. The monotony of completing the same tasks the same way each day stifled any potential for growth or learning. Collaborative opportunities were few and far between, leaving her feeling isolated.

“Every morning, I felt a sense of dread, and it was taking a toll on my mental health,” Howes said. “Burnout was right in my face, and I knew I needed to do something.”

Burnout in the workplace is not new—but it is worsening. SHRM’s Employee Mental Health in 2024 Research Series, released for Mental Health Awareness Month in May,  found that 44 percent of 1,405 surveyed U.S. employees feel burned out at work, 45 percent feel “emotionally drained” from their work, and 51 percent feel “used up” at the end of the workday.

“If you consider how many workers are feeling burned out and the direct and indirect effects burnout has on an organization, it should really raise a red flag to organizational leaders,” said Daroon Jalil, a senior researcher at SHRM who led the mental health research initiative.

Burnout can have profound effects on employees, including physical and emotional exhaustion, diminished job performance, increased absenteeism, lower job satisfaction, and even long-term health problems such as anxiety and depression.

Employees who are burned out are also more likely to leave their companies. According to the SHRM data:

• Workers who are burned out from their work are nearly three times more likely to be actively searching for another job (45 percent versus 16 percent of those who did not report burnout).
• Workers who feel burned out from their work are significantly less likely to go above and beyond what is expected of them at work (40 percent versus 56 percent).

The SHRM research aligns with previous reports, including the American Psychology Association’s 2023 Work in America Survey, in which 57 percent of workers said they experienced negative impacts due to work-related stress associated with burnout, including emotional exhaustion, irritability, and anger.

When employees feel burned out, it’s not just their own productivity that takes a hit—it’s the entire team’s. Employees experiencing burnout are more likely to check out mentally, leading to reduced employee engagement and absenteeism.

Howes explained that burnout can lead to missed deadlines, lower quality work, and a general feeling of sluggishness that spreads throughout the office. Burnout can also increase turnover. When employees feel overwhelmed, unappreciated, or unsupported, they’re more likely to find another job where they feel a greater sense of purpose.

The SHRM data found that employees whose managers have a negative impact on their mental health are two times less likely to say they believe in the mission of their organization (43 percent versus 91 percent of those whose managers have a positive impact).

“Additionally, when employees are exhausted and unmotivated, they’re less likely to think creatively, problem-solve, or contribute new ideas, hindering the company’s ability to adapt to changing market conditions and stay competitive,” Howes said.

How Companies Can Address Burnout

Howes said that recognizing and addressing burnout is crucial for maintaining a healthy work environment—both for the individual who is experiencing burnout as well as organizations that are facing the effects of a burned-out workforce. As an individual, preventing burnout involves taking proactive steps to maintain a healthy work/life balance, manage stress effectively, and prioritize self-care.

“However, I believe a large part of dealing with burnout is also the responsibility of the company,” Howes added. “Organizations should always be looking for new ways to engage their workforce to promote retention and improve well-being.”

Organizations should work toward creating an environment that fosters belonging and authenticity, which can reduce burnout. The SHRM research showed that workers who feel a strong sense of belonging at their organization were 2.5 times less likely to feel burned out from their work. Additionally, employees who feel they can be their authentic selves at work are 2.5 times less likely to feel emotionally drained from their work.

Another effective way to address these concerns is with regular recognition, according to Howes.

“Organizations should encourage leadership and managers to offer regular and specific recognition for their employees’ hard work and accomplishments,” she said.

Terri Bogue, the chief operating officer of Indiana-based technology company Thor Projects, said during the SHRM Annual Conference & Expo 2022 that individuals can avoid experiencing burnout in several ways:

• Try to maintain an optimistic point of view when dealing with work challenges.
• Reframe your perceptions, because many people harbor false perceptions of the expectations others place on them.
• Give yourself some credit.
• Focus on maintaining a healthy diet, exercising regularly, taking mental health days, and seeking professional support when needed.
• Find ways to limit your demands.

“We need to make sure our expectations, perceptions, and results match,” Bogue said. “When they don’t, that’s when we experience burnout.”

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The neuroscience of singing: How choirs help our brains and bodies recover from burnout

For some, the sensation feels like fireworks exploding out of their brain into the night sky.

For others, there’s a kind of buzz — electricity or vibration. Goosebumps cover their whole body.

"A bit like a warm hug." A moment of "collective happiness", "clarity", and feeling totally grounded. Entering some kind of "flow state".

