One in nine Japanese emergency physicians shows severe burnout across all three Maslach subscales

One in nine emergency physicians in Japan met the study-defined criteria for severe burnout across all three components of the Maslach Burnout Inventory-Human Services Survey, according to a multicenter cross-sectional questionnaire study published in BMC Emergency Medicine. The survey also found that 30.0% of participants exceeded the cutoff on the Clance Impostor Phenomenon Scale, a proportion the authors describe as broadly similar to figures reported in other studies.

The research was conducted in 34 Japanese emergency departments. Of the physicians invited, 307 emergency physicians took part, representing a participation rate of 70.4%.

The distribution of scores across the three Maslach subscales was uneven. Severe emotional exhaustion was recorded in 64 physicians, or 20.8% of the sample, while 69 physicians, or 22.5%, showed severe depersonalization. In total, 34 physicians, or 11.1%, scored severely across all three components simultaneously.

On the impostor phenomenon measure, 92 physicians, or 30.0% of participants, scored above the established cutoff. The authors note that this proportion appeared broadly similar to that reported in other studies, despite the presence of more severe personal accomplishment scores in their sample. The study was designed to determine the prevalence of burnout and the proportion of Japanese emergency physicians exceeding the impostor phenomenon cutoff, along with the factors associated with these outcomes.

To account for the fact that physicians were clustered within departments, the researchers used mixed-effects logistic regression with a random intercept for each emergency department. This approach allowed them to examine associations between the outcomes and both physician-level and department-level factors while adjusting for the multilevel structure of the data.

The multivariable analysis identified several associations. Severe emotional exhaustion scores were associated with average sleep period, with an odds ratio of 0.708 per unit increase (95% confidence interval, 0.505 to 0.995; P = 0.046), indicating that longer average sleep was linked to lower odds of severe emotional exhaustion. Reduced personal accomplishment scores were associated with younger age, with an odds ratio of 0.971 per year of age (95% confidence interval, 0.946 to 0.998; P = 0.035).

On the Clance Impostor Phenomenon Scale, high scores correlated with younger age as well, with an odds ratio of 0.951 per year (95% confidence interval, 0.917 to 0.985; P = 0.006). Taken together, these findings suggest that younger emergency physicians in the sample were more likely to report both reduced personal accomplishment and higher impostor phenomenon scores, while sleep duration was associated specifically with emotional exhaustion.

The authors caution that these are cross-sectional findings, which cannot establish causal relationships between sleep, age, and burnout or impostor phenomenon scores. The study measured associations at a single point in time among physicians working in 34 Japanese emergency departments, and the reported odds ratios describe statistical associations rather than demonstrated causal effects.

Nevertheless, the authors suggest that the results carry potential implications for emergency department management, such as the importance of attention to sleep opportunities and support for younger emergency physicians. They are careful to note, however, that further evaluation is required before specific recommendations can be made. Both burnout and the impostor phenomenon have previously been reported to negatively affect emergency physicians, which underlines the practical relevance of quantifying how commonly these conditions occur and which factors are associated with them in this workforce.

As an open-access article published on 22 October 2026, the study provides a detailed snapshot of psychological well-being among Japanese emergency physicians.

Subject of Research: Burnout and impostor phenomenon among emergency physicians in Japan

Article Title: Burnout and impostor phenomenon among emergency physicians in Japan: a multicenter cross-sectional study

Article References: Morikawa, M., Uechi, T., Hanaki, N., Goto, Y., Funakoshi, H., Takeuchi, S., Yajima, T., & Sato, N. (2026). Burnout and impostor phenomenon among emergency physicians in Japan: a multicenter cross-sectional study. BMC Emergency Medicine. https://doi.org/10.1186/s12873-026-01824-0

Image Credits: AI Generated

DOI: 10.1186/s12873-026-01824-0

Keywords: burnout, impostor phenomenon, emergency physicians, Japan, cross-sectional study, Maslach Burnout Inventory, emotional exhaustion, depersonalization, personal accomplishment, sleep, mental health, emergency departments