Prevalence and determinants of academic burnout among undergraduates in a traditional Chinese medicine university: a cross-sectional study.

Background: Academic burnout (AB), characterized by emotional exhaustion (EE), cynicism (CY), and reduced academic efficacy (AE) in academic settings, has become a growing concern in higher education. Students in traditional Chinese medicine (TCM) universities face unique challenges due to the demanding curriculum, which integrates both TCM and modern medical knowledge, along with high clinical practice expectations. However, limited data exist on the prevalence and determinants of AB in this population. This study aimed to determine the prevalence and identify the determinants of AB among undergraduates at Guangzhou University of Chinese Medicine (GZUCM). Methods: A cross-sectional study was conducted from 1 March to 31 August 2025. Using convenience sampling, a self-administered questionnaire was distributed to undergraduates at GZUCM. The questionnaire collected demographic information, academic-related characteristics, health-related behaviors, family background, perceived school climate (assessed with the revised Perceived School Climate Scale), and AB (using the the Chinese version of the Maslach Burnout Inventory-Student Survey, MBI-SS). Data were analyzed using SPSSAU (version 26.0). Descriptive statistics were used to summarize participant characteristics. Differences in AB prevalence across characteristics were assessed using Mann-Whitney U test, Chi-square test, or Fisher's exact test. Spearman's correlation analyzed relationships between AB and perceived school climate dimensions. Binary logistic regression (backward LR) identified independent predictors, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) reported. Results: Out of 747 invited undergraduates, 666 completed the questionnaire (response rate 89.29%). The median age was 21 (IQR: 19, 21) years. The median (IQR) scores on the MBI-SS subscales were 17 (12, 20) for EE, 9 (5, 13) for CY, and 25 (22, 29) for AE. The overall prevalence of AB was 20.87%. Among the burnout subdimensions, high EE was present in 63.66% of undergraduates, high CY in 67.57%, and low AE in 37.24%. Factors significantly associated with AB included religious affiliation (aOR = 5.56, 95% CI: 1.93-15.87, Conclusion: This study reveals a notable prevalence (20.87%) of AB among TCM undergraduates, with independent determinants including religious affiliation, pre-university urban residence, irregular daily routine, lower academic ranking, and reduced teacher support. These findings highlight that burnout arises from an interplay of demographic, behavioral, academic, and environmental factors. To address this, we propose four actionable strategies: (a) training faculty to provide supportive mentorship and growth-oriented feedback; (b) integrating mandatory courses on time management and sleep hygiene into the core curriculum; (c) implementing targeted support programs for students with lower academic rankings and those from religious minority backgrounds; and (d) establishing cross-year peer mentoring initiatives. Clinical trial registration: https://www.chictr.org.cn/ identifier ChiCTR2300070050.