TOPLINE:

Educational debt of over $250,000 was associated with increased burnout symptoms in early-career family physicians. Higher debt correlated with long work hours, which was independently linked to increased symptoms of burnout.

METHODOLOGY:

• Researchers examined the correlation among educational debt, work hours, and burnout symptoms in 4905 early-career family physicians (83.2% of participants younger than 38 years; 57.8% women) in the US.
• Data were collected from two surveys conducted by the American Board of Family Medicine: The Initial Certification Questionnaire (2017-2020), which inquired about educational debt, and the National Graduate Survey (2020-2023), which inquired about practice organization, hours worked, satisfaction, burnout symptoms, and other activities.
• Participants were categorized by levels of educational debt at residency graduation: none; less than $150,000; $150,000-$249,999; $250,000-$350,000; and more than $350,000.
• Burnout symptoms were assessed using responses to questions about feeling burned out and becoming indifferent toward people, with answers indicating weekly or more frequent occurrences.
• Total work hours were categorized as less than 40, 40-49, 50-59, and 60 or more hours per week.

TAKEAWAY:

• Only 17.8% of early-career family physicians had no educational debt, whereas 16.2% had debt exceeding $350,000. Overall, 44.3% had symptoms of burnout.
• Early-career family physicians worked a higher average number of hours per week as their educational debt grew (P = .002). Both educational debt (P = .002) and work hours per week (P < .001) independently correlated with burnout symptoms.
• Physicians with debt of $250,000-$350,000 and those with debt over $350,000 had higher odds of burnout symptoms than those with no debt (adjusted odds ratio [aOR], 1.24; 95% CI, 1.01-1.51 and aOR, 1.47; 95% CI, 1.19-1.82, respectively).
• Physicians who worked 40 or more hours per week had significantly higher odds of burnout symptoms than those who worked less than 40 hours per week, with the odds increasing as work hours rose (aOR, 1.45; 95% CI, 1.22-1.72 for 40-49 hours; aOR, 1.83; 95% CI, 1.54-2.17 for 50-59 hours; and aOR, 2.87; 95% CI, 2.40-3.44 for ≥ 60 hours).

IN PRACTICE: 

“Our findings emphasize that efforts to stem the tide of rising educational debt for physicians may be an important component of addressing the high rates of burnout symptoms among family physicians. Health system leaders, policy makers, and legislators should explore additional ways of reducing this burden on early-career family physicians,” the authors wrote.

SOURCE:

The study was led by Dean A. Seehusen, MD, MPH, of the Medical College of Georgia in Augusta, Georgia. It was published online on September 22, 2025, in Annals of Family Medicine.

LIMITATIONS:

The limited scope of burnout assessment, using only two questions, may lead to inaccurate estimations of burnout prevalence. The focus of the study on early-career family physicians limits the generalizability of findings to other specialties. Unmeasured factors may also contribute to burnout.

DISCLOSURES:

One author declared receiving support from the American Board of Family Medicine Foundation as a visiting scholar. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.