{"id":"https://openalex.org/W7220437685","doi":"https://doi.org/10.66021/pakmcr1381","title":"From Service Burden to Burnout: The Protective Role of Supervisory Support Among Internal Medicine Postgraduate Residents in Punjab Teaching Hospitals A Cross-Sectional Survey Running head: Service burden, supervisory support, and burnout in Punjab Intern","display_name":"From Service Burden to Burnout: The Protective Role of Supervisory Support Among Internal Medicine Postgraduate Residents in Punjab Teaching Hospitals A Cross-Sectional Survey Running head: Service burden, supervisory support, and burnout in Punjab Intern","publication_year":2026,"publication_date":"2026-06-21","ids":{"openalex":"https://openalex.org/W7220437685","doi":"https://doi.org/10.66021/pakmcr1381"},"language":"en","primary_location":{"id":"pmh:oai:ojs2.pakjmcr.com:article/1381","doi":"https://doi.org/10.66021/pakmcr1381","is_oa":true,"landing_page_url":"https://pakjmcr.com/index.php/1/article/view/1381","pdf_url":"https://pakjmcr.com/index.php/1/article/download/1381/1341","source":{"id":"https://openalex.org/S5407043329","display_name":"Pakistan Journal of Medical & Cardiological Review","issn_l":"3007-2379","issn":["3007-2379","3007-2387"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"3007-2379","raw_type":"info:eu-repo/semantics/article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":[],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://pakjmcr.com/index.php/1/article/download/1381/1341","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5155643961","display_name":"Dr. Qismat Ullah","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Dr. Qismat Ullah","raw_affiliation_strings":["FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157622124","display_name":"Muhammad Tahir Sarfraz Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405261028","display_name":"Bannu Medical College","ror":"https://ror.org/04nfxh820","country_code":"PK","type":"education","lineage":["https://openalex.org/I4405261028"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Dr. Muhammad Nauman khan","raw_affiliation_strings":["FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","institution_ids":[]},{"raw_affiliation_string":"Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan","institution_ids":["https://openalex.org/I4405261028"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113838549","display_name":"Asif Ali Shah","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Dr. Asif Ali Shah","raw_affiliation_strings":["FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157390673","display_name":"Dr. Meshqat Ullah Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405261028","display_name":"Bannu Medical College","ror":"https://ror.org/04nfxh820","country_code":"PK","type":"education","lineage":["https://openalex.org/I4405261028"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Dr. Meshqat Ullah Khan","raw_affiliation_strings":["FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","institution_ids":[]},{"raw_affiliation_string":"Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan","institution_ids":["https://openalex.org/I4405261028"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157560272","display_name":"Dr. Junaid Sarfraz Khan","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Dr. Junaid Sarfraz Khan","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5157622124","display_name":"Muhammad Tahir Sarfraz Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405261028","display_name":"Bannu Medical College","ror":"https://ror.org/04nfxh820","country_code":"PK","type":"education","lineage":["https://openalex.org/I4405261028"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Dr. Muhammad Rehan Khan","raw_affiliation_strings":["FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Internal Medicine Trainee , Khalifa Gul Nawaz Teaching Hospital , MTI Bannu , Khyber Pakhtunkhwa , Pakistan","institution_ids":[]},{"raw_affiliation_string":"Fourth-year MBBS Student , Bannu Medical College , Bannu , Pakistan","institution_ids":["https://openalex.org/I4405261028"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10795","display_name":"Healthcare professionals\u2019 stress and burnout","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10795","display_name":"Healthcare professionals\u2019 