The Role Of Stress, Resilience, And Social Support In Academic Burnout Among Medical Students : A Systematic Review
Keywords
Academic Burnout, Medical Students, Resilience, Social Support, StressAbstract
Academic burnout has become an increasingly important mental health concern among medical students due to the demanding nature of medical education, characterized by intensive academic workloads, clinical responsibilities, and sustained psychological pressure. Understanding the psychological and environmental factors associated with academic burnout is essential for supporting students' well-being and academic success. This systematic review aimed to synthesize current evidence regarding the roles of academic stress, resilience, and social support in academic burnout among medical students. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were performed in PubMed, Scopus, ProQuest, and Google Scholar. A total of 1,358 records were initially identified, of which 10 studies met the predefined eligibility criteria and were included in the final narrative synthesis following the PRISMA 2020 selection process. The synthesized evidence consistently identified academic stress as the principal psychological risk factor associated with academic burnout, whereas resilience and social support emerged as the primary protective factors associated with lower burnout levels. Additional determinants, including personality traits, academic adaptability, anxiety, workload, psychological well-being, and life satisfaction, were also associated with academic burnout, indicating that burnout is influenced by multiple interacting psychological, academic, and environmental factors. Overall, the findings highlight that academic burnout among medical students is a multifactorial phenomenon, highlighting the importance of integrated psychological and institutional strategies that address both psychological risk factors and protective resources to support students' well-being and foster healthier learning environments in medical education. However, the findings should be interpreted with caution because most included studies employed cross-sectional designs and substantial methodological heterogeneity precluded quantitative meta-analysis
References
Boni, R. A. S., Paiva, C. E., de Oliveira, M. A., Lucchetti, G., Fregnani, J. H. T. G., & Paiva, B. S. R. (2018). Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors. PLoS ONE, 13(3), e0191746. https://doi.org/10.1371/journal.pone.0191746
Chunming, W. M., Harrison, R., MacIntyre, R., Travaglia, J., & Balasooriya, C. (2017). Burnout in medical students: A systematic review of experiences in Chinese medical schools. BMC Medical Education, 17, 217. https://doi.org/10.1186/s12909-017-1064-3
Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014). Burnout Among U.S. Medical Students, Residents, and Early Career Physicians Relative to the General U.S. Population. Academic Medicine, 89(3), 443–451. https://doi.org/10.1097/ACM.0000000000000134
Frajerman, A., Morvan, Y., Krebs, M. O., Gorwood, P., & Chaumette, B. (2019). Burnout in medical students before residency: A systematic review and meta-analysis. European Psychiatry, 55, 36–42. https://doi.org/10.1016/j.eurpsy.2018.08.006
Gao, X. (2023). Academic stress and academic burnout in adolescents: A moderated mediating model. Frontiers in Psychology, 14, Article 1133706. https://doi.org/10.3389/fpsyg.2023.1133706
Hwang, E., & Kim, J. (2022). Factors affecting academic burnout of nursing students according to clinical practice experience. BMC Medical Education, 22(1), 346. https://doi.org/10.1186/s12909-022-03422-7
Ishak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. A. (2013). Burnout in medical students: A systematic review. The Clinical Teacher, 10(4), 242–245. https://doi.org/10.1111/tct.12014
Lee, S. J., Choi, Y. J., & Chae, H. (2017). The effects of personality traits on academic burnout in Korean medical students. Integrative Medicine Research, 6(2), 207–213. https://doi.org/10.1016/j.imr.2017.03.005https://doi.org/10.3946/kjme.2016.928.1.49
Liu, Y., & Cao, Z. (2022). The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience. Frontiers in Public Health, 10, Article 938132. https://doi.org/10.3389/fpubh.2022.938132
Liu, Z., Xie, Y., Sun, Z., Liu, D., Yin, H., & Shi, L. (2023). Factors associated with academic burnout and its prevalence among university students: A cross-sectional study. BMC Medical Education, 23(1), 317. https://doi.org/10.1186/s12909-023-04316-y
Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311
Nazari, A. M., et al. (2025). Self-compassion, academic stress, and academic self-efficacy among undergraduate nursing students. BMC Medical Education.
Rotenstein, L. S., Ramos, M. A., Torre, M., et al. (2016). Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students. JAMA, 316(21), 2214–2236. https://doi.org/10.1001/jama.2016.17324
Thun-Hohenstein, L., Höbinger-Ablasser, C., Geyerhofer, S., Lampert, K., Schreuer, M., & Fritz, C. (2021). Burnout in medical students. Neuropsychiatrie, 35(1), 17–27. https://doi.org/10.1007/s40211-020-00359-5
Wang, Q., Sun, W., & Wu, H. (2022). Associations between academic burnout, resilience and life satisfaction among medical students: A three-wave longitudinal study. BMC Medical Education, 22(1), 248. https://doi.org/10.1186/s12909-022-03326-6
West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-analysis. The Lancet, 388(10057), 2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X
Xie, F., Qin, Z., Wang, X., Zhang, Y., Zeng, P., & Wang, J. (2019). Academic adaptability and academic burnout among medical students: The mediating role of academic self-efficacy. BMC Medical Education, 19, 264.
Ye, Y., Huang, X., & Liu, Y. (2021). Social support and academic burnout among university students: A moderated mediation model. Psychology Research and Behavior Management, 14, 335–344. https://doi.org/10.2147/PRBM.S300797
Yu, J., & Chae, S. (2020). The mediating effect of resilience on the relationship between academic burnout and psychological well-being of medical students. Korean Journal of Medical Education, 32(1), 13–21. https://doi.org/10.3946/kjme.2020.149
Yuliyanasari, N., et al. (2025). Burnout Among Undergraduate Medical Students and its Associated Factors. Herb-Medicine Journal.
Zhang, J., et al. (2025). The relationship between stress and academic burnout in college students: The mediating role of perceived social support and self-esteem.




