<p>Burnout remains a vexing issue for healthcare workers, educators and policy makers. Continuing high prevalence rates have focused the need for new and innovative approaches. The deleterious personal and professional consequences of burnout when it does develop place this focus on primary prevention. Yet despite its benefits, primary prevention initiatives have several barriers to engagement which impact their effectiveness. In this article, the authors explore potential barriers to engagement with primary level prevention of burnout amongst physicians-in-training, many of which are rooted in the social and professional contexts of training. Understanding the motivations of physicians-in-training should be used to guide the development of initiatives which combine protection against burnout with relevant goal-directed, instrumental outcomes. Three principles which can guide initiatives combining these features are explored. Promoting curiosity and curiosity-led enquiry combines a well-established protective attribute with educational and professional benefits. Curiosity-led endeavours can be developed into areas of special interest and competence, harnessing the protective benefits of self-efficacy and peer acknowledgement. Finally, special interests and the professional roles to which they lead foster the development of professional social networks and mentorship relationships. These are protective, particularly for physicians-in-training navigating role and organisational transitions. Supporting interventions with instrumental outcomes is both beneficial in engaging investment and also sustainable across the career-span. Burnout remains a challenging issue, and while programmatic interventions continue to have a role, the benefits of broader primary preventative approaches should be considered in terms of the potential engagement and sustainability advantages they confer.</p>