This study assessed the relationship of academic burnout and career choice motivations in senior dental students in Tehran. The total burnout score was found to be 38.89%. The domain scores were 46.69% for overload, 37.99% for lack of development and 31.98% for neglect. Mafla et al. [22] assessed the prevalence of academic burnout and its association with different factors in dental students in Colombia. They reported that only 7% of dental students met the criteria for academic burnout. Mohebbi et al. [18] assessed the prevalence of academic burnout among Iranian dental students using the BCSQ-12-SS questionnaire. They reported that the average burnout score was 29.6 out of a maximum score of 60. Alemany Martínez et al. [3] assessed the prevalence of academic burnout in postgraduate students of oral surgery and implant, orthodontics and comprehensive dentistry, attending Barcelona University. They reported that 2–3% of dental students had high levels of academic burnout. Difference in the prevalence of academic burnout values reported in different studies may be due to the use of different data collection tools as well as different environments. However, the high rate of academic burnout observed in dental students in Tehran is alarming and calls for the necessary measures to decrease it.
Montero-Marin et al. [21] used BCSQ-SS to assess academic burnout in Huesca University in Spain. They showed that 27.73%, 16.97% and 18.80% of students had high levels of academic burnout in overload, lack of development and neglect domains, respectively. The prevalence of academic burnout in overload, lack of development and neglect domains was 19.49, 28.21 and 23.59, respectively in dental students attending the Santiago University. The results obtained in the aforementioned two universities regarding the prevalence of academic burnout were in agreement with our findings to show somehow burnout among dental students. The participants above the 75th percentile of the BCSQ-12-SS score, are considered as “high scores”, whereas those with scores below the 75th percentile are considered to have some degrees of burnout. [21, 23]
High level of income, good social position and work independence were the most common career choice motivations of dental students in our study. Failure in entering other fields of education was the least common motivation. In agreement with the study of Hashemipour et al.[24] that showed the most important motivation for choosing dentistry was relationship with people and income. Khami et al. [25] reported that in dental students with at least one parent being a dentist, the characteristics of this profession had the least effect on them choosing this field of study. Pagnin et al. [26] evaluated medical students and showed that professional autonomy, intellectual curiosity, altruism and interest in human relationships were the most frequent reasons for choosing medicine. However, medical students motivated by personal illness or illness or death of a family member had significantly greater emotional exhaustion than those with other motivations.
In our study, GPA score had no significant correlation with academic burnout, which was in agreement with the findings of Maslach. [1] Lee et al. [27] demonstrated that students with higher GPA scores had higher self-confidence for dealing with problems and less frequently experienced burnout. Nikodijevi et al. [28] reported that students with a lower GPA score had higher rate of burnout. These results were different from our findings in this respect, which may be due to the different educational environments (theoretical and clinical) and creating motivation for students, such that students with higher motivations had higher GPA scores and lower rate of burnout. Considering the high prevalence of burnout in our study irrespective of the GPA score of students, it may be concluded that the reasons for burnout are far beyond the personal factors and may involve the environmental factors as well.
The correlation of burnout and age was not significant in our study. In a study by Krokter Kogoj et al, [29] older dental students showed higher rate of burnout while Galán et al. [30] reported that younger dental students had higher rate of burnout. The results of the aforementioned two studies were different from our findings. The reason may be due to the fact that we only assessed senior dental students, all of which were approximately of the same age while the aforementioned two studies evaluated dental students of different academic years. In our study, academic burnout had no significant correlation with gender, marital status, university, or city of residence, which was in agreement with the results of Singh et al [31]. Montero-Marin et al, [21] and Galán et al. [30] found no significant association between academic burnout and gender either, which indicates that there is no educational discrimination between males and females. In the study by Mafla et al, [22] marital status had a significant correlation with burnout, which was different from our findings. The reason may be the difference in laws and regulations supporting the married individuals in the two countries.
Classification of motivations into three categories of altruism, social status and security, and others’ advice revealed lower level of burnout in students with others’ advice motivations and higher level of burnout in students with altruism motivations. This finding indicates that dental students who chose dentistry based on the advice of their parents or others or because they thought that dentistry would be easier than medicine, were more satisfied with their conditions. On the other hand, dental students who chose dentistry since they thought it is a combination of art and science or because they wanted to resolve the health issues or esthetic needs of patients were not satisfied with their conditions and their expectations had not been met.
In our study, mother’s level of education had a significant correlation with burnout in students, and the level of burnout was lower in dental students whose mothers had a level of education equal or lower than high-school diploma. This finding indicates that although mothers with lower level of education probably encouraged their children to pursue dentistry and reach high academic degrees more, it seems that more educated mothers in Iran are more stress full and have more concern about their children future so cause stress and more burnout for them. In Iran the same as some other countries the effect of mothers education on their chidren’s health and achievements is more dominant than fathers’ and it worths greater investment in mothers' education. [32, 33] Financial support by the family also had a significant correlation with burnout. Two theories are suggested to explain this finding: The first theory suggests that in presence of good financial support from the family, the student would have no financial concerns and would better focus on studying; this would decrease burnout. The other theory states that higher financial support by the family brings about higher convenience, which may decrease the efficiency and performance of students and decrease their motivation, causing burnout. Our findings were somehow in favor of the second theory. Multivariate analysis revealed higher rate of burnout in dental students with good financial support from the family and those with altruism motivations, and lower rate of burnout in those whose mothers’ educational level was equal or below high-school diploma and had others’ advice motivations.
This study was conducted in Tehran. Thus, the obtained results cannot be generalized to the entire country. Further studies on other cities of Iran are required to cast a final judgment in this respect. Further studies are also required to find the reasons for high level of burnout in dental students in Tehran and come up with strategies to decrease it. We have included motivation in this study which may itself be related to competence, autonomy and relatedness [34] and in future studies it is suggested to investigate each of them separately for dental students.