Compassion Fatigue in Medical Students and Recent Medical Graduates: A Scoping Review.

Abstract

Phenomenon: Compassion fatigue (CF) manifests as profound exhaustion not relieved by sleep, empathy loss leading to depersonalized patient interactions, ineffective coping, inability to function, emotional overwhelm, and reduced self-care. Documentation of the experience of CF among medical students and recent medical graduates is beginning to appear in the literature, yet our understanding of the extent of its occurrence, its personal impact, and impact on patient care is currently rudimentary. The objective of this scoping review is to identify the extent and type of evidence on CF among medical students and recent medical graduates, review definitions, current terminology, associated factors, and knowledge gaps. Approach: This scoping review used the Joanna Briggs Institute (JBI) methodology for scoping reviews. We systematically searched the electronic databases MEDLINE, Embase, PsycINFO, CINAHL, and Scopus for eligible studies published between 1992 and 2025. Our inclusion criteria included the occurrence of burnout and secondary traumatic stress (STS) or equivalent terms in medical trainees. Medical trainees included medical students studying at university and recent medical graduates within two years of graduation, working under supervision at clinical institutions. We excluded more senior doctors, two years post-graduation and above. We searched electronic databases and extracted data from studies using Microsoft Excel. A narrative summary of the results is presented. Findings: Fifteen papers met the inclusion criteria. The data indicated emerging literature on CF among medical trainees. Inconsistencies in terminology confound CF conceptualization. Factors associated with CF include heavy workloads, frustrations with institutional IT systems and administrative processes, and non-supportive work environments. Medical trainees experience stress inherently associated with their professional stage, and our data suggests that recent medical graduates are aware an adverse event could occur due to their high workload. STS, a critical component of CF, was found to be associated with working in critical care, with traumatized individuals, with patients who die in traumatic circumstances, including by suicide, and interacting with distressed families. Knowledge gaps included quantifying CF prevalence among medical trainees and evaluating the efficacy of trauma-informed interventions, particularly those generated by clinical and educational institutional responses. Insights: This review indicates that CF exists among medical trainees, negatively impacts the individual, and has concerning implications for patient care. Further research is needed to determine the prevalence among medical trainees and the efficacy of interventions, in particular institutional responses to mitigate CF. Organizational responses likely may include reducing workloads of medical trainees, simplifying institutional IT systems and processes, screening medical trainees for CF, and providing education on the condition and evidence-based interventions.