ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2026
Emergency physician burnout and attrition in Canada: a longitudinal study.
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1 citing paper in PubMed.
- How to stop Canada's emergency physicians from leaving their profession.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
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Authors and funding
14 authors.
Kerstin de WitDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa. kerstin.dewit@queensu.ca.
Jasmeet BenepalDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Arani SivakumarDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Natasha ClaytonDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Louise C F RangDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Susan A BartelsDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Rodrick K LimDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Patrick M ArchambaultDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Teresa M ChanDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Sara GrayDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Kerri RitchieDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Caroline Gérin-LajoieDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Mathew MercuriDepartment of Emergency Medicine (de Wit, Clayton, Rang, Bartels), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit, Chan, Mercuri), Department of Medicine, McMaster University, Hamilton, Ont.; School of Medicine (Benepal), Queen's University, Kingston, Ont.; Schulich School of Medicine and Dentistry (Sivakumar), Western University, London, Ont.; Emergency Department (Clayton), Hamilton Health Sciences, Hamilton, Ont.; Department of Pediatrics and Medicine (Lim), Western University, London, Ont.; Department of Family and Emergency Medicine (Archambault), Université Laval, Que.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; McMaster Education Research, Innovation, and Theory program (Chan), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; School of Medicine (Chan), Toronto Metropolitan University, Toronto, Ont.; Division of Emergency Medicine (Gray), Department of Medicine, University of Toronto, Toronto, Ont.; People Health and Wellness, and The Ottawa Hospital Research Institute (Ritchie), The Ottawa Hospital; Department of Psychiatry (Gérin-Lajoie), The Ottawa Hospital, Ottawa, Ont.; Canadian Medical Association (Gérin-Lajoie), Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Mercuri, Chan), University of Toronto, Toronto, Ont.; Department of Philosophy (Mercuri), University of Johannesburg, Auckland Park, South Africa.
Network of Canadian Emergency Researchers
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCanadian emergency staff have been dealing with record patient attendances, long wait times, bed blocking, and department overcrowding. We sought to report temporal trends in Canadian emergency physician burnout, and describe the impact of emergency medicine practice on physician well-being.
methodsWe undertook a longitudinal study on Canadian emergency physician wellness that enrolled participants in April 2020. Participants were invited to 3 follow-up surveys in November 2020, September 2022, and January 2025. The primary outcomes were emotional exhaustion, depersonalization, and personal accomplishment scores. We conducted a deductive qualitative thematic analysis of the 2025 survey free-text responses by applying the framework created with our 2022 survey, to identify interconnected themes explaining burnout causes, consequences, and mechanisms that physicians use to stay in the specialty.
resultsThe response rate to the survey was 410/615 (67%) in January 2025, from respondents in all provinces or territories in Canada except Yukon and Nunavut. Of 410 participants, 41 (10%) had left the profession. Among those who remained in emergency medicine and completed the full survey, 69/351 (20%) had taken time off emergency medicine and 170/351 (48%) had reduced their clinical hours in emergency medicine. In total, 229/351 (65%) scored either high emotional exhaustion, high depersonalization, or both. Burnout levels in 2020, 2022, and 2025 remained unchanged. Respondents pointed to a broken health care system, unrealistic societal expectations, and insurmountable workplace challenges as reasons for burnout. The consequences were physician distress and leaving the profession. Mechanisms to continue in emergency medicine were reducing work hours, modifying work roles, and changing health care institutions.
interpretationEmergency physician burnout remains high, with almost half of respondents having reduced their work hours, and 10% having left the profession. Provincial, regional, and institutional health care leaders could reduce emergency physician burnout by following EM:POWER recommendations and instituting work models that facilitate reducing clinical hours and taking time away from emergency medicine when needed.
Indexed as
Burnout, ProfessionalEmergency MedicinePhysiciansAdultCanadaDepersonalizationEmotional ExhaustionFemaleHumansJob SatisfactionLongitudinal StudiesMaleMiddle AgedSurveys and Questionnaires
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