Deberdt, GeraldineGeraldineDeberdtRabaey, PalomaPalomaRabaeyVan Damme, SamSamVan DammeQuenon, Laure-AnnLaure-AnnQuenonDecat, PeterPeterDecatDemeester, ThomasThomasDemeester2026-06-102026-06-102026https://imec-publications.be/handle/20.500.12860/59652Background In recent years, our understanding of the various stress factors affecting the mental well-being of medical trainees during on-call work has grown. Although we have developed a general understanding, we still lack insight into the underlying interrelationships and causal effects of these factors, necessary to address and prioritize the mental health needs of young doctors. Objectives We aimed to measure the causal effects of selected stress factors related to on-call work contributing to occupational stress among General Practitioners (GPs) in training. Methods We identified key stress factors through a literature review and group discussion. Furthermore, we built a Directed Acyclic Graph (DAG) for each identified factor to draw valid causal inferences based on data collected from an observational survey. Results Our analysis indicated that GPs in training experience interruptions to leisure time, fear of potential work-related errors, and anticipatory and vigilant behaviour towards potential patient complaints as key contributors to elevated stress levels during on-call work. Conclusion Our study revealed the importance of psychological or emotional stressors during an on-call shift encountered by GPs in training, encouraging preventive measures. Trial registration Not applicable.engJournal article10.1186/s12875-025-03140-1WOS:001671273300001MEDICAL-STUDENTSPHYSICIANSWORKPREVALENCEBURNOUTMEDLINE:41436969