Physical and mental health of medical professionals: a systematic review

Gracino, Mariana Evangelista; Zitta, Ana Laura Lima; Mangili, Otavio Celeste; Massuda, Ely Mitie

doi:10.1590/0103-1104201611019

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REVIEW • Saúde debate 40 (110) • Jul-Sep 2016 • https://doi.org/10.1590/0103-1104201611019 copy

Physical and mental health of medical professionals: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The objective of this systematic literature review was to identify the main diseases that affect physicians worldwide, through an electronic survey in the Virtual Health Library (BVS) database based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) methodology. We analyzed 57 of the 374 scientific papers published on this subject between 2005 and 2015 in English, Portuguese, and Spanish. The findings showed that mental affections prevailed, highlighting the occupational exhaustion (burnout syndrome). Among the physical ailments, musculoskeletal affections prevailed.

KEYWORDS
Occupational diseases; Burnout, professional; Occupational health

Study (authors)	Year	Journal	Country	Language	Method	Short definition
Aldrees et al.ALDREES, T. M. et al. Physician well-being: prevalence of burnout and associated risk factors in a tertiary hospital, Riyadh, Saudi Arabia. Ann Saudi Med, Riade, n. 33, v. 5, p. 451-456, 2013.	2013ALDREES, T. M. et al. Physician well-being: prevalence of burnout and associated risk factors in a tertiary hospital, Riyadh, Saudi Arabia. Ann Saudi Med, Riade, n. 33, v. 5, p. 451-456, 2013.	Annals of Saudi Medicine	India	English	Cross -sectional study	Prevalence of burnout syndrome in physicians of various specializations at a hospital in Saudi Arabia.
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Assunção et al.ASSUNÇÃO, Á. et al. Working conditions and common mental disorders in physicians in Brazil. Occupational Medicine, Oxford, v. 63, n. 3, p. 234-237, 2013.	2013ASSUNÇÃO, Á. et al. Working conditions and common mental disorders in physicians in Brazil. Occupational Medicine, Oxford, v. 63, n. 3, p. 234-237, 2013.	Occupational Medicine	United Kingdom	English	Cross-sectional study	Detects that in Brazil common mental disorders affect more female than male physicians.
Balch et al.BALCH, C. M. et al. Burnout and career satisfaction among surgical oncologists compared with other surgical specialties. Ann Surg Oncol, Nova York, v. 18, n. 1, p. 16-25, 2011.	2011BALCH, C. M. et al. Burnout and career satisfaction among surgical oncologists compared with other surgical specialties. Ann Surg Oncol, Nova York, v. 18, n. 1, p. 16-25, 2011.	Annals of Surgical Oncology	United States	English	Cross-sectional study	Comparative of the incidence of burnout, depression, suicidal ideation, professional satisfaction and quality of life between oncologist surgeons and 14 other surgical specializations.
Bellieni et al.BELLIENI, C. V. et al. Assessing burnout among neonatologists. J Matern Fetal Neonatal Med, Boca Raton, v. 25, n. 10, p. 2130-2134, 2012.	2012BELLIENI, C. V. et al. Assessing burnout among neonatologists. J Matern Fetal Neonatal Med, Boca Raton, v. 25, n. 10, p. 2130-2134, 2012.	Journal of Maternal-Fetal and Neonatal Medicine	United Kingdom	English	Cross-sectional study	Level of professional burnout of neonatologists and its association with suicidal ideation, time in the profession, children, and religion.
Beltrán; MorenoBELTRÁN, C. A.; MORENO, M. P. Factores psicosociales asociados a patologías laborales en médicos de nivel primario de atención en Guadalajara, México. Rev Med Urug (Montev), Montevidéu, v. 23, n. 4, p. 251-259, 2007.	2007BELTRÁN, C. A.; MORENO, M. P. Factores psicosociales asociados a patologías laborales en médicos de nivel primario de atención en Guadalajara, México. Rev Med Urug (Montev), Montevidéu, v. 23, n. 4, p. 251-259, 2007.	Revista Medica del Uruguay	Uruguay	Spanish	Cross-sectional study	Most frequent diseases: musculoskeletal, respiratory, gastrointestinal, and psychological.
