conviction that “well-being is a system issue, not an individual burden for those suffering from it,” as illustrated in Table 7. The programme is growing, with more than 550 counselling sessions in 2022, compared to 300 in 2019. 48 Sustainability and Resilience in the Saudi Arabian Health System The Partnership for Health System Sustainability and Resilience Table 7: SCFHS Da’em health professional framework of institutional causes of burnout and contributions to well-being Trainee Training Programme Training Institution Regulator (SCFHS) Demands •Sleep deprivation •Moral distress •Interprofessional communication•Mental workload •Ideal/high expectations •Poor task distribution •Institutional and internal regulations •Productivity targets •Administrative burden •Patient load and complexity•Compliance with regulations •Holding active institutional/programme accreditation status •Maintaining professional registration and licensing •Time pressure related to training completion •Training tuition Bidirectional •Personal values •Personality traits •Psychological capital •Professional habits •Socioeconomic status •Specialty •Team dynamics •Balance between professional duties and training •Autonomy •Institutional values •Physical environment •Safety •Stafﬁng •Scheduling •Workload •Professional community •Information •Technologies •Sponsorship •Rewards •Legislative function •Quality assurance •Corporate ef ﬁciency •Governance •Matching system for selection of best applicants Resources •Mindfulness •Resilience •Family support •Healthy lifestyle •Curriculum •Supervision •Mentorship •Coaching •Peer support •Recognition •Learning opportunities •Well-being and support •Administrative support •Corporate excellence•National well-being programme (Da’em) •Quality assurance and monitoring •Regulations and resources supporting trainee rights and well-being •Institutional/programme support •Faculty development •Trainee empowerment programme Source: Saudi Commission for Health Specialties, 2022.

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