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This study represents an extrapolation to the practical realm of a theoretical model that has been supported thus far only by laboratory studies. The model regards the rejection of help by people in need as being stressful for caregivers partly because it violates their expectations of acceptance and threatens their self-image as competent caregivers. It was hypothesized that high levels of perceived rejection by patients and others at work would contribute to burnout in medical caregivers. It was also predicted that high levels of stress preparation in caregivers' training with regard to job expectancies and patient (non)compliance would lessen burnout and buffer the effects of spurning. Responses to a questionnaire by a sample of physicians and hospital nurses revealed a direct association of perceived spurning, as well as an inverse association of stress preparation with burnout, and gave some indication of buffering, as hypothesized. Expressions of violated expectancies and of job disillusionment were directly associated with burnout and inversely associated with stress preparation. Informal job expectancy shaped by coworkers was found to be directly associated with burnout in physicians, but it was inversely associated with burn out in nurses. The implications of these findings are considered