Journal Club

Personal life events and medical student burnout: A multicenter study. Dyrbye LN, Thomas MR, Huntington JL et al. Academic Medicine 2006; 81(4):374-384.

Reviewed by Sandy Sanguino, Northwestern University

Burnout, a marker of professional distress, is prevalent among residents and practicing physicians. Little is known about burnout amongst medical students. The authors were interested in determining the frequency of burnout among medical students and the relationship between burnout and personal life events.

All medical students (1,089) attending three medical schools (one private, one public, and one public with a focus on primary care) in Minnesota in 2004 were asked to participate in this study. The students were surveyed electronically in April 2004. The students were blinded to the specific hypotheses of the study. Students complete a 118 item questionnaire. Questions asked included demographic information, recent personal life events, burnout, symptoms of depression, alcohol use and quality of life questions. Validated survey instruments were used to identify burnout, symptoms of depression, at-risk alcohol use and mental and physical quality of life.

The survey was completed by 545 students (50% response rate). The researchers found that 239 students (45%) met the criteria for burnout. Overall, the prevalence of burnout increased with advanced years of training. 56% of students screened positive for symptoms of depression and 22% had at-risk alcohol use. While the frequency of a positive depression screen and at-risk alcohol use decreased as year of training increased the frequency of burnout increased. 37% of students experienced at least one major negative personal life event (divorce, major-illness-personal or close family member, death of a close family member) in the previous year. 14% of students experienced at least one positive life event (marriage, birth/adoption of a child). The number of negative personal life event in the last 12 months correlated with the prevalence of burnout. Personal life events demonstrated a stronger relationship to burnout that the year in training on multivariate analysis.

Limitations to the study include a low response rate (50%), use of self report data, and the limited number of personal life events explored.

This study suggests that medical educators need to be aware of the prevalence of personal and professional distress as well as the impact that life events can have on students. Given the impact of life events on student's well-being, appropriate services need to be in place to address these needs. As burnout is common at all levels of the profession, formal education about stressors and management of stress including use of available resources seems important. Stressors are unlikely to disappear and learners need to have strategies and skills to deal with these important issues.

(Comment: Burnout is not unique to older physicians. Many factors affect burnout including personal life events. This study re-affirms the importance of monitoring these events and developing systems to help students both prevent and manage stress. - Bill Raszka)