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, an emergency physician of 22 years and researcher 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. The researchers reported that burnout levels were statistically unchanged from the height of the pandemic in November 2020, a finding they say should put to rest any assumption that burnout was a temporary, pandemic-era phenomenon.
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. Under supported. No end in sight," wrote one respondent. Another described the toll on their professional identity: "I feel like I am running on empty."
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. Unlike the study's 2022 survey wave, researchers found almost no references to depression or emotional instability among 2025 respondents. Instead, exhaustion, moral distress, and detachment emerged as the dominant themes, alongside a new emphasis on 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. They point to the Canadian Association of Emergency Physicians' EM:POWER initiative, which calls for scheduling models, staffing supports, and administrative changes that give physicians more control over their workload, as one avenue for provincial, regional, and institutional leaders to act on. 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.
