title: Predictors of persistent burnout in internal medicine residents: a prospective cohort study.
abstract: OBJECTIVE
  Resident burnout continues to be a major problem despite work hours restrictions. The authors conducted a longitudinal study to determine whether burnout in internal medicine residents is persistent and what factors predispose residents to persistent burnout.
  
  
  METHODS
  The authors mailed a survey to internal medicine residents at the University of Colorado Denver Health Science Center each May, from 2003 through 2008. The survey measures included the Maslach Burnout Inventory organized into three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment. The authors defined burned-out residents as having a high EE or DP score and persistent burnout as being burned out during all three years of residency.
  
  
  RESULTS
  Of the 179 eligible residents, 86 (48%) responded to the survey during all three years of their residency. Sixty-seven residents (78%) were burned out at least once: 58 residents (67%) were burned out during their internship, 58 (67%) during their second year, and 50 (58%) during their third year (P < .08). Of the 58 burned-out interns, 42 (72%) continued to be burned out through their three years of training. Persistent burnout was more likely to occur in men (OR = 3.31, P < .01) and was associated with screening positive for depression as an intern (OR = 4.4, P < .002).
  
  
  CONCLUSIONS
  Once present, burnout tends to persist through residency. Men and residents who screened positive for depression as interns are at the highest risk for persistent burnout. Interventions to prevent burnout during internship may significantly decrease burnout throughout residency.
authors.affiliation: Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA. jessica.campbell@dhha.org
authors.forename: Jessica
authors.initials: J
authors.lastname: Campbell
authors.forename: Allan V
authors.initials: AV
authors.lastname: Prochazka
authors.forename: Traci
authors.initials: T
authors.lastname: Yamashita
authors.forename: Ravi
authors.initials: R
authors.lastname: Gopal
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002055:Burnout, Professional / Q000523:psychology*; D016009:Chi-Square Distribution; D003120:Colorado; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D010561:Personnel Staffing and Scheduling; D010820:Physicians / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance