A new CMAJ study links persistently high burnout among Canadian emergency physicians to patient safety and workforce attrition risks
Nearly two-thirds of Canadian emergency physicians reported high burnout in January 2025, according to a longitudinal study published July 27, 2026, in the Canadian Medical Association Journal (CMAJ). One in ten respondents had left emergency medicine entirely, and nearly half had reduced their clinical hours since the start of the COVID-19 pandemic, the study found.
Burnout levels unchanged since pandemic peak
The study was led by Dr. Kerstin de Wit, a Canada Research Chair and professor of emergency medicine at Queen's University in Kingston, Ontario, on behalf of the Network of Canadian Emergency Researchers. It followed a cohort of 615 emergency physicians enrolled across every Canadian province and territory except Yukon, beginning in April 2020, near the outset of the pandemic. Participants completed follow-up surveys in November 2020, September 2022, and January 2025, using the Maslach Burnout Inventory (MBI), a standardized tool that measures burnout across three dimensions: emotional exhaustion, depersonalization, and personal accomplishment.
Of the 410 physicians who responded to the January 2025 survey, a response rate of 66.7 per cent, 351 completed the full MBI. According to the study, 163 respondents, or 46.4 per cent, reported high emotional exhaustion, and 193 respondents, or 55 per cent, reported high depersonalization. In total, 229 respondents, or 65.2 per cent, met the threshold for high burnout on at least one measure. Researchers found burnout levels were statistically unchanged from the height of the pandemic in November 2020. Dr. de Wit told Canadian Occupational Safety the pattern predates COVID-19 entirely. "I don't think what we're experiencing now relates to the pandemic, and it would have happened whether we had the pandemic or not," she said, noting overcrowding in emergency departments was already visible in 2016 and 2017.
Workforce attrition and reduced hours
Beyond the burnout scores, the study points to a workforce retention problem. Of the 410 respondents, 41 physicians, or 10 per cent, said they had left emergency medicine altogether: 10 had retired, 25 had moved to a different clinical specialty, and six had left clinical medicine entirely, the study reported. Among those still practising, 170 respondents, or 48.4 per cent, said they had reduced their clinical hours in emergency medicine since before the pandemic.
The researchers also found that women physicians reported significantly higher emotional exhaustion and lower personal accomplishment scores than their male colleagues, even after adjusting for age and reduced shift schedules. Physicians who had cut back their clinical hours reported worse emotional exhaustion scores than those who had not, a pattern the study's authors describe as concerning because it suggests reducing hours may be a symptom of burnout rather than a lasting fix.
What is driving the burnout?
A qualitative analysis of open-ended survey responses, completed by 187 of the 351 respondents, pointed to a broken health care system, an increasingly demanding workplace, and what the study calls unrealistic societal expectations of emergency physicians. "This continues to be brutal. Under resourced. Undersupported. No end in sight," wrote one respondent. Another described the toll on their professional identity: "I feel like I am running on empty."
Dr. de Wit, who still practises emergency medicine, said the findings mirror her own experience on shift. "We're working much harder. The pressures are much, much greater on every shift. We're just exhausted," she said.
Several respondents said patients increasingly expect emergency departments to resolve issues outside their scope of practice, including social and primary care needs. "I cannot be all things to all people," one physician wrote. Exhaustion, moral distress, and detachment emerged as the dominant qualitative themes, alongside coping strategies such as setting boundaries and reducing shift loads.
Calls for system-level change
The study's authors argue physician burnout is more than an individual wellness issue, describing it as a patient safety risk that runs counter to the health system's own quality and access goals. Dr. de Wit said many physicians who wanted to leave the specialty had come to feel their warnings were being ignored. "Many of the participants had given up trying to tell people about how bad things were going to hospital executives. Some went to politicians. They just felt they were being ignored," she said. The recommendations echo broader conversations happening across our coverage of workplace mental health support strategies for employers, where reducing chronic occupational stress has become a growing priority for safety leaders outside health care as well.
The authors add that burnout among younger physicians carries a stronger association with patient safety incidents than burnout among more senior colleagues, which they say adds urgency to efforts described in our reporting on healthcare sector staffing shortages across Canada.
The findings align with the Canadian Medical Association's 2025 National Physician Health Survey, which similarly found emergency physicians reporting higher-than-average burnout scores relative to other specialties. The study's authors acknowledge limitations common to survey research, including responder bias, and note that not everyone who enrolled in 2020 completed the 2025 survey.
