title: Efficacy of burnout interventions in the medical education pipeline.
abstract: OBJECTIVE
  Little is known about the efficacy of current interventions to mitigate burnout among medical students and residents, despite its association with mood disorders, absenteeism, low job satisfaction, and medical errors. This review summarizes the efficacy data of burnout interventions and how each modality is used.
  
  
  METHODS
  OVID-SP Medline, Google Scholar and PsychINFO were searched for combinations of medical subject headings (MeSH) terms: premedical students, medical students, internships, intern, medical graduate, clinical clerkship, and residents in combination with a keyword group of burnout, professional burnout, suicide, attempted suicide, and prevention. Studies with data on the efficacy from burnout prevention programs were included for review.
  
  
  RESULTS
  Nineteen studies were selected for inclusion in this review. Eleven different types of interventions and combinations of interventions were used. There were six studies on the impact of the 2003 duty-hour restrictions by the Accreditation Council for Graduate Medical Education on burnout. Other approaches included self-development groups, conversion to a pass-fail grading system and training in mindfulness, communication, and stress management. Half of the intervention approaches had at least one study demonstrating benefit in reducing burnout. Self-development groups, the Respiratory One Method for relaxation, and conversion to a pass-fail grading system appear to reduce burnout. The burnout data on mindfulness training and the 2003 resident duty-hour restrictions are mixed. There were no studies available on burnout among premedical students or suicide prevention among medical students or residents.
  
  
  CONCLUSIONS
  There is a growing body of evidence-based interventions to mitigate burnout which can be used in the development of future programs. More research is needed to identify and intervene against burnout earlier in the medical education pipeline, including at the undergraduate level.
authors.affiliation: Baylor Scott & White Health, Temple, TX, USA, drdanielwilliams@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Williams
authors.forename: Gian
authors.initials: G
authors.lastname: Tricomi
authors.forename: Jay
authors.initials: J
authors.lastname: Gupta
authors.forename: Annie
authors.initials: A
authors.lastname: Janise
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000517:prevention & control / Q000628:therapy*; D055317:Evidence-Based Practice; D006801:Humans; D007396:Internship and Residency; D010820:Physicians / Q000523:psychology*; D013337:Students, Medical / Q000523:psychology*; D016896:Treatment Outcome