The study, published in BMC Medical Education, recruited 265 residents and fellows between November 2024 and February 2025 using convenience sampling. Participants completed an anonymous questionnaire covering sociodemographic characteristics, physical activity as measured by the short form of the International Physical Activity Questionnaire, fatigue as measured by the Three-Dimensional Work Fatigue Inventory, and burnout as measured by the Maslach Burnout Inventory. The three-dimensional fatigue framework distinguishes physical fatigue, mental fatigue, and emotional fatigue, allowing the researchers to see which dimensions of exhaustion moved together and which did not. Burnout, in turn, was assessed across its classic dimensions of emotional exhaustion, depersonalization, and personal accomplishment.

The statistical signals were strongest for moderate physical activity. In multivariable analyses, moderate activity independently predicted lower physical fatigue (β = −2.388, 95% CI: −3.897 to −0.88), lower mental fatigue (β = −2.425, 95% CI: −3.974 to −0.875), lower emotional fatigue (β = −2.255, 95% CI: −4.04 to −0.47), and lower total fatigue scores (β = −7.068, 95% CI: −11.419 to −2.717), all at p < 0.05. When the researchers turned to burnout odds, the contrast between activity levels was striking. Residents classified as physically active had significantly lower odds of burnout compared with their inactive peers (OR = 0.20, 95% CI: 0.06 to 0.64), meaning their odds were roughly 80 percent lower in this adjusted model. Residents who were only minimally active did not show a statistically significant reduction in burnout odds (OR = 0.52, 95% CI: 0.24 to 1.13), hinting that the protective association may emerge only above a certain activity threshold.

Sitting time told the opposite story, at least partially. Each additional hour of daily sitting was associated with higher physical fatigue (β = 0.544, 95% CI: 0.267 to 0.82), higher mental fatigue (β = 0.354, 95% CI: 0.07 to 0.638), and higher total fatigue (β = 0.972, 95% CI: 0.175 to 1.770), all at p < 0.05. Notably, sitting time was not significantly associated with emotional fatigue, and in the adjusted models it was not significantly linked to burnout odds either. That dissociation is technically interesting: it suggests sedentary time tracks closely with the bodily and cognitive dimensions of tiredness, while the emotional dimension of burnout follows a partly separate statistical pathway.

The correlation structure of the data reinforced that picture. Total fatigue was strongly correlated with emotional exhaustion (r = 0.70, p < 0.001) and moderately correlated with depersonalization (r = 0.542, p < 0.001). In other words, the residents who reported the deepest overall tiredness were also the ones most likely to report feeling drained by their work and detached from the people around them, the two dimensions that define burnout criteria in this study.

The Lebanese context is inseparable from these numbers. The authors note that economic collapse, political instability, and recurring crises have strained the healthcare system and increased stress on trainees, intensifying the demanding schedules that already limit residents’ opportunities to stay active. Against that backdrop, the researchers expected burnout levels to exceed international norms. Instead, they report that burnout patterns among Lebanese trainees were comparable to those reported internationally, which they interpret as a reflection of how widely these pressures affect medical training rather than a uniquely Lebanese pathology.

As with any cross-sectional survey, the direction of the relationship cannot be established from these data alone. It is possible that physical activity protects against fatigue and burnout, but equally possible that exhausted residents simply have less energy and time to exercise, or that unmeasured factors such as workload, rotation type, or personal circumstances influence both activity and burnout simultaneously. Convenience sampling also means the 265 participants may not represent all residents and fellows in Lebanon, and self-reported questionnaires can be influenced by recall and response biases. The authors frame their findings as associations, not causal effects, and call for longitudinal and interventional research to test whether promoting activity actually lowers burnout in this population.

What the study does establish is a measurable pattern in a population that is rarely surveyed under these conditions. Burnout and fatigue are major concerns among medical residents because they affect well-being, performance, and patient safety, and physical activity is known to improve mental health and reduce stress and fatigue. By documenting that physically active trainees in Lebanon carried markedly lower burnout odds while more sedentary trainees reported greater physical and mental tiredness, the survey adds a data point from a country whose healthcare workforce has been tested by years of overlapping crises. The authors conclude that promoting physical activity alongside institutional wellness initiatives, structured reforms, and supportive work environments should be prioritized to sustain physicians’ well-being and preserve the quality of healthcare delivery, while acknowledging that activity programs alone cannot substitute for the structural changes that shape how much rest and exercise trainees can realistically achieve.

Subject of Research: Physical Activity and Burnout Among Medical Residents in Lebanon

Article Title: Physical activity and its relationship with burnout and fatigue among medical residents and fellows in Lebanon: a multicenter cross-sectional study

Article References: Salame, G., Mahfouz, P., El Kahwaji, C., Cherfane, M., Azar, J., Aoun Bahous, S., & Matar, M. (2026). Physical activity and its relationship with burnout and fatigue among medical residents and fellows in Lebanon: a multicenter cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10292-w

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10292-w

Keywords: Physical, activity, relationship, burnout, fatigue, medical, residents, fellows, Lebanon, multicenter, cross-sectional, scientific research