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Electronic Paperwork Increasing Burnout Risk Among Young Doctors

Electronic Paperwork Increasing Burnout Risk Among Young Doctors

An overload of electronic paperwork is increasing the risk of burnout among young doctors, a new study says.

Nearly one third of medical residents regularly spend hours upon hours after their shift filling out electronic health records, a practice they call “pajama time,” researchers recently reported in the journal Academic Medicine.

The more time young docs spend after hours on these records, the higher their odds of burnout and the lower their rate of job satisfaction, researchers found.

Those who typically spend three or more hours per night on pajama time are significantly more likely to experience burnout, the study found.

Residents burdened with after-hours record work also perform worse on examinations that track their progress as doctors-in-training, results showed.

“We suspected that if residents were spending a lot of time in the [electronic health record], they might have less time to read, reflect and study, which could affect exam performance,” said lead researcher Dr. Wendy Barr, an instructor of medicine at Yale School of Medicine in New Haven, Connecticut.

“What surprised us was the strength of the association and the clear dose-response pattern,” Barr said in a news release.

The nationwide study focused on more than 9,000 medical residents – doctors who’ve completed medical school and are getting specialized hands-on training in their chosen field of practice.

Researchers wanted to see how after-hours record work affected the residents. During this time, doctors review lab results and imaging online, respond to patient messages and catch up on their documentation.

“We used a brief, two-item screening tool that’s widely used in burnout research,” Barr said. “It asks how often, over the past two weeks, residents have experienced emotional exhaustion or depersonalization — feeling detached from patients. If either occurs at least once a week or more, that meets the threshold for burnout.”

The survey, administered by the American Board of Family Medicine after the 2024 in-training examination, had a remarkable 99% response rate from the residents. Because it was conducted by the certifying board, it captured nearly the entire population of upper-year family medicine residents.

Results showed that nearly one-third of medical residents spend three or more hours working on electronic health records after their shift.

Such pajama time was linked to a 61% higher risk of burnout; 28% increased risk of low exam scores; 39% lower odds of professional satisfaction; and 38% lower odds of training program satisfaction, researchers found.

Third-year residents who spend more time in clinic reported higher levels of pajama time than second-year residents, researchers said.

“The more you’re in clinic, the more pajama time you seem to have,” Barr said. “That tells us there’s a systems aspect to this.”

Older residents, women, international medical students and residents from groups underrepresented in medicine were more likely to spend three or more hours a night on pajama time, researchers said.

This paperwork could be costing the U.S. health care system some talented upcoming doctors, if burnout causes them to quit, Barr said.

“If someone has high pajama time as a resident, are they less likely to work full-time later? That becomes a workforce issue,” she added. “As residency programs, we should be measuring this and intervening early.”

Barr added that it’s "not just about documentation or efficiency. It’s about helping physicians build a way of practicing that they can sustain for a lifetime.”

More information

The American Medical Association has more on physician burnout.

SOURCES: Yale School of Medicine, news release, March 20, 2026; Academic Medicine, Dec. 12, 2025

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