Effects of exercise interventions on depressive symptoms in perimenopausal women in China: a systematic review and meta-analysis.

Over the past decade, there has been an increasing prevalence and publicity of concern on physician well-being and burnout internationally (). Physician burnout is a long-term stress reaction characterized by depersonalization, including cynical or negative attitudes toward patients, emotional exhaustion, a sense of decreased personal achievement, and a lack of empathy for patients (). Burnout is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon, arising from chronic exposure to occupational stressors. Physician burnout has been associated with negative personal, clinical, and organizational consequences and outcomes (). Physician burnout has been reported to be associated with reduced job satisfaction and physical health consequences such as cardiovascular risks, mental health issues, prolonged fatigue, and even occupational injuries (, ). One of the major concerns is the impact on the safety and quality of patient care. It has been widely reported that burnout is associated with higher patient safety incidents, poorer doctor-patient relations and higher patient dissatisfaction (, ). Burnout is also a significant factor associated with physician attrition (). Coupled with the increasing complexity of patients and societal expectations, Obstetrics and Gynaecology (OB-GYN) is notorious for high levels of physician burnout and trainee attrition due to the demanding nature of their profession (). In a National Survey the United States of more than 9,000 physicians in over 29 specialties (), 49% of physicians reported they were burned out and OB-GYN was ranked 2nd in the highest rate among specialties. According to a Royal College of Obstetricians and Gynaecologists report (), attrition rates amongst trainees are approaching 30%- one the highest in any specialty.