This is what it's like to sing in harmony as part of a community choir.

Humans have come together in song for — at least —  tens of thousands of years. Through ancient songlines and sacred hymns, in times of celebration and in grief.

And if you ask any of those who dedicate a window of their everyday lives to this practice, they'll tell you just how good it feels.

Many say it's a form of therapy, and that without it, they're not sure they would survive.

Scientists have been singing the praises   of choirs for decades. These musical gatherings seem to support social and emotional wellbeing for all sorts of groups — among small or large crowds, those with established connections and those who are just getting to know each other, and across cultures.

Researchers have established how group singing can support and even facilitate recovery in patients with Parkinson's disease , post-natal depression and some types of cancer — and they say they've only just begun to scratch the surface on the cognitive possibilities.

A safe place to recover and reconnect

Emily Fleming went in search of a choir as part of her recovery from chronic illnesses that worsened after an episode of severe burnout.

In her mid-20s, Emily was diagnosed with myalgic encephalomyelitis, also known as chronic fatigue syndrome or ME/CFS. She became so unwell she was unable to leave her house for about a year, feeling isolated, disconnected, and confused about the road to recovery.

"Most health professionals would say, 'this is something you'll have forever, you won't ever be able to run again, you won't be able to go out and do the things you used to do', which is just devastating. And so I guess in the back of my mind, I'd always thought that recovery for me looks like getting back into the community," she says.

When Emily eventually became well enough to venture out into the world again, she set her sights on a community choir run by Brisbane musician Emma Dean.

"I had wanted to join a choir for so long because I loved music at school, it was a big part of my life. And then as an adult, I felt like there was a part of me missing … I thought, I'm just gonna do it. Because I think it's what my soul is longing for."

It's a common refrain at Cheep Trill. Every week, choristers gather in community halls — one on Brisbane’s north side and one on the south — to sing together. Manager Corinne Buzianczuk and musical assistant Tony Dean lead the choir in a physical and vocal warm-up before Emma takes the reins to work on the one of the arrangements she's been teaching the group for their end-of-term performance.

Section by section, sopranos, altos, tenors and basses practise their do-dos and woah-ohs, listening intently and frequently bursting into applause when their fellow singers nail a phrase — or a kind giggle when someone flubs a lyric.

There's a break for tea and biccies before switching to a fresh song for the second half of rehearsals. A hum of friendly chatter fills the hall once more as people stack and pack away the chairs, wash up the mugs and wander back out into the night.

From her first rehearsal, Emily says she felt an instant connection with her fellow singers.

"Choir people are just the best, because it's so inclusive …  I didn't get to connect with people for such a long time and so I do miss having that kind of connection with people of different ages. That for me has been what Cheep Trill has given me — intergenerational friendships," she says.

"To have this community of people that are from different walks of life, and in different stages of life, and to really understand that we're kind of going through the same thing."

This sense of community is more than just a hunch — there's an extensive volume of research that shows how singing as part of a group can alleviate feelings of loneliness and isolation, and increase self-efficacy and self-esteem.

Researchers led by Genevieve Dingle, director of clinical psychology programs at the University of Queensland, have found choirs are particularly powerful for people experiencing chronic ill health or significant social disadvantages .

Rockelle Duffy, who joined Cheep Trill in 2023, says it has been a lifeline — a safe space in a particularly dark period.

She had been struggling with what she now understands is functional neurological disorder and fibromyalgia on top of a major depressive disorder and anxiety. Like Emily, Rockelle became unable to work or leave her home.

"I found that I was really reclusive. I had incredibly terrifying dark thoughts constantly running in my brain, screaming at me … I became fearful of going out. So while that's going on in one part of my mind, this little creative spark kept trying to light up and grab my attention," Rockelle says.

She decided to join Cheep Trill after accompanying a friend and long-term member, David Truong .

"I remember going the first night of that term … I just was turned into this blubbering mess. I was streaming tears, my nose was full of snot, my body was shaking … I felt really safe just to sit there and go through whatever was going on for me,” Rockelle says.

“During the course of that term, one of the few things that would get me out of the house aside from attending to the multitude of medical appointments and so forth was choir."

Through the choir, Rockelle has been able to connect with her creativity, process difficult emotions and explore new opportunities — she's started singing in a rock band and writing her own music.

But she says the biggest change has been regaining her self-worth and learning to show up for herself day after day.

