Background: The COVID-19 pandemic has precipitated unprecedented psychological distress among healthcare professionals globally, with heightened occupational stress contributing to elevated burnout, depression, anxiety, and psychological strain. However, the differential impact across geographic contexts remains inadequately documented, particularly in low- and middle-income countries.

Objective: To examine and compare the psychological well-being and burnout profiles of doctors in urban (Delhi) and semi-urban (Solan) healthcare settings during the COVID-19 pandemic, identifying geographic disparities in mental health outcomes and occupational strain.

Methods: A comparative cross-sectional research design was employed with 106 doctors—53 each from Delhi (mean age: 34.4 ± 10.6 years) and Solan, Himachal Pradesh (mean age: 26.6 ± 4.3 years). Participants completed two standardized instruments: the Depression Anxiety Stress Scale (DASS-21) and the Maslach Burnout Inventory (MBI). Independent samples t-tests were conducted to compare mean scores across psychological strain and burnout dimensions between the two geographic locations.

Results: Delhi-based doctors reported significantly higher levels of depression (M = 7.29, SD = 4.27 vs. M = 3.12, SD = 3.90; t = 5.25, p <. 01), anxiety (M = 6.30, SD = 4.07 vs. M = 4.10, SD = 3.50; t = 2.98, p <. 01), and stress (M = 8.21, SD = 4.11 vs. M = 5.85, SD = 3.82; t = 3.06, p <. 01) compared to Solan doctors. Similarly, Delhi doctors demonstrated significantly elevated burnout across all three dimensions: emotional exhaustion (M = 26.29, SD = 8.24 vs. M = 17.01, SD = 8.09; t = 5.85, p <. 01), depersonalization (M = 14.12, SD = 5.01 vs. M = 9.50, SD = 5.53; t = 4.50, p <. 01), and reduced personal accomplishment (M = 30.76, SD = 7.80 vs. M = 24.24, SD = 10.72; t = 3.50, p <. 01). These substantial differences suggest that the urban healthcare context intensifies occupational stressors and their psychological consequences.

Discussion: The pronounced disparities between Delhi and Solan doctors likely reflect contextual differences in pandemic exposure intensity, patient acuity, workload burden, and organizational resources. Contributing stressors include patient-inflicted violence, fear of disease transmission to family members, inadequate personal protective equipment, lack of COVID-specific training, and extended work hours. The elevated emotional exhaustion among urban doctors underscores the vulnerability of practitioners in high-volume, resource-constrained urban settings.