Our CME/CPD Programs

​Overview of Burnout

Burnout is a syndrome characterized by emotional exhaustion, depersonalization and  cynicism, and a reduced sense of personal/professional accomplishment that arises primarily from chronic occupational stress (Maslach & Leiter, 2016; Panagioti et al., 2017). Burnout is specifically linked to workplace factors and is classified as an occupational phenomenon rather than a medical disorder (Harvey et al., 2021; World Health Organization, 2019). 

​

Neurobiological Impacts

Neurobiological studies reveal distinct structural and functional brain changes in individuals experiencing burnout. MRI results show changes in brain regions involved in stress regulation and executive function (Arnsten & Shanafelt, 2021; Chmiel & Kurpas, 2025; Guille & Sen, 2024; Panagioti et al., 2017). Studies consistently demonstrate amygdala enlargement (especially in women), gray matter loss in the dorsolateral and ventromedial prefrontal cortex, and striatal caudate-putamen atrophy, with hippocampal volume typically unaffected, distinguishing burnout from depression and PTSD, which often involve hippocampal changes (Chmiel & Kurpas, 2025). Functional MRI and EEG studies show fronto-cortical hyperactivation, weakened amygdala–anterior cingulate cortex coupling, and fragmentation of rich-club networks (disruption of highly interconnected brain hubs that are critical for efficient global communication and integration across the brain), indicating compensatory executive overdrive and global inefficiency (Arnsten & Shanafelt, 2021; Chmiel & Kurpas, 2025; Chmiel & Malinowska, 2025; Shang et al., 2022). 

 

Impact on Individuals, Patients, and the Field

In the medical field, burnout has profound impacts on physicians, patients, healthcare organizations, and the greater field of healthcare. For physicians themselves, burnout is associated with increased risk of depression, substance misuse, suicide, and physical health problems (Harvey et al., 2021; Salvagioni et al., 2017). Patients are impacted as physician burnout is linked to increased medical errors, lower quality of care, poor adherence to guidelines, impaired communication, and adverse outcomes (Hodkinson et al., 2022; McClafferty et al., 2022; Panagioti et al., 2017). At an organizational level, burnout undermines organizational culture, increases absenteeism and turnover, and drives up costs related to recruitment and lost productivity (McClafferty et al., 2022; Panagioti et al., 2017; Zhang et al., 2020). The field of healthcare is affected as burnout leads to disengagement, reduced productivity, and early retirement, contributing to workforce shortages (Hodkinson et al., 2022; McClafferty et al., 2022). 

 

Types of Interventions

Interventions to reduce burnout fall into two main categories: systemic/organizational and individual. Systemic and organization-level interventions are needed because the primary drivers of physician burnout stem directly from workplace and organizational factors. Interventions targeting these factors have demonstrated a greater impact on reducing burnout than individual-focused strategies alone (Harvey et al., 2021; Panagioti et al., 2017; West et al., 2018). However, while individual-level interventions generally yield smaller effects, they remain valuable components of a comprehensive approach, as they produce modest but significant improvements in well-being (Harvey et al., 2021; West et al., 2018; West et al., 2016; Dyrbye et al., 2019). Research suggests that bundled, multifaceted strategies—combining both systemic/organizational and individual approaches—are most effective (West et al., 2016).

 

Our Approach

In our CME/CPD programs, we cover both types of interventions: systemic/organizational and individual, and we give participants strategies they can use to take action at both levels. Our primary focus, however, is on individual-level strategies, as these are typically easier to implement and require action only from the individual.

 

The systemic and organizational interventions we include are the ones shown by research to have the greatest impact on burnout. These approaches can be used by frontline clinicians to advocate for workplace changes or by physician leaders seeking to implement organization-wide improvements.

 

The individual-level strategies we include go beyond standard approaches, which typically focus on mindfulness, cognitive behavioral therapy (CBT), and stress management skills training. We recognize that participants are likely to already be familiar with these methods, so we introduce less conventional techniques that have been shown by research to positively modulate autonomic, neuroendocrine, immune, and brain-body pathways. Our goal is to offer more innovative strategies that are effective, accessible, and practical, and allow participants to achieve meaningful, lasting change.

References

 

Arnsten, A. F. T., & Shanafelt, T. (2021). Physician distress and burnout: The neurobiological perspective. Mayo Clinic Proceedings, 96(3), 763–769. https://doi.org/10.1016/j.mayocp.2020.12.027

 

Chmiel, J., & Kurpas, D. (2025). Burnout and the brain—a mechanistic review of magnetic resonance imaging (MRI) studies. International Journal of Molecular Sciences, 26(17), 8379. https://doi.org/10.3390/ijms26178379

 

Chmiel, J., & Malinowska, A. (2025). Neural correlates of burnout syndrome based on electroencephalography (EEG)—A mechanistic review and discussion of burnout syndrome cognitive bias theory. Journal of Clinical Medicine, 14(15), 5357. https://doi.org/10.3390/jcm14155357

 

Dyrbye, L. N., Shanafelt, T. D., Gill, P. R., Satele, D. V., & West, C. P. (2019). Effect of a professional coaching intervention on the well-being and distress of physicians: A pilot randomized clinical trial. JAMA Internal Medicine, 179(10), 1406–1414. https://doi.org/10.1001/jamainternmed.2019.2425

 

Guille, C., & Sen, S. (2024). Burnout, depression, and diminished well-being among physicians. The New England Journal of Medicine, 391(16), 1519–1527. https://doi.org/10.1056/NEJMra2302878

 

Harvey, S. B., Epstein, R. M., Glozier, N., et al. (2021). Mental illness and suicide among physicians. The Lancet, 398(10303), 920–930. https://doi.org/10.1016/S0140-6736(21)01596-8

 

Hodkinson, A., Zhou, A., Johnson, J., et al. (2022). Associations of physician burnout with career engagement and quality of patient care: Systematic review and meta-analysis. BMJ, 378, e070442. https://doi.org/10.1136/bmj-2022-070442

 

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

 

McClafferty, H. H., Hubbard, D. K., Foradori, D., et al. (2022). Physician health and wellness. Pediatrics, 150(5), e2022059665. https://doi.org/10.1542/peds.2022-059665

 

Panagioti, M., Panagopoulou, E., Bower, P., et al. (2017). Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Internal Medicine, 177(2), 195–205. https://doi.org/10.1001/jamainternmed.2016.7674

 

Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., et al. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781

 

Shang, Y., Yang, Y., Zheng, G., et al. (2022). Aberrant functional network topology and effective connectivity in burnout syndrome. Clinical Neurophysiology, 138, 163–172. https://doi.org/10.1016/j.clinph.2022.03.014

 

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

 

West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: Contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529. https://doi.org/10.1111/joim.12752

 

World Health Organization. (2019). Burn-out an “occupational phenomenon”: International classification of diseases. https://www.who.int/mental_health/evidence/burn-out/en/

 

Zhang, X. J., Song, Y., Jiang, T., Ding, N., & Shi, T. Y. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26), e20992. https://doi.org/10.1097/MD.0000000000020992