As a group, medical students begin their training with lower levels of burnout than their general peer group, according to a new study in JAMA Network Open. During medical school, however, med students’ burnout levels rise to the point that they exceed their peers’ burnout.
Medical students who are mistreated in medical school and those who view their school as unsupportive are more likely to have burnout, tend to have lower empathy scores and are more likely to say they regret their career choice by the time they graduate, the study found.
Examining the learning environment
“These findings suggest the prevalence of burnout among medical students and students’ empathetic orientation and career satisfaction are, at least partially, attributable to factors within the learning environment,” the study’s authors wrote.
To conduct the study, researchers examined data from the American Association of Medical Colleges’ surveys of a cohort of students. These students completed surveys in their second year and again when they were graduating. The researchers examined data from over 14,100 medical students’ surveys.
Roughly 23% of the students reported mistreatment—defined by the researchers as experiences of negative behaviors and discrimination related to sex, race/ethnicity and sexual orientation. Students who reported more positive faculty interactions were more likely to have higher empathy scores upon graduation; students reporting better interactions with their peers were less likely to report career regret upon graduation.
The study researchers believe this is the first longitudinal study to examine the association between mistreatment and empathy and career choice regret.
Interventions to reduce mistreatment and alleviate burnout
In the study, the researchers offer several potential interventions to improve the medical school learning environment and reduce mistreatment. By extension, these could lower students’ burnout levels and improve their empathy levels. The researchers recommend fostering learning communities, implementing pass/fail grading, providing faculty development and considering approaches to eliminate mistreatment.
“Pass/fail grading during the preclinical years has been shown to be associated with better group cohesion and lower stress levels among students without a detrimental effect on subsequent academic performance,” they wrote. “Our study further suggests that lower stress levels at the beginning of year 2 of medical school may lessen the gravity of burnout symptoms during the clinical years.”