This study assessed the relationship between 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. [33] 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. [28] 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. [10] assessed the prevalence of academic burnout in postgraduate students of Oral Surgery and Implant, Orthodontics, and Comprehensive Dentistry at Barcelona University. They reported that 2% to 3% of dental students had high levels of academic burnout. Montero-Marin et al. [31] used BCSQ-SS to assess academic burnout in Huesca University in Spain. They showed that students had high level of academic burnout due to overload, lack of development, and neglect domains, respectively. The prevalence of academic burnout was noticeable in dental students at Santiago University. The findings of the aforementioned study were in agreement with ours because we similarly represented that burnout is common among Iranian dental students. The participants above the 75th percentile of the BCSQ-12-SS score are considered as “high scorers”, whereas those with scores below the 75th percentile are assumed to have some degrees of burnout [31, 34]. 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 which calls for taking necessary measures.
High level of income, good social position, and work independence were the most common career choice motivations of dental students in our study. Failing to enter other fields of education was the least common motivation. In agreement with the study of Hashemipour et al.[35], we showed that the most important motivation for choosing dentistry was relationship with people and income. Khami et al. [32] reported that in dental students with at least one parent being a dentist, the characteristics of this profession had the least effect on those choosing this field of study. Pagnin et al. [14] 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 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]. The correlation between burnout and age was not significant in our study. In a study by Krokter Kogoj et al. [13], older dental students showed higher rate of burnout, while Galán et al. [36] reported that younger dental students had higher rate of burnout. 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. [37]. Montero-Marin et al., [31], and Galán et al. [36]. However, Mafla et al. [33]illustrated that marital status had a significant correlation with burnout, which was different from our findings.
The classification of motivations into three categories of altruism, social status and security, and others’ advice motivation 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. Higher altruism motivation has been shown to support medical students against high educational burnout [38]. Higher burnout levels in those with altruism motivations in the present study may reveal that such students are not meeting what they had expected in the field. More qualitative in-depth studies are needed to delve into the underlying factors in curriculum design and/or implementation. Moreover, the career choice motivation questions of the current study could have benefited from Likert scale response alternatives instead of a binary “yes /no” to reveal the range of the importance and priority.
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 held high-school diploma or lower-level certificate. 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 stressful and preoccupied with their children’s future which causes stress and burnout. In Iran, the same as some other countries, compared to fathers, the effect of mother’s education on their chidren’s health and achievement is more dominant. Consequently, it is worth investing more time and effort in mothers' education. [39, 40] Financial support by the family also had a significant correlation with burnout. Two assumptions are considered by the authors to explain this finding. First, in the presence of good financial support from the family, the student have no financial concerns and better focus on studying. This could decrease burnout. However, in the absence of sufficient family support, the burnout increases. The other assumption speculates that higher financial support by the family brings about higher convenience, which may decrease the students’ performance efficiency and subsequently their motivation. Our findings were somehow in favor of the first assumption. Regression analysis revealed higher rate of burnout in dental students with inadequate financial support from the family and those with altruism motivations. In addition, lower rate of burnout existed in the students whose mothers’ educational level was equal to or below high-school diploma and had others’ advice motivations.
Our study highlighted the challenges that students were engaged with causing them experience more burnout such as low financial support from family and their career choice motivations as altruism that was among their expectations that had not been met in field of dentistry. Thus, it is suggested to serve some strategies and mentorship to deal with such situations to prevent or decrease future probable burnout.
This study was conducted in Tehran and on senior dental students. Being the final outcome from the dental school, we focused on senior dental students as the burn out and its determinants may change throughout the study period. Thus, the obtained results may have limitation in generalizability for the other parts of the country or for other countries. 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 [41, 42]. In future studies, it is suggested to investigate each of them separately for dental students. Furthermore, it is suggested that studies based on self-determination theory would be designed and conducted to elaborate on the subject more precisely.