Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.
OBJECTIVE
To compare the prevalence of burnout and other forms of distress across career stages and the experiences of trainees and early career (EC) physicians versus those of similarly aged college graduates pursuing other careers.


METHODS
In 2011 and 2012, the authors conducted a national survey of medical students, residents/fellows, and EC physicians (≤ 5 years in practice) and of a probability-based sample of the general U.S. population. All surveys assessed burnout, symptoms of depression and suicidal ideation, quality of life, and fatigue.


RESULTS
Response rates were 35.2% (4,402/12,500) for medical students, 22.5% (1,701/7,560) for residents/fellows, and 26.7% (7,288/27,276) for EC physicians. In multivariate models that controlled for relationship status, sex, age, and career stage, being a resident/fellow was associated with increased odds of burnout and being a medical student with increased odds of depressive symptoms, whereas EC physicians had the lowest odds of high fatigue. Compared with the population control samples, medical students, residents/fellows, and EC physicians were more likely to be burned out (all P < .0001). Medical students and residents/fellows were more likely to exhibit symptoms of depression than the population control samples (both P < .0001) but not more likely to have experienced recent suicidal ideation.


CONCLUSIONS
Training appears to be the peak time for distress among physicians, but differences in the prevalence of burnout, depressive symptoms, and recent suicidal ideation are relatively small. At each stage, burnout is more prevalent among physicians than among their peers in the U.S. population.
Dr. Dyrbye is associate professor of medicine, Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. West is associate professor of medicine and biostatistics, Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Mr. Satele is statistician in Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. Dr. Boone was with the American Medical Association, Chicago, Illinois, at the time this study was conducted and is with the University of Illinois, Chicago, Chicago, Illinois, now. Dr. Tan was with the American Medical Association, Chicago, Illinois, at the time this study was conducted and is chief strategy officer, Immunization Action Coalition, St. Paul, Minnesota, now. Dr. Sloan is professor of biostatistics and oncology, Health Sciences Research, Mayo Clinic, Rochester, Minnesota. Dr. Shanafelt is professor of medicine, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Liselotte N
LN
Dyrbye
Colin P
CP
West
Daniel
D
Satele
Sonja
S
Boone
Litjen
L
Tan
Jeff
J
Sloan
Tait D
TD
Shanafelt
D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D015999:Multivariate Analysis; D016017:Odds Ratio; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D059020:Suicidal Ideation; D014481:United States / Q000453:epidemiology