{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:24:52Z","timestamp":1780410292505,"version":"3.54.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Physician burnout has reached crisis proportions despite increasingly competitive medical school admissions, suggesting that academic selection alone may not protect career sustainability. This report examines which baseline characteristics predict and which fail to predict long-term physician wellbeing.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We report findings from a 25-year research programme at the Medical University of Gda\u0144sk, Poland, comprising one longitudinal and two cross-sectional studies. The longitudinal study tracked the 1999 admission cohort (\n n<\/jats:italic>\n \u202f=\u202f320) through 6\u202fyears of medical education and 4\u202fyears post-graduation (\n n<\/jats:italic>\n \u202f=\u202f54). Baseline measures included academic achievement, sense of coherence (SOC-29), depression (MMPI-D), anxiety (STAI), and coping strategies (CRI). Post-graduation outcomes included licensing-examination performance (\n n<\/jats:italic>\n \u202f=\u202f268), career satisfaction, burnout (MBI), and quality of life. Two cross-sectional surveys (\n n<\/jats:italic>\n \u202f=\u202f566;\n n<\/jats:italic>\n \u202f=\u202f334) examined fatigue, motivation, resilience, and satisfaction.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Academic achievement during medical school predicted licensing-examination performance [\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.21,\n F<\/jats:italic>\n (6,270)\u202f=\u202f11.95,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001] but did not predict career satisfaction (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.01, ns), burnout (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.01, ns), or quality of life (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.01\u20130.21, mostly ns). In contrast, sense of coherence at admission accounted for substantial variance in career satisfaction (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.40,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), general wellbeing (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.88,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01), and life satisfaction (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.40,\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). Cluster analysis identified three post-graduation profiles, labelled \u201cCommitted,\u201d \u201cClever,\u201d and \u201cBright,\u201d differentiated by sense of coherence and coping rather than by academic achievement [\n F<\/jats:italic>\n (2,47)\u202f=\u202f20.18,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001 for satisfaction,\n \n \u03b7\n 2<\/jats:sup>\n <\/jats:italic>\n \u202f=\u202f0.46]. The most academically successful graduates (\u201cBright\u201d) reported the lowest income and lowest life satisfaction, while the least academically successful (\u201cClever\u201d) reported the highest. Cross-sectional surveys revealed peak study-related stress at year four (transition to clinical training) and progressive erosion of intrinsic motivation across training stages.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Cognitive admission metrics efficiently identify students capable of mastering medical content but do not predict, and may not protect against, burnout, dissatisfaction, or impaired quality of life. We argue for reframing physician burnout as a modifiable occupational hazard and redirecting investment from selection toward resilience-building throughout medical education.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1836438","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:49:02Z","timestamp":1780408142000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Why academic selection fails to protect against physician burnout: a brief research report from a 25-year longitudinal programme"],"prefix":"10.3389","volume":"14","author":[{"given":"Maciej","family":"Walkiewicz","sequence":"first","affiliation":[{"name":"Department of Psychology, Medical University of Gda\u0144sk","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1136\/bmj.324.7343.952","article-title":"Factors associated with success in medical school: systematic review of the literature","volume":"324","author":"Ferguson","year":"2002","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.3109\/0142159X.2014.993600","article-title":"Selecting medical students: an unresolved challenge","volume":"37","author":"Powis","year":"2015","journal-title":"Med Teach"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"171","DOI":"10.2147\/LRA.S240564","article-title":"Burnout in healthcare workers: prevalence, impact and preventative strategies","volume":"13","author":"De Hert","year":"2020","journal-title":"Local Reg Anesth"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.mayocp.2021.11.021","article-title":"Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2020","volume":"97","author":"Shanafelt","year":"2022","journal-title":"Mayo Clin Proc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e070442","DOI":"10.1136\/bmj-2022-070442","article-title":"Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis","volume":"378","author":"Hodkinson","year":"2022","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/00001888-200604000-00009","article-title":"Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students","volume":"81","author":"Dyrbye","year":"2006","journal-title":"Acad Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s12888-023-04751-5","article-title":"Pooled prevalence of depressive symptoms among medical students: an individual participant data meta-analysis","volume":"23","author":"Pacheco","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1001\/jama.2016.17324","article-title":"Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis","volume":"316","author":"Rotenstein","year":"2016","journal-title":"JAMA"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0226361","DOI":"10.1371\/journal.pone.0226361","article-title":"Suicide among physicians and health-care workers: a systematic review and meta-analysis","volume":"14","author":"Dutheil","year":"2019","journal-title":"PLoS One"},{"key":"ref10","volume-title":"The Complexities of Physician Supply and Demand: Projections From 2021 to 2036","year":"2024"},{"key":"ref11","volume-title":"Taking action against Clinician Burnout: A Systems Approach to Professional Well-Being","year":"2019"},{"key":"ref12","volume-title":"Identifying Best Practice in the Selection of Medical Students (Literature Review and Interview Survey)","author":"Cleland","year":"2012"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s10459-016-9715-4","article-title":"Do personality traits assessed on medical school admission predict exit performance? 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