title: Burnout in premedical undergraduate students.
abstract: BACKGROUND
  There has been growing recognition that medical students, interns, residents and practicing physicians across many specialties are prone to burnout, with recent studies linking high rates of burnout to adverse mental health issues. Little is known about the trajectory and origins of burnout or whether its roots may be traced to earlier in medical training, specifically, during undergraduate studies. Here, the authors surveyed undergraduates at UC San Diego (UCSD) to assess the relationship of burnout to premedical status while controlling for depression severity.
  
  
  METHODS
  Undergraduate students at UCSD were invited to participate in a web-based survey, consisting of demographic questions; the Maslach Burnout Inventory Student Survey (MBI-SS), which gauged the three dimensions of burnout; and the nine-item Patient Health Questionnaire (PHQ-9), to assess depression severity.
  
  
  RESULTS
  A total of 618 premedical students and 1,441 non-premedical students completed the questionnaire. Premedical students had greater depression severity and emotional exhaustion than non-premedical students, but they also exhibited a greater sense of personal efficacy. The burnout differences were persistent even after adjusting for depression. Also, premedical women and Hispanic students had especially high levels of burnout, although differences between groups became nonsignificant after accounting for depression.
  
  
  CONCLUSIONS
  Despite the limitations of using a burnout questionnaire not specifically normed for undergraduates, the unique ethnic characteristics of the sample, and the uncertain response rate, the findings highlight the importance of recognizing the unique strains and mental health disturbances that may be more common among premedical students than non-premedical students. Results also underscore the close relationship between depression and burnout, and point the way for subsequent longitudinal, multi-institutional studies that could help identify opportunities for prevention and intervention.
authors.affiliation: Stanford University, Palo Alto, CA, USA. cbyoung@stanford.edu
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Fang
authors.forename: Daniel
authors.initials: D
authors.lastname: Fang
authors.forename: Christina B
authors.initials: CB
authors.lastname: Young
authors.forename: Christina
authors.initials: C
authors.lastname: Young
authors.forename: Shah
authors.initials: S
authors.lastname: Golshan
authors.forename: Christine
authors.initials: C
authors.lastname: Moutier
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D002140:California / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D026684:Personal Autonomy; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult