Background Physician wellness is a growing concern in medical education, with burnout rates among medical professionals continuing to rise. While there is increasing recognition that systemic reforms are essential to addressing this issue, there is a significant gap in theory-based frameworks to guide the implementation of such reforms. Without a shared theoretical language or guiding principles, efforts to reform medical education often lack coherence, making it difficult to evaluate their effectiveness or replicate successful strategies. Methods This paper aims to fill this gap by applying Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) model to create a concrete, theory-informed framework for systemic reform in medical education. I present 12 actionable recommendations that focus on two key areas: (1) reducing hindrance job demands that frustrate basic psychological needs and contribute to burnout, and (2) increasing job resources that promote need satisfaction and well-being. These recommendations are designed to provide a clear and scalable approach for institutions to adopt. Results The recommendations in this paper offer practical strategies for optimizing learning environments in medical education. The strategies focus on enhancing physician autonomy, competence, and relatedness by addressing both job demands that hinder well-being and resources that foster engagement and growth. By applying SDT and JD-R as guiding principles, these reforms ensure that systemic changes are measurable and sustainable over the long term. Conclusions This paper provides a theory-guided framework for systemic reforms aimed at promoting physician wellness in medical education. By applying the SDT and JD-R theories, medical educators and institutions can implement targeted strategies to reduce burnout and foster a thriving work environment. The framework not only offers actionable recommendations but also a means of measuring the impact and effectiveness of these reforms, ensuring their long-term success in improving physician well-being.
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