Brown; Goske; JohnsonBROWN, S. D.; GOSKE, M. J.; JOHNSON, C. M. Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior. J Am Coll Radiol, Nova York, v. 6, n. 7, p. 479-485, 2009.	2009BROWN, S. D.; GOSKE, M. J.; JOHNSON, C. M. Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior. J Am Coll Radiol, Nova York, v. 6, n. 7, p. 479-485, 2009.	Journal of the American College of Radiology	Holland	English	Bibliographic review	Interference of conditions such as depression, burnout and stress on the disruptive behavior of physicians, jeopardizing the professional practice.
Chen et al.CHEN, K. et al. Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci, Austrália, v. 10, n. 11, p. 1471-1478, 2013.	2013CHEN, K. et al. Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci, Austrália, v. 10, n. 11, p. 1471-1478, 2013.	International Journal of Medical Sciences	Australia	English	Cross-sectional study	Incidence of burnout and its correlation with the dissatisfaction and bad professional practice and alcohol abuse in Taiwan physicians.
Dewa et al.DEWA, C. S. et al. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res, Londres, v. 14, n. 325, p. 1-10, 2014.	2014DEWA, C. S. et al. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res, Londres, v. 14, n. 325, p. 1-10, 2014.	BMC Health Services Research	United Kingdom	English	Systematic review	Incidence of burnout syndrome in five studies and its impact on physicians’ productivity.
Dyrbye et al.DYRBYE, L. N. et al. Physician satisfaction and burnout at different career stages. Mayo Clin Proc, Rochester, v.88, n. 12, p. 1358-1367, 2013.	2013DYRBYE, L. N. et al. Physician satisfaction and burnout at different career stages. Mayo Clin Proc, Rochester, v.88, n. 12, p. 1358-1367, 2013.	Mayo Clinic Proceedings	United Kingdom	English	Cross-sectional study	Incidence of burnout syndrome throughout the career in the various medical specializations in the United States.
Dyrbye et al.DYRBYE, L. N. et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med, Filadélfia, v. 89, n. 3, p. 443-451, 2014.	2014DYRBYE, L. N. et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med, Filadélfia, v. 89, n. 3, p. 443-451, 2014.	Academic Medicine	United States	English	Cross-sectional study	Comparison between the prevalence of occupational exhaustion, depression, suicidal ideation, and fatigue in the different stages of the medical career with the general population in the US.
Escribà-Agüir; Artazcoz; Pérez-HoyosESCRIBÀ-AGÜIR, V.; ARTAZCOZ, L.; PÉREZ-HOYOS, S. Efecto del ambiente psicosocial y de la satisfacción laboral en el síndrome de burnout en médicos especialistas. Gac Sanit, Barcelona, v. 22, n. 4, p. 300-308, 2008.	2008ESCRIBÀ-AGÜIR, V.; ARTAZCOZ, L.; PÉREZ-HOYOS, S. Efecto del ambiente psicosocial y de la satisfacción laboral en el síndrome de burnout en médicos especialistas. Gac Sanit, Barcelona, v. 22, n. 4, p. 300-308, 2008.	Gaceta Sanitária	Spain	Spanish	Cross-sectional study	Interference of psychosocial risk factors and sources of satisfaction at work on the burnout syndrome in physicians of several specializations and stages of the career in Spain
Fogaça; Carvalho; Nogueira-MartinsFOGAÇA, M. C.; CARVALHO, W. B.; NOGUEIRA-MARTINS, L. A. Estudo preliminar sobre a qualidade de vida de médicos e enfermeiros intensivistas pediátricos e neonatais. Rev Esc Enferm USP, São Paulo, v. 44, n. 3, p. 708-712, 2010.	2010FOGAÇA, M. C.; CARVALHO, W. B.; NOGUEIRA-MARTINS, L. A. Estudo preliminar sobre a qualidade de vida de médicos e enfermeiros intensivistas pediátricos e neonatais. Rev Esc Enferm USP, São Paulo, v. 44, n. 3, p. 708-712, 2010.	Revista da Escola de Enfermagem da USP	Brazil	Portuguese	Descriptive study	Detection of low quality of life of intensivist pediatricians and neonatologist physicians.
Galán-Rodas et al.GALÁN-RODAS, E. et al. Salud mental en médicos que realizan el servicio rural, urbano-marginal en salud en el Perú: un estudio de línea base. Rev Peru Med Exp Salud Publica, Lima, v. 28, n. 2, p. 277-281, 2011.	2011GALÁN-RODAS, E. et al. Salud mental en médicos que realizan el servicio rural, urbano-marginal en salud en el Perú: un estudio de línea base. Rev Peru Med Exp Salud Publica, Lima, v. 28, n. 2, p. 277-281, 2011.	Revista Peruana de Medicina Experimental y Salud Pública	Peru	Spanish	Baseline study	Relates depression to lack of logistic and human resources for medical practice.
