Determinants of stress on resident physicians: systematic review and meta-synthesis


  • Ricky Cik Kohar Department of Neurology, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
  • Junita Maja Pertiwi Department of Neurology, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
  • Finny Warouw Department of Neurology, Sam Ratulangi University, Manado, North Sulawesi, Indonesia



Determinant, Resident physician, Stress, Burnout


Stress/burnout on resident physicians is common. Various determinants can be related to resident stress. This systematic review was conducted to determine how situational, personal, or professional determinants influence resident stress. We identified an English and Indonesia articles using online database including PubMed, Wiley Online Library, Google Scholar, Garba Rujukan Digital (GARUDA), and manually searching bibliographies of the included studies from January 01, 2001 until April 30, 2021. Three main search terms included are resident physician, determinant, and stress/burnout. Study selection included was peer-reviewed literatures of observational studies that discuss about stress determinants on residents from various year of training and medical specialties. Methodological quality of studies was assessed using Newcastle-Ottawa Scale adopted for cross-sectional studies. Data extraction conducted by 3 authors. All pooled synthesis were summarized based on narrative methods. Fifty-three cross-sectional, 1 prospective, and 1 combination of cross-sectional and longitudinal studies meet our inclusion criteria (n=29.031). Fifty-one percent are male, and the average age of the participants was 29 years old. The most stress/burnout validated tool used are Maslach Burnout Inventory. The average quality of study was moderate for cross-sectional studies. The main identified determinant was situational, the second was personal, and the latter was professional. The most stressor identified was ‘excessive working time per week, includes night shift, on-call, work on day off, and rotation more than 24 hours.’ Stress/burnout on residents closely related mainly to situational, followed by personal, and less by professional determinants. There was needed for an intervention to the educational program from institution in the future for better accomplishment.


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How to Cite

Kohar, R. C., Pertiwi, J. M., & Warouw, F. (2021). Determinants of stress on resident physicians: systematic review and meta-synthesis. International Journal of Research in Medical Sciences, 9(12), 3665–3675.



Systematic Reviews