Burnout syndrome among medical residents in a tertiary hospital in Latin America: a mixed-methods cross-sectional study of structural and cultural factors

Background Burnout syndrome is a major concern in postgraduate medical training, particularly in hierarchical, high-demand clinical environments. Evidence from Latin American private teaching hospitals remains limited. Objective To determine the prevalence and associated factors of burnout among medical residents in a tertiary hospital in Ecuador and to explore residents’ lived experiences through qualitative interviews. Methods A convergent mixed-methods design was used among 69 medical residents at a tertiary teaching hospital in Latin America. Burnout was assessed using the Maslach Burnout Inventory (MBI-HSS). Classic burnout was defined as high emotional exhaustion, high depersonalization, and low personal accomplishment. Multivariable logistic regression was used to explore associated factors. Additionally, semi-structured interviews were conducted with residents across specialties and training years to explore perceptions of training culture, workload, gender dynamics, and work–personal time balance. Qualitative data were analyzed using thematic analysis. Results The prevalence of classic burnout was 37.7%. High EE was observed in 60.9%, high DP in 47.8%, and low RP in 65.2%. No statistically significant associations were found between burnout and age, sex, marital status, or specialty after adjustment. Qualitative findings identified first-year residency as a critical vulnerability period and highlighted hierarchical culture, workload intensity, and perceived misalignment between institutional expectations and lived training experience as central stressors. Conclusions Burnout among residents in this setting reflects structural and cultural dimensions of medical training rather than individual sociodemographic characteristics. Institutional interventions targeting formative culture and workload organization are warranted.