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Background:The mental health of doctors is increasingly topical, internationally and locally. Of importance is the phenomenon of burnout, a far-reaching repercussion of chronic workrelated stress. Psychiatrists are more vulnerable to stress, burnout and suicide in comparison with other medical specialities. There is a void in published research relating to South African psychiatric trainees. Aim:The study aimed to investigate burnout and associated factors among psychiatric registrars at a South African university.Setting: Department of Psychiatry at the University of the Witwatersrand.Methods: This was a cross-sectional study via an anonymous self-administered questionnaire. The questionnaire comprised three sections: demographics; the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and questions relating to contributing factors, protective factors and consequences of burnout. The MBI-HSS is recognised as the leading measure of burnout, consisting of three subscales: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Results:The questionnaire was completed by 33 out of 55 psychiatric registrars (60.0% response rate). Data from 31 registrars were used in the analyses, as two registrars did not provide informed consent. Among participants, EE was the most commonly affected, followed by DP and lastly PA. The majority (67.8% or n = 21) had scores in the high category for any one of the three subscales (EE/DP/PA). Significant factors associated with burnout included poor work and non-professional life balance (p = 0.017), utilising annual leave days for work-related tasks (p < 0.001), irregular holidays (p = 0.003) and financial debt (p = 0.026). A possible protective factor was an amicable relationship with fellow psychiatric registrars. Conclusion:There is evidence of some degree of burnout in more than two-thirds of participants. Associated factors lie largely at an organisational level, and while optimising individual resilience is important, systemic support plays a key role.

Tobacco use is recognised as a serious, worldwide public health concern. Smoking cessation is of great interest across a wide range of medical specialities, including family medicine. However, smoking cessation among people with mental illness (PWMI) has attracted scant attention in South African literature. This is despite PWMI suffering disproportionately from the damages of tobacco. The harms of smoking are not limited to physical health but extend to mental health. This article discusses the need for multifaceted smoking cessation treatments for PWMI in the public health sector, taking into consideration the prevalence and unique drivers of smoking in this population. A brief overview of patterns of tobacco use, associated harms and smoking cessation interventions in South Africa is given; all within the context of mental illness.