How satisfied are doctors at the start of their careers with their work, continuing education, and personal lives? The REST JD Report, published in 2025 by the European Junior Doctors Association (EJD), provides a Europe-wide overview using a standardized methodology. The survey included doctors in specialty training in 26 countries. A total of 6165 responses were received, of which 5831 responses from 19 countries met the specified response rates and were included in the analysis. The participants were 29 years old on average, and 80% were in the first 4 years of their training.

Thirty-two percent of the respondents were dissatisfied or very dissatisfied with their work and professional development. Another 23% were undecided, while 45% described themselves as satisfied or very satisfied. Overall, more than half of the respondents were either dissatisfied or did not express clear satisfaction with their professional situation.

Work-life balance was rated as less favorable. Only 25% of the respondents were satisfied or very satisfied, while 52% reported dissatisfaction, including 13% who were very dissatisfied. The authors identified work-life balance as a key area of concern. According to the report, poor work-life balance was associated with burnout and dropping out of continuing education or the medical profession.

Working Hours

Working hours provide an important context for these findings. Participants reported working an average of 57 hours per week, 17 hours more than the average 40 hours specified in their contracts, and 9 hours above the 48-hour limit under the European Working Time Directive. Overall, 71% of participants exceeded this limit. One fifth worked more than 70 hours per week, and 1 in 10 worked more than 80 hours.

Overtime was part of the routine for 88% of the respondents. Among those who worked longer than specified in their contracts, 69% said that these additional hours were neither paid nor compensated with time off. Long shifts were also common; 62% reported 24-hour shifts, while 70% worked shifts lasting more than 13 hours. Nearly three quarters worked at night, and 18% reported more than seven night shifts in a month.

The analysis showed an association between weekly working hours and satisfaction with work-life balance. At least 60% of physicians working more than 48 hours a week were dissatisfied compared to 26% of those working fewer than 48 hours a week. Above this threshold, the odds of dissatisfaction were significantly higher, with an odds ratio of 4.62 (95% CI, 4.08-5.24).

The cross-country analysis showed a similar pattern. Greece, Malta, Portugal, and Switzerland had longer working hours and reported lower satisfaction, whereas Estonia, Netherlands, and Luxembourg had shorter working hours and reported higher satisfaction. The average weekly working hours ranged from 43 hours in Estonia to 72 hours in Greece. Only two of the 19 countries analyzed had average working hours less than 48 hours.

Working hours also varied according to the specialty. Physicians in surgical specialties worked the longest hours, averaging 62 hours per week. The average duration was 56 hours in clinical disciplines, 52 hours in community-based care, and 50 hours in central services and clinical support areas.

Surgical residents also reported the lowest satisfaction with work-life balance, followed by those in clinical specialties. Satisfaction was somewhat higher among physicians in community-based care, central services, and clinical support areas.

The issue was not limited to the number of hours worked. The survey also identified shortcomings in the break and rest periods. Participants worked shifts of more than 6 hours on an average of 5 days per week but took only short breaks during regular working hours on 2 of those days. They had an average of 6 days off during the month covered by the survey.

Thirty-five percent had not taken the required minimum of 4 weeks of annual leave during the previous year. The rest of the days also varied substantially between countries. Participants in Netherlands, Estonia, and Switzerland reported an average of 8-9 days off per month, compared with 4-5 days in Latvia, Greece, and Malta. Surgical residents had the fewest days off among the specialty groups, averaging 5.4 days.

Broader Consequences

The report links working hours with concerns beyond job satisfaction, including health problems, quality of specialty training, and patient safety. The evidence summarized in the report includes exhaustion, symptoms of depression and anxiety, and burnout. During very long shifts and frequent night shifts, sleep deprivation and fatigue can impair attention, working memory, and clinical decision-making.

Working conditions may also affect continuation of medical education. According to the authors, sleep deprivation, disruption of circadian rhythms, and fatigue can interfere with the learning, concentration, and development of clinical skills. These effects may be particularly relevant in specialties with high workloads and unpredictable schedules, including surgical specialties and critical care.

The EJD, therefore, links working hours not only to residents’ personal well-being but also to the quality of specialty training, patient safety, and whether physicians remain in medicine or their chosen specialty over the long term.

Reforming Working Hours

The EJD calls for structural changes. Hospitals and training centers should gradually phase out 24-hour shifts and limit shifts to a maximum of 13 hours. The association also recommends that work schedules be issued at least 6 weeks in advance and that reliable daily, weekly, and annual rest periods be established.

The EJD also recommends better monitoring of actual workloads. Digital systems should record working and rest periods, track overtime, and ensure that additional hours are compensated. Training should include dedicated time protected from routine clinical duties, along with adequate rest areas and occupational health services.

The report also recommends mental health support and measures to address fatigue-related risks, while urging countries participating in the EJD to strengthen oversight of working time violations and link funding or accreditation of training programs to compliance with working time standards.

This story was translated from Univadis Germany, part of the Medscape Professional Network.