Burnout has become a critical concern in medical education because of demanding curriculum, excessive study workloads, and the increased responsibility of caring for patients [1]. While often regarded as anticipated challenges of medical education, the academic and psychosocial stressors associated with medical school, such as sleep deprivation, peer competition, pressure to succeed, and the financial burden of student loans, contribute to significant declines in the mental health and quality of life of medical students [2]. The resulting psychological morbidity of medical students has been well described in the literature, with medical students being more likely to experience burnout compared with the general population [3]. Additionally, compared with US college graduates aged 22 to 32 years, medical students showed higher rates of emotional exhaustion, depersonalization, and overall burnout and a greater likelihood of depressive symptoms [4]. For example, a longitudinal study of 4287 medical students across 5 institutions by Dyrbye et al [5] found that burnout was reported by nearly half (49.6%) of respondents, demonstrating just how common burnout was among medical students.

As a measure of depersonalization, emotional exhaustion, and a diminished sense of personal accomplishment [6], burnout also has a well-established connection to depression and suicidal ideation [7]. Thus, burnout is a particular concern among medical students: 1 systematic review found that the overall prevalence of depression or depressive symptoms among medical students was 27.2%, and the overall prevalence of suicidal ideation was 11.1%. Across 9 longitudinal studies, included in the same systematic review that measured depressive symptoms before and during medical school, the median absolute increase in symptoms was 13.5% [8]. Depression among medical students has been further linked to substance abuse, impaired professional function, diminished physical health, and thoughts of dropping out [7,9]. Burnout can not only derail students’ careers but also harm future patients because burnout has been linked to increased errors in patient care [4,8], decreased professionalism, and an overall decline in empathy [7,10].

Medical students use a variety of strategies to cope with burnout, including religion, self-distraction, positive reframing, humor, acceptance, substance use, self-blame, and venting [11,12]. Coping mechanisms such as self-blame and substance use are associated with an increased risk of suicidal ideation, anxiety, and depression among medical students, while religion and positive reframing serve as negative predictors of these outcomes [12,13].

Several studies report spirituality as a coping strategy that medical students use to protect against burnout and its effects [12,14]. However, spirituality and religion have been defined and measured inconsistently in the literature, sometimes through single-item indicators that may not adequately capture their multidimensional nature. The National Cancer Institute defines spirituality as “having to do with deep, often religious, feelings and beliefs, including a person’s sense of peace, purpose, connection to others, and beliefs about the meaning of life” [15]. In addition, Pérez and Rohde [16] describe religion as encompassing beliefs, actions, and institutions grounded in supernatural entities, powers, or processes, whereas spirituality emphasizes belief in and the subjective experience of a relationship with God or a higher power. Therefore, religion may include more structured or institutional elements, such as rituals and community participation, while spirituality may place greater emphasis on an individual’s internal beliefs and experiences. Despite these distinctions, the constructs overlap conceptually and historically because both may involve the supernatural, transcendence, meaning, and connection to a higher power [16].

For the purposes of the present scoping review, spirituality is broadly defined to encompass organized and noninstitutional religious practices, beliefs, events, and participation associated with the ideas of connectedness and higher purpose. Wachholtz and Rogoff [17] provide an example of the protective role of spirituality on burnout, reporting that higher levels of spiritual well-being and daily spiritual experiences were associated with lower psychological distress and burnout among medical students. Similarly, Habib et al [18] found that religiosity and religious well-being were significantly and positively associated with life satisfaction.

With the potential to reduce burnout and its associated harmful effects—such as stress, anxiety, depression, and suicidal ideation—an in-depth understanding of spirituality’s protective role may improve the quality of life of medical students. While existing reviews on this topic have focused on nurses [19], physicians [20], or health care workers overall [21] or have focused separately on spirituality [22] or burnout among medical students [23], none have specifically assessed the connection between spirituality and burnout among medical students alone. This gap makes it difficult to draw medical-student-specific conclusions. Thus, a comprehensive review of current evidence on how spiritual or religious practices influence the psychosocial health of medical students is needed.

This review aims to map and synthesize the existing literature on the relationship between spirituality and burnout among undergraduate medical students worldwide. The current evidence base is highly heterogeneous in how spirituality and burnout are conceptualized, the instruments used to operationalize these constructs, and the study designs used, including cross-sectional, qualitative, and mixed methods approaches across diverse educational contexts. Given this variability, a scoping review guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology is well suited to address our objectives, as it allows for a comprehensive examination of how key constructs are defined and measured, the range and characteristics of study populations and settings, and the nature of reported associations without aiming to estimate pooled effects. Using the population, concept, and context (PCC) framework, this review focuses on undergraduate medical students, spirituality and religious practices, and studies conducted in any geographic or educational setting. By mapping the extent and characteristics of this literature, we aim to identify conceptual and methodological gaps that may guide future research and support the development of well-grounded approaches to student well-being.

This scoping review followed the PRISMA-ScR checklist outlined by Tricco et al [24] (Multimedia Appendix 1). In line with PRISMA-ScR guidelines and to promote methodological transparency, the protocol for this scoping review has been registered with the OSF Registries [25].

Formal data collection began when the final database searches were completed in July 2025. These searches yielded 1788 records, of which 39 peer-reviewed studies met the inclusion criteria. During full-text screening, articles were most frequently excluded because they did not explicitly evaluate the association between spirituality and burnout, represented an ineligible publication type, or included populations beyond undergraduate medical students without reporting separate results for medical students. The complete study selection process and all reasons for exclusion are presented in Figure 1.

Data extraction was conducted from March through April 2026. The included literature spanned publications from 2007 through 2025 and represented 19 countries across 5 continents. The studies varied in their definitions and measurement of spirituality, religiosity, burnout, psychological distress, and positive well-being. Most used observational designs, while a smaller number used longitudinal, qualitative, or mixed methods approaches. These variations supported the decision to map and narratively synthesize the evidence rather than conduct a quantitative meta-analysis.

The review has been completed, and the manuscript reporting results was completed in May 2026 and is under review as of September 2026. The review was completed without deviations from the registered protocol.