Gander et al.GANDER, P. et al. A gender-based analysis of work patterns, fatigue, and work/life balance among physicians in postgraduate training. Acad Med, Filadélfia, v. 85, n. 9, p. 1525-1536, 2010.	2010GANDER, P. et al. A gender-based analysis of work patterns, fatigue, and work/life balance among physicians in postgraduate training. Acad Med, Filadélfia, v. 85, n. 9, p. 1525-1536, 2010.	Academic Medicine	United States	English	Cross-sectional study	Physicians in New Zealand described social isolation due to long working hours.
Garcia et al.GARCIA, T. T. et al. Prevalence of burnout in pediatric intensivists: an observational comparison with general pediatricians. Pediatr Crit Care Med, Baltimore, v. 15, n. 8, p. 347-353, 2014.	2014GARCIA, T. T. et al. Prevalence of burnout in pediatric intensivists: an observational comparison with general pediatricians. Pediatr Crit Care Med, Baltimore, v. 15, n. 8, p. 347-353, 2014.	Pediatric Critical Care Medicine	United States	English	Cohort study	Relates the great responsibility over patients’ life to the higher incidence of burnout among Brazilian pediatric intensivists.
Gurman; Klein; WekslerGURMAN, G. M.; KLEIN, M.; WEKSLER, N. Professional stress in anesthesiology: a review. J Clin Monit Comput, Dordrecht, v. 26, n. 4, p. 329-335, 2012.	2012GURMAN, G. M.; KLEIN, M.; WEKSLER, N. Professional stress in anesthesiology: a review. J Clin Monit Comput, Dordrecht, v. 26, n. 4, p. 329-335, 2012.	Journal of Clinical Monitoring and Computing	Holland	English	Bibliographic review	High incidence of burnout among anesthesiologists due to the great responsibility regarding a patient’s safety during surgery.
Harms et al.HARMS, B. A. et al. A 25-year single institution analysis of health, practice, and fate of general surgeons. Ann Surg, Filadélfia, v. 242, n. 4, p. 520-529, 2005.	2005HARMS, B. A. et al. A 25-year single institution analysis of health, practice, and fate of general surgeons. Ann Surg, Filadélfia, v. 242, n. 4, p. 520-529, 2005.	Annals of Surgery	United States	English	Cross-sectional study	Highlights the rate of alcohol dependence among interviewed surgeons.
Lee et al.LEE, R. T. et al. Correlates of physician burnout across regions and specialties: a meta-analysis. Hum Resour Health, Londres, v. 11, n. 48, p. 1-16, 2013.	2013LEE, R. T. et al. Correlates of physician burnout across regions and specialties: a meta-analysis. Hum Resour Health, Londres, v. 11, n. 48, p. 1-16, 2013.	Human Resources for Health	United Kingdom	English	Meta-Analysis	Main factors associated to occupational burnout in several regions and specializations.
Leiter; Frank; MathesonLEITER, M. P.; FRANK, E.; MATHESON, T. J. Demands, values, and burnout. Can Fam Physician, Maryland, v. 55, n. 12, p. 1224-1225, 2009.	2009LEITER, M. P.; FRANK, E.; MATHESON, T. J. Demands, values, and burnout. Can Fam Physician, Maryland, v. 55, n. 12, p. 1224-1225, 2009.	Canadian Family Physician	Canada	English	Cross-sectional study	Influence of high workload and incongruence between personal values and health system on the burnout syndrome in Canadian physicians.
Lim; PintoLIM, R. C. H.; PINTO, C. Work stress, satisfaction and burnout in New Zealand radiologists: Comparison of public hospital and private practice in New Zealand. J Med Imaging Radiat Oncol, Carlton, v. 53, n. 2, p. 194-199, 2009.	2009LIM, R. C. H.; PINTO, C. Work stress, satisfaction and burnout in New Zealand radiologists: Comparison of public hospital and private practice in New Zealand. J Med Imaging Radiat Oncol, Carlton, v. 53, n. 2, p. 194-199, 2009.	Journal of Medical Imaging and Radiation Oncology	United Kingdom	English	Cross-sectional study	Rates of occupational burnout and stress among radiologist physicians practicing in public and private hospitals in New Zealand
Liu et al.LIU, L. et al. The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study. BMC Public Health, Londres, v. 12, n. 219, 2012.	2012LIU, L. et al. The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study. BMC Public Health, Londres, v. 12, n. 219, 2012.	BMC Public Health	United Kingdom	English	Cross-sectional study	Characterizes the exposure to strong physical and emotional demands as generator of internal and external stressors.
Lovseth et al.LOVSETH, L. T. et al. Associations between confidentiality requirements, support seeking and burnout among university hospital hhysicians in Norway, Sweden, Iceland and Italy (the HOUPE study). Stress Health, Chichester, v. 29, n. 5, p. 432-437, 2013.	2013LOVSETH, L. T. et al. Associations between confidentiality requirements, support seeking and burnout among university hospital hhysicians in Norway, Sweden, Iceland and Italy (the HOUPE study). Stress Health, Chichester, v. 29, n. 5, p. 432-437, 2013.	Stress and Health	United States	English	Cross-sectional study	Medical confidentiality as a barrier to seeking emotional support among hospital physicians in Sweden, Norway, Iceland, and Italy, influencing in occupational burnout
Magnavita; FileniMAGNAVITA, N.; FILENI, A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med, Torino, v. 119, n. 5, p. 359-366, 2013.	2013MAGNAVITA, N.; FILENI, A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med, Torino, v. 119, n. 5, p. 359-366, 2013.	Radiologia Medica	Italy	English	Cross-sectional study	Prevalence of depression and anxiety symptoms among radiologist physicians participating in the National Congress of the Italian Society of Medical Radiology.
Magnavita et al.MAGNAVITA, N. et al. Work stress in radiologists: a pilot study. Radiol Med, Torino, v. 113, n. 3, p. 329-346, 2008.	2008MAGNAVITA, N. et al. Work stress in radiologists: a pilot study. Radiol Med, Torino, v. 113, n. 3, p. 329-346, 2008.	Radiologia Médica	Italy	English	Pilot study	Occupational stress and its psychosocial effects on Italian radiologists and radiotherapists
McAbee et alMCABEE, J. H. et al. Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey. J Neurosurg Spine, Charlottesville, v. 123, n. 1, p. 1-13. 2015.	2015MCABEE, J. H. et al. Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey. J Neurosurg Spine, Charlottesville, v. 123, n. 1, p. 1-13. 2015.	Journal of Neurosurgery	United States	English	Cross-sectional study	Rate of burnout syndrome in North American neurosurgeons and its impact on bad medical practices and satisfaction with the career
Misiołek et al.MISIOŁEK, A. et al. The prevalence of burnout syndrome in Polish anaesthesiologists. Anaesthesiol Intensive Ther, Varsóvia, v. 46, n. 3, p. 155-161, 2014.	2014MISIOŁEK, A. et al. The prevalence of burnout syndrome in Polish anaesthesiologists. Anaesthesiol Intensive Ther, Varsóvia, v. 46, n. 3, p. 155-161, 2014.	Anaesthesiology Intensive Therapy	Poland	English	Cross-sectional study	Risk for occupational burnout among physicians practicing in intensive care and pain clinic care departments.
Mendonça; Coelho; JúcaMENDONÇA, V. L. G.; COELHO, J. A. P. M.; JÚCA, M. J. Síndrome de burnout em médicos docentes de uma instituição pública. Psicologia em Pesquisa - UFJF, Juiz de Fora, v. 6, n. 2, p. 90-100, 2012.	2012MENDONÇA, V. L. G.; COELHO, J. A. P. M.; JÚCA, M. J. Síndrome de burnout em médicos docentes de uma instituição pública. Psicologia em Pesquisa - UFJF, Juiz de Fora, v. 6, n. 2, p. 90-100, 2012.	Psicologia em Pesquisa	Brazil	Portuguese	Cross-sectional study	Correlation between stress at work with occupational burnout and fatigue among medical teachers at a Brazilian faculty.
Nishimura et al.NISHIMURA, K. et al. Cross-sectional survey of workload and burnout among japanese physicians working in stroke care - the nationwide survey of acute stroke care capacity for proper designation of comprehensive stroke center in Japan (J-Aspect) study. Circ Cardiovasc Qual Outcomes, Hagerstown, v. 7, n. 3, p. 414-422, 2014.	2014NISHIMURA, K. et al. Cross-sectional survey of workload and burnout among japanese physicians working in stroke care - the nationwide survey of acute stroke care capacity for proper designation of comprehensive stroke center in Japan (J-Aspect) study. Circ Cardiovasc Qual Outcomes, Hagerstown, v. 7, n. 3, p. 414-422, 2014.	Circulation: Cardiovascular Quality and Outcomes	United States	English	Cross-sectional study	Incidence and risk factors for burnout syndrome among Japanese neurologists and neurosurgeons.
Oliveira Júnior et al.OLIVEIRA JÚNIOR, G. S. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg, Cleveland, v. 117, n. 1, p. 182-193, 2013.	2013OLIVEIRA JÚNIOR, G. S. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg, Cleveland, v. 117, n. 1, p. 182-193, 2013.	2013 Anesthesia and analgesia	United States	English	Cross-sectional study	Rate of depression and occupational burnout among medical residents in anesthesiology, correlated with suicidal ideation, drug abuse and medical errors rates.
Opoku; ApentengOPOKU, S. T.; APENTENG, B. A. Career satisfaction and burnout among Ghanaian physicians. Int Health, Oxford, v. 6, n. 1, p. 54-61, 2014.	2014OPOKU, S. T.; APENTENG, B. A. Career satisfaction and burnout among Ghanaian physicians. Int Health, Oxford, v. 6, n. 1, p. 54-61, 2014.	International Health	United Kingdom	English	Cross-sectional study	Factors associated with burnout syndrome and professional satisfaction among physicians in Ghana.
Picard et al.PICARD, J. et al. Burnout, empathy and their relationships: a qualitative study with residents in General Medicine. Psychol Health Med, Abingdon, v. 21, n. 3, p. 354-361, 2015.	2015PICARD, J. et al. Burnout, empathy and their relationships: a qualitative study with residents in General Medicine. Psychol Health Med, Abingdon, v. 21, n. 3, p. 354-361, 2015.	Psychology, Health and Medicine	United Kingdom	English	Cross-sectional study	Relation between empathy and occupational burnout among residents.
Pistelli et al.PISTELLI, Y. et al. Síndrome de desgaste profesional en médicos pediatras - análisis bivariado y multivariado. Arch Argent Pediatr, Buenos Aires, v. 109, n. 2, p. 129-134, 2011.	2011PISTELLI, Y. et al. Síndrome de desgaste profesional en médicos pediatras - análisis bivariado y multivariado. Arch Argent Pediatr, Buenos Aires, v. 109, n. 2, p. 129-134, 2011.	Archivos Argentinos de Pediatria	Argentina	Spanish	Cross-sectional study	Incidence of the professional waste syndrome among residents in pediatrics and pediatricians at a children’s hospital in Argentina
Popa et al.POPA, F. et al. Occupational burnout levels in emergency medicine - a stage 2 nationwide study and analysis. J Med Life, Bucareste, v. 3, n. 4, p. 449-453, 2010.	2010POPA, F. et al. Occupational burnout levels in emergency medicine - a stage 2 nationwide study and analysis. J Med Life, Bucareste, v. 3, n. 4, p. 449-453, 2010.	Journal of Medicine and Life	Romania	English	Cross-sectional study	Causal factors, coping mechanisms and repercussions of occupational burnout and depression among emergency physicians.
Roth et al.ROTH, M. et al. Career burnout among pediatric oncologists. Pediatr Blood Cancer, Hoboken, v. 57, p. 1168-1173, 2011	2011ROTH, M. et al. Career burnout among pediatric oncologists. Pediatr Blood Cancer, Hoboken, v. 57, p. 1168-1173, 2011	Pediatric Blood and Cancer	United States	English	Cross-sectional study	Prevalence of occupational burnout among oncology pediatricians in 13 countries.
RubinRUBIN, R. Recent suicides highlight need to address depression in medical students and residents. JAMA, Chicago, v. 312, n. 17, p. 1725-1727, 2014	2014RUBIN, R. Recent suicides highlight need to address depression in medical students and residents. JAMA, Chicago, v. 312, n. 17, p. 1725-1727, 2014	JAMA - Journal of the American Medical Association	United States	English	Theoretical reflection	Reflection on suicide rates among medical population.
Serralheiro et al.SERRALHEIRO, F. C. et al. Prevalência da síndrome de burnout em anestesiologistas de instituição de ensino superior em medicina. Arquivos Brasileiros de Ciências da Saúde, Santo André, v. 36, n. 3, p. 140-143, 2011	2011SERRALHEIRO, F. C. et al. Prevalência da síndrome de burnout em anestesiologistas de instituição de ensino superior em medicina. Arquivos Brasileiros de Ciências da Saúde, Santo André, v. 36, n. 3, p. 140-143, 2011	Arquivos Brasileiros de Ciências da Saúde	Brazil	Portuguese	Cross-sectional study	Prevalence of burnout syndrome among Brazilian anesthesiologists and its relation with physical activity.
Shanafelt et al.SHANAFELT, T. D. et al. Suicidal ideation among american surgeons. Arch Surg, Chicago, v. 146, n.1, p. 54-62, 2011	2011SHANAFELT, T. D. et al. Suicidal ideation among american surgeons. Arch Surg, Chicago, v. 146, n.1, p. 54-62, 2011	JAMA Surgery	United States	English	Cross-sectional study	Rate of suicidal ideation among North American surgeons and its link with depression, occupational burnout, medical errors, and antidepressant use.
Nascimento Sobrinho et al.NASCIMENTO SOBRINHO, C. L. et al. Condições de trabalho e saúde dos médicos em Salvador, Brasil. Rev Assoc Med Bras, São Paulo, v. 52, n. 2, p. 97-102, 2006.	2006NASCIMENTO SOBRINHO, C. L. et al. Condições de trabalho e saúde dos médicos em Salvador, Brasil. Rev Assoc Med Bras, São Paulo, v. 52, n. 2, p. 97-102, 2006.	Revista da Associação Médica Brasileira	Brazil	Portuguese	Cross-sectional study	Identifies mental tiredness as the most prevalent symptom among Brazilian physicians interviewed.
Stafford; JuddSTAFFORD, L.; JUDD, F. Mental health and occupational wellbeing of Australian gynaecologic oncologists. Gynecol Oncol, Nova York, v. 116, n. 2010, p. 526-532, 2010	2010STAFFORD, L.; JUDD, F. Mental health and occupational wellbeing of Australian gynaecologic oncologists. Gynecol Oncol, Nova York, v. 116, n. 2010, p. 526-532, 2010	Gynecologic Oncology	United States	English	Cross-sectional stud	Prevalence of psychiatric diseases and occupational burnout among oncologist gynecologists in Australia and its influence on professional satisfaction
Taft; Keefer; KeswaniTAFT, T. H.; KEEFER, L.; KESWANI, R. N. Friends, alcohol, and a higher power - an analysis of adaptive and maladaptive coping strategies among gastroenterologists. J Clin Gastroenterol, Nova York, v. 45, n. 8, p. 76-81, 2011	2011TAFT, T. H.; KEEFER, L.; KESWANI, R. N. Friends, alcohol, and a higher power - an analysis of adaptive and maladaptive coping strategies among gastroenterologists. J Clin Gastroenterol, Nova York, v. 45, n. 8, p. 76-81, 2011	Journal of Clinical Gastroenterology	United States	English	Cross-sectional study	Coping strategies among North American gastroenterologists in stressing situations and its relation to burnout
Tomioka et al.TOMIOKA, K. et al. Working hours, occupational stress and depression among physicians. Occupational Medicine, Oxford, v. 61, n. 3, p. 163-170, 2011	2011TOMIOKA, K. et al. Working hours, occupational stress and depression among physicians. Occupational Medicine, Oxford, v. 61, n. 3, p. 163-170, 2011	Occupational Medicine	United Kingdom	English	Cross sectional study	Demonstrates a positive relation between working hours and the prevalence of depression.
Torres et al.TORRES, A. R. et al. Qualidade de vida e saúde física e mental de médicos: uma autoavaliação por egressos da faculdade de medicina de Botucatu - Unesp. Rev Bras Epidemiol, São Paulo, v. 14, n. 2, p. 264-275, 2011	2011TORRES, A. R. et al. Qualidade de vida e saúde física e mental de médicos: uma autoavaliação por egressos da faculdade de medicina de Botucatu - Unesp. Rev Bras Epidemiol, São Paulo, v. 14, n. 2, p. 264-275, 2011	Revista Brasileira de Epidemiologia	Brazil	Portuguese	Cross-sectional study	Self-evaluation of quality of life, professional satisfaction, and physical and mental health by physicians in Brazil.
