Purpose: Mistreatment in medical training environments has been linked to emotional exhaustion, yet the underlying mechanisms remain underexplored. This study examines the mediating role of emotional regulation and social support in the relationship between mistreatment and burnout among graduate medical trainees.

Method: We conducted a cross-sectional survey of 266 graduate medical trainees from one of the largest GME institutions in the northeastern United State. The survey included measures of workplace mistreatment, emotional regulation, social support, and burnout. Path analysis was employed to test direct and indirect relationships among mistreatment, emotional regulation, social support, and burnout.

Results: Mistreatment was significantly associated with burnout, with personal attacks demonstrating a strong direct effect (β = 0.36) and a substantial total effect (β = 0.55). Emotional dysregulation partially mediated this relationship, with a significant indirect effect (β = 0.16). Suppressive emotional regulation strategies also contributed to burnout. Social support played a protective role, reducing the impact of mistreatment on burnout.

Conclusions: These findings underscore the detrimental impact of mistreatment on medical trainee well-being and the critical role of emotional regulation and social support in mitigating burnout. Institutional interventions should focus on strengthening peer and leadership support networks, and integrating emotional regulation training into residency programs. Addressing these factors can enhance resilience, improve professional fulfillment, and promote a more supportive medical training environment.