Why Do French MDs Say They’re Less Burned Out Than Others?

A Medscape report has revealed notable discrepancies between global physicians regarding their personal health, mental and physical well-being, burnout, and efforts to achieve and maintain balance in such a demanding profession. 

French clinicians were most likely (88%) and German clinicians (45%) least likely to report that their own health and wellness was “a priority” or “important.” French doctors were also most likely (64%) to report feeling neither depressed nor burned out, well ahead of Canada (55%) and other European countries (Spain, 37%; Germany, 52%). In contrast, more than half of doctors in Argentina (64%) and Brazil (54%) said they were depressed, burned out, or both.

The findings were published in the Medscape International Physician Mental Health & Well-Being Report 2025.

Burnout a Sign of Weakness in France

Commenting on the findings to Medscape Medical News, Ariel Frajerman, MD, PhD, a medical psychiatrist at the Institute of Psychiatry and Neuroscience in Paris, said that these results were likely influenced by cultural factors. “In France, burnout is considered a sign of weakness,” he said, “but it is still better perceived than depression.” 

Frajerman’s team conducted a survey in 2021 that showed that French medical students have a negative image of psychiatry. Simply asking doctors whether they considered themselves to be burnt out or depressed, in the absence of validated tools such as a burnout scale or depression questionnaire, could introduce bias and inaccurate assessments, he suggested. A French doctor will tend to self-censor. In the best-case scenario, they might admit to burnout (but not to depression).

Brazilian Work Conditions Challenging

In contrast, 32% of doctors in Brazil reported feeling burned out, 7% depressed, and 15% both.

The fact that more than half (54%) of Brazilian doctors felt depressed or burned out may be related to professional factors, according to Mauricio Wajngarten, MD, PhD, a cardiologist at the University of São Paulo in Brazil. 

He told Medscape Medical News that recent changes in the supply, training, and work of doctors in Brazil meant that there had been a massive increase in medical courses, without parallel improvement in the quality of medical education. Residency vacancies had not been sufficient to keep up with increased numbers of graduated physicians.

While the density of doctors had increased overall, jobs had been geographically concentrated in large cities, especially Brasília. In contrast, more than 30% of the population of Brazil lives in cities with fewer than 50,000 inhabitants, but these attract only 8% of doctors.

Living in big cities implies a higher cost of living and greater employment competition, Wajngarten pointed out. Small cities have fewer resources and there is a shortage of specialists. Either way, professionals feel insecure — something that has been noted in other surveys of doctors in Brazil showing a high level of stress, depression, anxiety, and burnout.

Wajngarten added that proportionally fewer Brazilian healthcare professionals work in public health services than in private medical care. Yet employment contracts in private institutions require more from professionals while offering fewer advantages and professional protection.

A further factor in Brazil is that the average age of doctors is falling. It is projected that more than 85% will be under 45 by 2035. Younger physicians have fewer opportunities to exercise autonomous and rewarding professional activity, Wajngarten said.

The Importance of Work-Life Balance Varies

Despite reporting ostensibly better mental health, more than half (53%) of French doctors said they would take a pay cut in exchange for a better work-life balance. However, only half of French doctors regarded having more family and personal time as “very important” — a lower proportion than all other countries.

Doctors in the US, Canada, Italy, Portugal, Spain, and the UK were more likely than not to say they would trade some financial compensation in exchange for a better work-life balance. Doctors in Brazil were split 50-50. Overall, more than 90% of respondents felt that vacations were “very” or “somewhat” important to their happiness and mental health. Doctors in France were less likely than those in many countries to rate vacations as very or somewhat important for their happiness and mental health.

Again, however, external factors may sway doctors’ opinions. Recent surveys have shown that doctors’ mental health was significantly influenced by their work conditions. A European Union directive mandates a minimum of 20 paid vacation days per year, and most employers in the EU exceed that. In addition, extended summer vacations are a tradition in much of Central and Southern Europe.

In contrast, American workers take notoriously few holiday days. US respondents were more likely (32%) than those in Europe or Canada to take 2 or fewer vacation weeks, and less likely (22%) to take more than 4 weeks. The US has no federal or state statutory minimum paid vacation or paid public holidays. Paid leave is at the discretion of employers, and some offer none at all.

Similarly, Brazilian doctors were less likely (22%) than those in most European countries or Canada to take 4 weeks or more vacation. Brazil’s recommended working time is over 60 hours per week and shifts are exhausting, Wajngarten said.

He added that although doctors there have an average declared income higher than that of other professionals and three times the average of Brazilians with taxable salaries, 30% of doctors face student loan debt, which could also influence their attitudes. 

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.