title: The prevalence of medical student mistreatment and its association with burnout.
abstract: OBJECTIVE
  Medical student mistreatment has been recognized for decades and is known to adversely impact students personally and professionally. Similarly, burnout has been shown to negatively impact students. This study assesses the prevalence of student mistreatment across multiple medical schools and characterizes the association between mistreatment and burnout.
  
  
  METHODS
  In 2011, the authors surveyed a nation ally representative sample of third-year medical students. Students reported the frequency of experiencing mistreatment by attending faculty and residents since the beginning of their clinical rotations. Burnout was measured using a validated two-item version of the Maslach Burnout Inventory.
  
  
  RESULTS
  Of 960 potential respondents from 24 different medical schools, 605 (63%) completed the survey, but 41 were excluded because they were not currently in their third year of medical school. Of the eligible students, the majority reported experiencing at least one incident of mistreatment by faculty (64% [361/562]) and by residents (76% [426/562]). A minority of students reported experiencing recurrent mistreatment, defined as occurring "several" or "numerous" times: 10% [59/562] by faculty and 13% [71/562] by residents. Recurrent mistreatment (compared with no or infrequent mistreatment) was associated with high burnout: 57% versus 33% (P < .01) for recurrent mistreatment by faculty and 49% versus 32% (P < .01) for recurrent mistreatment by residents.
  
  
  CONCLUSIONS
  Medical student mistreatment remains prevalent. Recurrent mistreatment by faculty and residents is associated with medical student burnout. Although further investigation is needed to assess causality, these data provide impetus for medical schools to address student mistreatment to mitigate its adverse consequences.
authors.affiliation: Dr. Cook was, at the time of this research, fellow, Medical Education Research, Innovation, Teaching, and Scholarship Program, University of Chicago, Chicago, Illinois, and she is currently core faculty, Internal Medicine Residency Program, MedStar Franklin Square Medical Center, Baltimore, Maryland. Dr. Arora is associate professor, Department of Medicine, assistant dean, Scholarship and Discovery Program, and associate program director, Internal Medicine Residency Program, University of Chicago, Chicago, Illinois. Dr. Rasinski was, at the time of this research, assistant professor, Department of Medicine, and he is currently survey manager, Chicago Consortium for School Research, University of Chicago, Chicago, Illinois. Dr. Curlin was, at the time of this research, associate professor, Department of Medicine, codirector, Program of Medicine and Religion, and associate faculty, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois. He is currently Trent Professor of Medical Humanities, Trent Center for Bioethics, Humanities and History of Medicine, Duke University, Durham, North Carolina. Dr. Yoon is assistant professor, Department of Medicine, and associate faculty, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois.
authors.forename: Alyssa F
authors.initials: AF
authors.lastname: Cook
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Rasinski
authors.forename: Farr A
authors.initials: FA
authors.lastname: Curlin
authors.forename: John D
authors.initials: JD
authors.lastname: Yoon
mesh_terms: D002055:Burnout, Professional / Q000453:epidemiology*; D002982:Clinical Clerkship / Q000379:methods* / Q000458:organization & administration* / Q000639:trends; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate / Q000592:standards / Q000639:trends; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D020380:Needs Assessment; D015995:Prevalence; D028743:Professional Misconduct / Q000706:statistics & numerical data*; D012577:Schools, Medical / Q000592:standards / Q000639:trends; D012919:Social Behavior; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult