Rebuilding wellbeing in public health: a qualitative study of physician burnout and recovery in Canada

Burnout among Canadian public health professionals increased during the COVID-19 pandemic, yet qualitative insights into public health physicians’ experiences are limited. This study explored individual- and systems-level factors influencing burnout among Canadian public health physicians during the COVID-19 pandemic and identified potential strategies to rebuild workforce resilience. A qualitative descriptive study was conducted using semi-structured interviews with 19 Canadian public health physicians and Public Health & Preventive Medicine residents between July and August 2024. Participants were recruited from a 2024 national survey of public health physician leaders and residents. Interviews conducted in English or French via phone or video were transcribed and analyzed using thematic analysis in NVivo 14. Coding followed a primarily deductive approach informed by the interview guide, with inductive codes added as new themes emerged. Burnout was shaped by both individual- and systems-level factors. Individual-level contributors included: 1) knowledge and skills deficiencies; 2) work-related stressors; 3) personal life stressors; 4) disrupted coping strategies; and 5) perceived lack of self-efficacy. Systems-level contributors included: 1) training and development gaps; 2) organizational constraints; 3) external pressures; and 4) effects of visible identity. Mitigating factors at the individual-level included: 1) prior training and work experience; 2) stress management at work; 3) privilege; 4) personal coping and social support; and 5) perceived lack of self-efficacy. Systems-level mitigating factors included: 1) safe workspace; and 2) supportive organizational culture. Participants identified four overarching strategies for addressing burnout: 1) building capacity and resilience; 2) decreasing bureaucracy to improve workflow efficiency; 3) creating healthier and safer work environments; and 4) advocating for recognition and prioritization of public health. Burnout among Canadian public health physicians during the COVID-19 pandemic reflected cumulative system strain, insufficient emergency preparedness, and chronic underinvestment in public health infrastructure. While individual coping and experience offered some protection, sustainable solutions should address the organizational and structural drivers of burnout.