Wada et al.WADA, K. et al. National survey of the association of depressive symptoms with the number of off duty and on- call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study. BMC Public Health, Oxford, v. 10, n. 127, 2010	2010WADA, K. et al. National survey of the association of depressive symptoms with the number of off duty and on- call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study. BMC Public Health, Oxford, v. 10, n. 127, 2010	BMC Public Health	United Kingdom	English	Cross-sectional study	Relates depressive condition to the number of off duty days among Japanese physicians.
Wang et al.WANG, J. et al. Prevalence and associated factors of depressive symptoms among Chinese doctors: a cross-sectional survey. Int Arch Occup Environ Health, Belim, v. 83, n. 3, p. 905-911, 2010	2010WANG, J. et al. Prevalence and associated factors of depressive symptoms among Chinese doctors: a cross-sectional survey. Int Arch Occup Environ Health, Belim, v. 83, n. 3, p. 905-911, 2010	International Archives of Occupational and Environmental Health	Germany	English	Cross-sectional study	Associates the suffering inherent to the medical profession with the higher rate of depressive symptoms among Chinese physicians than among the general Chinese population.

Study	Year	Journal	Country	Language	Method	Short definition
Auerbach et al.AUERBACH, J. D. et al. Musculoskeletal disorders among spine surgeons. Spine (Phila Pa 1976), Hagerstown, v. 36, n. 26, p. 1715-1721, 2011.	2011AUERBACH, J. D. et al. Musculoskeletal disorders among spine surgeons. Spine (Phila Pa 1976), Hagerstown, v. 36, n. 26, p. 1715-1721, 2011.	Spine	United States	English	Cross-sectional study	Prevalence of musculoskeletal disorders in spine surgeons due to bad ergonomics.
Brennan et al.BRENNAN, P. A. et al. Serum testosterone levels in surgeons during major head and neck cancer surgery: a suppositional study. Br J Oral Maxillofac Surg, Edimburgo, v. 49, n. 3, p. 190-193, 2011.	2011BRENNAN, P. A. et al. Serum testosterone levels in surgeons during major head and neck cancer surgery: a suppositional study. Br J Oral Maxillofac Surg, Edimburgo, v. 49, n. 3, p. 190-193, 2011.	British Journal of Oral and Maxillofacial Surgery	United States	English	Hypothetical study	Elevation of serum testosterone in head and neck surgeons directly proportional to the complexity of the procedure.
Beloyartseva et al.BELOYARTSEVA, M. et al. Widespread vitamin D deficiency among Indian health care professionals. Arch Osteoporos, Londres, n. 7, p. 187-192, 2012.	2012BELOYARTSEVA, M. et al. Widespread vitamin D deficiency among Indian health care professionals. Arch Osteoporos, Londres, n. 7, p. 187-192, 2012.	Archives of Osteoporosis	United Kingdom	English	Cross-sectional study	Proves that 79% of the Indians subjects in the study presented Vitamin D deficiency due to long working hours in environments with no access to sunlight.
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Liang et al.LIANG, B. et al. Ergonomic status of laparoscopic urologic surgery: survey results from 241 urologic surgeons in China. PLoS One, São Francisco, v. 8, n. 7, 2013.	2013LIANG, B. et al. Ergonomic status of laparoscopic urologic surgery: survey results from 241 urologic surgeons in China. PLoS One, São Francisco, v. 8, n. 7, 2013.	PLoS One	United States	English	Cross-sectional study	Frequent musculoskeletal disorders in surgeons due to the emergence of less invasive surgical techniques but ergonomically unfavorable.
Magnavita; FileniMAGNAVITA, N.; FILENI, A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med, Torino, v. 119, n. 5, p. 359-366, 2013.	2014MAGNAVITA, N.; FILENI, A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med, Torino, v. 119, n. 5, p. 359-366, 2013.	Radiologia Médica	Italy	English	Cross-sectional study	Increase on HDL and triglyceride levels and abdominal obesity in radiologists due to occupational stress
Mehrdad; Dennerlein; MorshedizadehMEHRDAD, R.; DENNERLEIN, J. T.; MORSHEDIZADEH, M. Musculoskeletal disorders and ergonomic hazards among iranian physicians. Arch Iran Med, Teerã, v. 15, n. 6, p. 1715-1721, 2012.	2012MEHRDAD, R.; DENNERLEIN, J. T.; MORSHEDIZADEH, M. Musculoskeletal disorders and ergonomic hazards among iranian physicians. Arch Iran Med, Teerã, v. 15, n. 6, p. 1715-1721, 2012.	Archives of Iranian Medicin	Iran	English	Cross-sectional study	Relation between working conditions and ergonomic risks with the main musculoskeletal disorders in clinicians.