What's happening to our bodies when we sing together?

It perhaps goes without saying that in a room full of self-confessed musical theatre nerds, there's a lot of talk about feelings. But the benefits of group singing go beyond the mushy stuff.

Professor Sarah Wilson, a clinical psychologist credited with pioneering music neuroscience research in Australia, explains it as "an internal therapy tool" that engages several parts of the brain at once.

That "singing network", as Professor Wilson calls it, includes areas that control complex motor activity, auditory processing, language, emotion and memory.

Vocal motor control networks activate and coordinate the right muscles to project our voice and manage our airflow. Auditory and language networks help us to pitch our notes correctly, adjust our volume and sing the right lyrics.

Professor Wilson explains that in choir singing, higher level executive functions are also involved, "making sure we come in at the right time, on the right note, and that hold note in our mind … timing it and coordinating relative to the music and the other singers".

Long-term, engaging in musical activities has been shown to support neuroplasticity — that is, the ability to heal and adapt, creating new pathways over time — in healthy ageing brains.

Some of Professor Wilson's work has focused on using singing, through Melodic Intonation Therapy, to help rehabilitate speech in patients recovering from severe strokes .

"We're watching their brain rewire itself, in real time, and switching back on parts of the language network to support their rehabilitation and brain plasticity," she says.

"So it's a really powerful, innate tool … both for our brain plasticity and cognitive health, but also our mental health."

There are also physiological factors at play — our heartbeats and breathing sync up when we sing together .

Both Emily and Rockelle say they've noticed the regular practice has helped in other ways, too.

“I first thought that it would be purely for my mental health … What I wasn't expecting was how much of a physical difference [choir] has made for me," Emily says.

"With the conditions that I have, standing up for a long period of time is really challenging. With choir, for two hours a week [I'm] standing up and down, and just sort of practising those movements. So that has really improved my standing tolerance."

Rockelle says singing has become part of her "self-deigned therapy program" in managing her FND and chronic pain.

"When my body doesn't want to behave the way we think it should, when the signals aren't working properly, I tune into music. I get out the choir [guide tracks], and I look at the [sheet music] … and I'll sway and I'll dance on the spot. It gets that cognitive conversation happening … to get me moving again," she says.

Rockelle says learning about how to engage and switch between her chest voice and head voice has been helpful for regulating her breathing during bouts of extreme anxiety or panic attacks.

The academic jury is still out on exactly how singing in a group affects our levels of oxytocin — that warm, fuzzy feel-good brain chemical.

Professor Wilson says we know singing directly activates the brain's reward network, and there is evidence to suggest choir practice can reduce cortisol levels — an indicator of stress — and even boost immune function.

In two recent studies that measured hormone response in choir singers — one from the University of Regensburg in 2017 , and a smaller pilot study from the University of Toronto in Canada in 2021 — researchers found that positive effects of singing were more pronounced after group singing compared with solo singing.

In addition, Professor Wilson explains that choir singing engages the mirror neuron system, which plays a powerful part in social bonding.

"When we have a verbal conversation, we can't do it together, we have to take turns — otherwise, it's impossible, we're just talking over each other. Whereas singing is this one chance where we get to use our voices in unison," she says.

"Our brain activity is mirroring each other. That activates our own circuitry, and it helps us put ourselves in their shoes. And that facilitates that bonding that we experience when we're singing in a choir."

Cultivating a community around creativity

Cheep Trill is just one of the hundreds — possibly thousands — of community choirs in Australia that focus on bringing amateur singers together in a non-auditioned and non-competitive format.

The purpose of these groups is as much about connection as it is about crafting perfect harmonies.

That people feel supported, welcomed, and held in this space is no coincidence. It's a culture that every single one of the dozen or so 'Trillers' who spoke to the ABC puts down — at least in part — to their musical director, Emma Dean.

In 2014, Emma had been slogging it out to make a name in New York, working as a kids' entertainer and performing late-night opening sets for off-Broadway drag and cabaret artists, making very little money and careening towards total burnout.

With her marriage falling apart and a deep depression setting in, Emma says she had reached rock bottom when a friend suggested that she should start a choir. 

And so she returned to Brisbane and started singing with a small group of musical mates on a friend's verandah. Something clicked into place — watching other people shine gave Emma a new purpose.

“This choir, this strange little group of people who gathered on this verandah, saved me. Really genuinely saved my life," she says.