stress and burnout","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12704","display_name":"Stress and Burnout Research","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/3207","display_name":"Social Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12869","display_name":"Occupational Health and Burnout","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/burnout","display_name":"burnout","score":0.878000020980835},{"id":"https://openalex.org/keywords/supervisory-support","display_name":"supervisor support","score":0.9120000004768372},{"id":"https://openalex.org/keywords/internal-medicine-residents","display_name":"internal medicine residents","score":0.7710000276565552},{"id":"https://openalex.org/keywords/postgraduate-medical-education","display_name":"graduate medical education","score":0.8790000081062317},{"id":"https://openalex.org/keywords/working-hours","display_name":"working hours","score":0.8690000176429749},{"id":"https://openalex.org/keywords/night-duty","display_name":"night duty","score":0.8460000157356262},{"id":"https://openalex.org/keywords/resident-well-being","display_name":"resident well-being","score":0.8209999799728394},{"id":"https://openalex.org/keywords/public-hospitals","display_name":"public hospitals","score":0.7639999985694885}],"concepts":[{"id":"https://openalex.org/C143916079","wikidata":"https://www.wikidata.org/wiki/Q2629248","display_name":"Burnout","level":2,"score":0.8687999844551086},{"id":"https://openalex.org/C2778476105","wikidata":"https://www.wikidata.org/wiki/Q628539","display_name":"Workload","level":2,"score":0.7021999955177307},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5550000071525574},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.527899980545044},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.46700000762939453},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.4449999928474426},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.42399999499320984},{"id":"https://openalex.org/C39896193","wikidata":"https://www.wikidata.org/wiki/Q380344","display_name":"Descriptive statistics","level":2,"score":0.3961000144481659},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.30889999866485596},{"id":"https://openalex.org/C3018898988","wikidata":"https://www.wikidata.org/wiki/Q260732","display_name":"Working hours","level":2,"score":0.2946000099182129},{"id":"https://openalex.org/C2776788475","wikidata":"https://www.wikidata.org/wiki/Q815298","display_name":"Occupational stress","level":2,"score":0.29249998927116394},{"id":"https://openalex.org/C2718322","wikidata":"https://www.wikidata.org/wiki/Q629463","display_name":"Job satisfaction","level":2,"score":0.2874999940395355},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.28600001335144043},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.28060001134872437}],"mesh":[],"locations_count":1,"locations":[{"id":"pmh:oai:ojs2.pakjmcr.com:article/1381","doi":"https://doi.org/10.66021/pakmcr1381","is_oa":true,"landing_page_url":"https://pakjmcr.com/index.php/1/article/view/1381","pdf_url":"https://pakjmcr.com/index.php/1/article/download/1381/1341","source":{"id":"https://openalex.org/S5407043329","display_name":"Pakistan Journal of Medical & Cardiological Review","issn_l":"3007-2379","issn":["3007-2379","3007-2387"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"3007-2379","raw_type":"info:eu-repo/semantics/article"}],"best_oa_location":{"id":"pmh:oai:ojs2.pakjmcr.com:article/1381","doi":"https://doi.org/10.66021/pakmcr1381","is_oa":true,"landing_page_url":"https://pakjmcr.com/index.php/1/article/view/1381","pdf_url":"https://pakjmcr.com/index.php/1/article/download/1381/1341","source":{"id":"https://openalex.org/S5407043329","display_name":"Pakistan Journal of Medical & Cardiological Review","issn_l":"3007-2379","issn":["3007-2379","3007-2387"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"3007-2379","raw_type":"info:eu-repo/semantics/article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.98580002784729,"id":"https://metadata.un.org/sdg/3"},{"display_name":"Decent work and economic growth","score":0.7257999777793884,"id":"https://metadata.un.org/sdg/8"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220437685.pdf","grobid_xml":"https://content.openalex.org/works/W7220437685.