Mohseni-Bandpei et al.MOHSENI-BANDPEI, M. A. et al. Prevalence and risk factors associated with low back pain in iranian surgeons. J Manipulative Physiol Ther, Lombard, v. 34, n. 6, p. 362-370, 2011.	2011MOHSENI-BANDPEI, M. A. et al. Prevalence and risk factors associated with low back pain in iranian surgeons. J Manipulative Physiol Ther, Lombard, v. 34, n. 6, p. 362-370, 2011.	Journal of Manipulative and Physiological Therapeutics	United States	English	Cross-sectional study	Influence of low satisfaction with work on the increase of risk from low back pain.
Mrena et al.MRENA, S. et al. Lens opacities among physicians occupationally exposed to ionizing radiation - a pilot study in Finland. Scand J Work Environ Health, Helsínquia, v. 37, n. 3, p. 237-243, 2011.	2011MRENA, S. et al. Lens opacities among physicians occupationally exposed to ionizing radiation - a pilot study in Finland. Scand J Work Environ Health, Helsínquia, v. 37, n. 3, p. 237-243, 2011.	Scandinavian Journal of Work, Environment & Health	Scandinavia	English	Cross-sectional study	Prevalence of opacity in the crystalline and cataract among Finnish physicians
Peters et al.PETERS, C. et al. The occupational risk of Helicobacter pylori infection among gastroenterologists and their assistants. BMC Infectious Diseases, Londres, v. 11, n. 154, 2011.	2011PETERS, C. et al. The occupational risk of Helicobacter pylori infection among gastroenterologists and their assistants. BMC Infectious Diseases, Londres, v. 11, n. 154, 2011.	BMC Infectious Diseases	United Kingdom	English	Systematic review	Higher level of infection by H. pylori in gastroenterologists
Rauchenzauner et al.RAUCHENZAUNER, M. et al. Arrhythmias and increased neuro-endocrine stress response during physicians' night shifts: a randomized cross-over trial. Eur Heart J, Londres, v. 30, p. 2606-2613, 2009.	2009RAUCHENZAUNER, M. et al. Arrhythmias and increased neuro-endocrine stress response during physicians' night shifts: a randomized cross-over trial. Eur Heart J, Londres, v. 30, p. 2606-2613, 2009.	European Heart Journal	United Kingdom	English	Cross-sectional study	Influence of working hours and conditions on cardiovascular health of Austrian physicians.
Ruitenburg; Frings-Dresen; SluiterRUITENBURG, M. M.; FRINGS-DRESENM, H. W; SLUITER, J. K. Physical job demands and related health complaints among surgeons. Int Arch Occup Environ Health, Berlim, v. 86, p. 271-279, 2013	2013RUITENBURG, M. M.; FRINGS-DRESENM, H. W; SLUITER, J. K. Physical job demands and related health complaints among surgeons. Int Arch Occup Environ Health, Berlim, v. 86, p. 271-279, 2013	International Archives of Occupational and Environmental Health	Germany	English	Cross-sectional study	Relates fine movements and relatively static posture of surgeons to physical work-related complaints.

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[1] Collaborators

The authors Ana Laura Lima Zitta and Mariana Evangelista Gracino jointly contributed to the definition of the research theme, the elaboration of the methodology for the scientific project, the selection of articles by means of inclusion and exclusion criteria, and reading the abstracts. Besides this, individually they read the full texts of the selected articles and subsequently discussed them. Afterwards, they wrote the scientific article, comprising introduction, methodology, results, discussion, and conclusion.

The authors Ely Mitie Massuda and Otávio Celeste Mangili guided the thematic delimitation concerning the scientific relevance, helped with the definition of inclusion and exclusion criteria of articles, and with the selection of the database. Moreover, they guided the methodology of the synthesis of the results and made the final revision of the article.