"They saved my love of music, because I kind of felt like music had betrayed me at some point. I knew that that wasn't completely the truth, but I knew I had to reignite the spark I felt for music."

In the 10 years since, the choir has evolved into a buzzing community of singers from all walks of life, welcoming fresh faces and expanding their repertoire each term.

It's seen new friendships blossom, family ties strengthen, and set the backdrop for at least one marriage proposal.

There are practical and intentional decisions that have allowed Cheep Trill to grow — finding a space that wheelchair users and singers with assistance dogs can navigate seamlessly, making sure there are vegan and gluten-free snacks available during the break, crafting arrangements that share melodies equally between parts, and working on creative solutions for singers with particular sensory needs.

Many community choirs have found ways to offer concessions on term fees or open up sponsored spots for choristers to pay it forward for singers who don’t have the financial means to join.

Emma says above all, she tries to conduct and teach in a way that "creates a space that is safe for people to explore their voice, to explore their creativity", without fear of judgement.

"We're not doing brain surgery. We're just singing a song. I actually quite like mistakes. They're fabulous," she says.

"It's also about facilitating a meeting place where people who have never come across other sorts of people are kind of forced to listen to each other."

Whatever the reasons behind it, there's just something magical that happens when people sing together.

What does it feel like to sing together in a choir?

On an almost-chilly Saturday morning earlier this month, the hundred-or-so Cheep Trillers gathered to share that magic with crowds wandering through the West End markets.

Diligently dressed in their brightest colours, the northside and southside chapters came together to perform four pieces for a small crowd under the shade of a mighty fig tree on the banks of the Brisbane River.

After 10 weeks spent working towards their creative debut, it was a big moment.

Rockelle noticed the feelings in her body, like "a ray of sunshine" penetrating from head to toe.

"My ears are soothed, my tummy settles and my heart swells with love," she says. "I feel light, I feel bright. I feel like I'm worthy. And that there's something here for me — let's keep going."

For Emily, it was a feeling of pure clarity. "Like that is the only thing that I'm thinking of in that moment. I'm not even thinking of the fact that I'm singing and remembering the words, I'm just thinking about how it sounds together, how we're blending our voices together."

There's a synchrony, too, in the way these singers talk about working creatively towards a common goal.

"That's the power of a choir. It's supportive, like you're an instrument in an orchestra, and everyone's voice is part of that," says Piet, who adds Cheep Trill has become like "a second family".

Liz Bremer joined this term as part of a challenge to herself after her father's death to do something each year that scares her.

"When it clicks, everybody starts to sound like one voice and you sort of don't even hear yourself. And that's when as soon as the song's finished, you just feel elated. It's really energising," she says.

"It feels electric," adds her new friend Lucy, another alto-slash-tenor who's new to Cheep Trill. "There's something beautiful about doing something where you can mess up and maybe embarrass yourself in public, but then you don't ... even if you sing off-key or you accidentally sing the wrong lyric, it is such a safe place."

Lucy passes the mic back to Liz: "It reminds you that you're not alone."

Professor Wilson calls it kama muta, a Sanskrit phrase that roughly translates to "being moved by love".

"It's that real sense of being moved by music … and being part of maybe something that's bigger, a communal sense, a higher connection," she says.

In fact, this suspected link between music and feelings of nostalgia or kama muta is currently under investigation by one of Professor Wilson's PhD students at the University of Melbourne. That research is still underway, but Professor Wilson says the hypothesis is that this overwhelming communal feeling is an important evolutionary function of music.

On a basic level, Emma says there is "this great joy, and a great relief that comes from being a part of something bigger than yourself".

"Singing solo is a very different experience to singing in a group … you feel lifted, you feel supported by so many other people around you," she says.

"You are creating something so special, that is not only making the people in the choir happy, but also the people listening to it. You're giving this incredible gift to people witnessing this magic."

Again, the science supports that sentiment. Another study from Professor Dingle and her fellow UQ researchers in 2023  found that watching a choir performance "can foster admiration, respect and positive regard toward choristers" among members of the audience.

The crowd watching Cheep Trill seemed to agree. Uplifting, engaging, playful, a little bit whimsical — a good vibe all round, was how some enjoying the performance put it afterwards.

They did notice, however, one singer standing towards the back who became a bit teary during a moving rendition of REM's Nightswimming. Overcome with emotion, perhaps. The choir sang on while she gathered herself — it's a safe space, after all.

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