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W2010348352","https://openalex.org/W2013578576","https://openalex.org/W2024903253","https://openalex.org/W2127625785","https://openalex.org/W2217463225","https://openalex.org/W2789303506","https://openalex.org/W2794223093","https://openalex.org/W2901297890","https://openalex.org/W3134358105","https://openalex.org/W3171716396","https://openalex.org/W4213284804","https://openalex.org/W4224237084"],"related_works":["https://openalex.org/W7220502180","https://openalex.org/W7166675928","https://openalex.org/W6980353422","https://openalex.org/W2279455625","https://openalex.org/W2333267139","https://openalex.org/W4388540988","https://openalex.org/W7216014112","https://openalex.org/W7117465769","https://openalex.org/W4284975695","https://openalex.org/W4410939554"],"abstract_inverted_index":{"Background:":[0],"Internal":[1,48,73,102,273,313],"Medicine":[2,49,74,103,274,314],"postgraduate":[3,20,75,104,275],"residents":[4,76,105,276],"in":[5,18,37,47,77,106,172,201,277,312],"teaching":[6,79,108,174,279],"hospitals":[7],"carry":[8],"a":[9,89,216,230],"dual":[10],"responsibility:":[11],"providing":[12],"frontline":[13],"clinical":[14],"care":[15],"and":[16,28,58,70,81,115,118,122,141,150,169,183,249,284,309],"engaging":[17],"structured":[19],"training.":[21],"Prolonged":[22],"working":[23,148,178,213,244,282],"hours,":[24,245],"frequent":[25],"night":[26,152,186],"duties,":[27],"limited":[29],"supervisory":[30,86,120,130,206,251,294],"support":[31,87,121,207,228,252,262,295],"may":[32],"raise":[33],"burnout":[34,46,71,123,192,199,220],"risk,":[35],"particularly":[36],"high-volume":[38],"public-sector":[39,285],"hospitals.":[40,109,175,280],"Local":[41],"evidence":[42],"from":[43],"Punjab":[44,78,107,278],"on":[45],"residents,":[50],"viewed":[51],"through":[52],"the":[53,65],"lens":[54],"of":[55,203,257],"service":[56,68,156,260],"burden":[57,69,157],"supervision,":[59],"remains":[60],"limited.":[61],"Objective:":[62],"To":[63],"determine":[64],"association":[66],"between":[67],"among":[72,100,272],"hospitals,":[80],"to":[82],"assess":[83],"whether":[84],"perceived":[85],"plays":[88],"protective":[90],"role.":[91],"Method:":[92],"A":[93],"Google":[94],"Forms-based":[95],"cross-sectional":[96],"survey":[97],"was":[98,162,194,209,264,270,296],"conducted":[99],"340":[101],"The":[110,259],"questionnaire":[111],"gathered":[112],"demographic,":[113],"training,":[114],"workload":[116,307],"data":[117],"measured":[119],"using":[124],"Likert-type":[125],"items":[126,128],"(six":[127],"for":[129,133],"support,":[131],"nine":[132],"burnout).":[134],"Descriptive":[135],"statistics,":[136],"reliability":[137],"analysis,":[138],"Pearson":[139],"correlation,":[140],"multivariable":[142],"linear":[143],"regression":[144],"were":[145,167,180,188,253,287],"performed.":[146],"Weekly":[147,212],"hours":[149,179,214,283],"monthly":[151,185],"duties":[153,187],"served":[154],"as":[155],"indicators.":[158],"Results:":[159],"Mean":[160,176,191,205],"age":[161],"30.05":[163],"(\u00b12.52)":[164],"years;":[165],"53.2%":[166],"male":[168],"77.6%":[170],"worked":[171],"government":[173,246],"weekly":[177],"78.56":[181],"(\u00b110.89)":[182],"mean":[184],"6.56":[189],"(\u00b11.74).":[190],"score":[193,208],"3.03":[195],"(\u00b10.84),":[196],"with":[197,219,289,299],"high":[198],"observed":[200],"32.6%":[202],"residents.":[204],"2.90":[210],"(\u00b10.62).":[211],"showed":[215,229],"positive":[217],"correlation":[218,233],"(r":[221,234],"=":[222,235],"0.23,":[223],"P":[224,237],"<":[225,238],".001).":[226,239],"Supervisory":[227],"moderate-to-strong":[231],"negative":[232],"\u22120.55,":[236],"In":[240],"adjusted":[241],"regression,":[242],"longer":[243],"hospital":[247],"placement,":[248],"lower":[250,300],"significant":[254],"independent":[255],"predictors":[256],"burnout.":[258,301],"burden-by-supervisory":[261],"interaction":[263],"not":[265],"statistically":[266],"significant.":[267],"Conclusions:":[268],"Burnout":[269],"common":[271],"Longer":[281],"placement":[286],"associated":[288,298],"higher":[290],"burnout,":[291],"while":[292],"stronger":[293],"consistently":[297],"Improving":[302],"resident":[303],"well-being":[304],"requires":[305],"both":[306],"review":[308],"strengthened":[310],"supervision":[311],"training":[315],"programmes.":[316]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-10-06T00:00:00"}