While many Canadians are trying to stay safe by staying home during the pandemic, physicians have been working for more than a year to provide proper health care to patients sick with COVID-19. 

The stressful work conditions brought on by the COVID-19 pandemic are contributing to physician burnout. 

A Canadian survey on resident physician burnout published by the National Library of Medicine in 2020 measured burnout as a combination of emotional exhaustion, depersonalization (similar to having an out-of-body experience) and a reduced sense of personal achievement resulting from chronic exposure to stress.

The study found a high prevalence of burnout, with nearly 70 per cent of the 718 survey respondents experiencing burnout. The survey indicated more hours worked, poor work-life balance, poor mental health supports—all factors affected by the high-stakes environment of practising during the COVID-19 pandemic—were associated with higher chances of burnout. 

In order to prevent burnout from skyrocketing during the COVID-19 pandemic, health-care workers in Ontario are joining together to provide increased support for physicians as they navigate challenging professional and personal circumstances.

Of the nearly 70 per cent of resident physicians surveyed who experienced burnout, emotional exhaustion was the most prevalent symptom. [Graphic by Jillian Piper]

Physicians are human, too

Dr. Leslie Flynn is an expert on physician burnout. She is a psychiatrist at Hotel Dieu Hospital in Kingston, Ont., where she has been studying physician mental health for more than 25 years. Flynn also helped to establish a Physician Wellness Advisory Committee three years ago, which she now leads as committee chair.

While physicians are working hard to curb the virus and save lives, Flynn said it’s important the public is aware that physicians are human and are also personally affected by the pandemic. 

“It’s really important to recognize that our health-care professionals have the same needs and wants as the public and yet have this incredibly important responsibility to deliver care to the public,” she said.

Dr. Claudio Soares, the department head of psychiatry at Kingston General Hospital, said his colleagues are exhausted due to the long and difficult fight against COVID-19.

“Everybody’s burnt out,” he said. “People are really at the end of their ropes because they’re just feeling that the pandemic is stretching for too long and are working here under extremely stressful circumstances.”


Hotel Dieu Hospital, affiliated with Queen’s University, is one of Canada’s top research hospitals.

Damage on several fronts

Soares said the stress of working as a physician during the pandemic comes from first-hand exposure to the damage and deaths caused by COVID-19 and the inability to help patients with other serious medical issues. 

He said medical workers are sometimes more stressed about the circumstances of the pandemic, rather than the disease itself.

“[The] tension and the stress was not necessarily related to treating patients with COVID-19. It was more related to the other patients that we couldn’t treat because we had to shut down services or shut down clinics … other patients couldn’t be seen like the cancer patients and surgeries,” he said.

Dr. Larry Milosevic is a critical care specialist at Trillium Health Partners Hospital in the Peel Region of Ontario, an area hit especially hard by the pandemic. Milosevic said other types of important patient care had to be postponed and reduced to make health-care resources available to treat patients with COVID-19.

“Our hospitals certainly exceeded our regular ICU capacity and we had to generate, as most hospitals did, more spaces for ICU,” he said. “We took over every space in the hospital that was capable of ventilating.”

Dr Larry Milosevic shows the personal protective equipment worn by doctors in ICUs during COVID-19. [Photo provided by Dr Larry Milosevic]

Staffing shortages and limited breaks

Not only were hospital rooms from other departments used in the fight against COVID, but Milosevic said many physicians from other departments were also recruited to work in the ICU.

“The question became how [are] you gonna staff that,” he said. “Because other services like the operating room were shut down, there was no elective surgery going on, so all those anaesthetists, cardiologists and the cardiovascular ICU people came and worked for us.”

Even with the extra medical personnel, Milosevic still was responsible for 45 ICU beds and said he was working almost twice the amount of time he would in a normal year. 

He explained medical professionals typically work one week in the ICU, then take a week off. Now, because the demand for ICU doctors is so great, they can’t get a week off. Instead, doctors work one week in the ICU, another week in a backup position and then return to working in the ICU. 

Milosevic said not having a break from work is affecting doctors.

“All of us are working all the time,” he said. “It’s just been a huge long stretch of continuous work, which is tiresome.”

Dr Larry Milosevic speaks to reporter William Smith about the evolution of PPE during the COVID-19 pandemic.

Creating networks for support

Flynn and Soares worked together at the beginning of the pandemic to create the COVID-19 Wellness and Psychiatry Response Team, which provides mental health support to physicians through a confidential email that all physicians in Kingston can access. Through the response team, physicians can schedule appointments for peer support chats or psychiatry appointments.

Soares said he estimates the number of physicians in Kingston using the services provided by the response team grows by four to five participants each week. He said this number is quite high, especially if you consider the fact that physicians rarely seek help.

“Physicians are known for waiting [until] the last minute to ask for help. They are usually the worst patients,” he said. “It takes a while for them to reach out, but if we can help one of those physicians to remain resilient and not [experience] burnout, [that] will also help them to remain functional to help patients.”

Milosevic said there is a similar program in Peel, where physicians have access to a mental health support hotline if they are feeling overwhelmed. He said he hasn’t used it, but believes a lot of other doctors have.

He said some physicians may not use the line because they fail to recognize the toll that the increased workload brought on by the pandemic is having on them.

“Up to this point, we’ve been so busy just trying to keep our head above water with all the cases that there hasn’t been a lot of time for self-reflection,” Milosevic said. “It’s just kind of go, go, go, go, go.”

Learning to put their own health first

Soares said he’s not surprised physicians are feeling burnt out because doctors are typically hard-working people. 

“Physicians are by nature workaholics and high achievers, so they tend to push themselves to their limit,” he said.

Flynn said she too often feels burnt out and tired, but staying on top of her own mental health practices is helping her get through the pandemic.

“To cope, I try to utilize some of the strategies I tell my patients and my colleagues. It’s things like making sure you eat well, get enough sleep, don’t abandon your exercise and relaxation breathing strategies,” she said. 

“That’s not simply mental health care, it’s crucial to our well-being.”

Featured graphic by Jillian Piper.

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