TY - JOUR
T1 - Descriptive analysis of interns' basic psychological needs, burnout and empathy in the COVID-19 pandemic in Ireland
AU - Patterson, Aileen
AU - Brady, Conan
AU - Burke, Elaine
AU - Castello, Stefania
AU - Courtney, Laura
AU - F Curley, Gerard
AU - Donnelly, Suzanne
AU - Hennessy, Martina
AU - McLoughlin, Declan M.
AU - O'Connell, Finbarr
AU - Roberts, T. E.
AU - Ten Cate, Olle
AU - Wald, Hedy
AU - Zgaga, Lina
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
PY - 2026/3
Y1 - 2026/3
N2 - BACKGROUND: The transition from medical student to doctor is recognised as challenging. Interns beginning their first clinical practice during the COVID-19 pandemic faced unprecedented uncertainty with unknown potential consequences for psychological well-being and the ability to practise empathetically. OBJECTIVES: This study investigated the effect of beginning the practice of medicine during the pandemic on the psychological needs, burnout and empathy of intern doctors. DESIGN: A mixed-methods, sequential cross-sectional study design. PARTICIPANTS AND SETTING: The national cohort of intern doctors registered to practise in Ireland between July 2020 and June 2021 across six Intern Training Networks was invited to participate in an online survey and semistructured interviews. RESULTS: Interns reported slightly lower or comparable rates of burnout and emotional exhaustion compared with prepandemic studies. Frustration of interns' autonomy was strongly associated with emotional exhaustion. Higher levels of personal accomplishment were described by interns regularly caring for patients with COVID-19, indicating professional reward from clinical responsibility. Interview analysis revealed five themes describing how interns experienced clinical practice; emotional experience, the need for future reflection, resilience strategies, mitigation measures and preservation of empathy. Protective factors against burnout included initial societal support, team cohesiveness and sharing, and the establishment of an overlap period between outgoing and incoming interns. Postponement of reflection and avoidant strategies employed during the crisis are indicators of future needs of this cohort. CONCLUSIONS: Interns beginning in practice during the pandemic experienced an extremely challenging clinical environment. Our work suggests they met these challenges head-on and retained empathy. Organisational, professional, community and societal responses were critical in supporting them to achieve relatedness and competence satisfaction. Further work is required to better understand autonomy supportive supervision.
AB - BACKGROUND: The transition from medical student to doctor is recognised as challenging. Interns beginning their first clinical practice during the COVID-19 pandemic faced unprecedented uncertainty with unknown potential consequences for psychological well-being and the ability to practise empathetically. OBJECTIVES: This study investigated the effect of beginning the practice of medicine during the pandemic on the psychological needs, burnout and empathy of intern doctors. DESIGN: A mixed-methods, sequential cross-sectional study design. PARTICIPANTS AND SETTING: The national cohort of intern doctors registered to practise in Ireland between July 2020 and June 2021 across six Intern Training Networks was invited to participate in an online survey and semistructured interviews. RESULTS: Interns reported slightly lower or comparable rates of burnout and emotional exhaustion compared with prepandemic studies. Frustration of interns' autonomy was strongly associated with emotional exhaustion. Higher levels of personal accomplishment were described by interns regularly caring for patients with COVID-19, indicating professional reward from clinical responsibility. Interview analysis revealed five themes describing how interns experienced clinical practice; emotional experience, the need for future reflection, resilience strategies, mitigation measures and preservation of empathy. Protective factors against burnout included initial societal support, team cohesiveness and sharing, and the establishment of an overlap period between outgoing and incoming interns. Postponement of reflection and avoidant strategies employed during the crisis are indicators of future needs of this cohort. CONCLUSIONS: Interns beginning in practice during the pandemic experienced an extremely challenging clinical environment. Our work suggests they met these challenges head-on and retained empathy. Organisational, professional, community and societal responses were critical in supporting them to achieve relatedness and competence satisfaction. Further work is required to better understand autonomy supportive supervision.
KW - Burnout
KW - Empathy
KW - MEDICAL EDUCATION & TRAINING
KW - Stress, Psychological
UR - https://www.scopus.com/pages/publications/105034818180
U2 - 10.1136/bmjopen-2025-108611
DO - 10.1136/bmjopen-2025-108611
M3 - Article
C2 - 41916621
AN - SCOPUS:105034818180
SN - 2044-6055
VL - 16
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e108611
ER -