Do Medical Residents Experience Burnout?

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The summary below is from the full report titled "Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program." It is in the 5 March 2002 issue of Annals of Internal Medicine (volume 136, pages 358-367). The authors are TD Shanafelt, KA Bradley, JE Wipf, and AL Back.

What is the problem and what is known about it so far?

Burnout is a loss of interest in one's work and a feeling of "just going through the motions." Physicians who are burned out are cynical and exhausted emotionally; they also feel they are working hard but accomplishing little. Burnout can affect people in helping professions, and it is associated with decreased job performance, reduced job commitment, and low career satisfaction. Physicians are at high risk for burnout. Their work is stressful, and they may try to do too much. They constantly address other people's problems and may ignore their own needs. Most knowledge of physician burnout comes from studies of experienced practicing physicians. We know little about burnout in doctors who are training to become practicing physicians (medical residents).

Why did the researchers do this particular study?

To describe the frequency of burnout and its consequences in doctors during medical residency training.

Who was studied?

115 internal medicine residents from a U.S. university-based training program. Almost half the doctors were in their first year of residency training.

How was the study done?

The residents completed questionnaires that included standardized questions that asked about symptoms of burnout, stress, depression, fatigue, alcohol consumption, and patient care. The researchers then looked at whether residents were burned out and whether burned-out residents reported providing patient care that was suboptimal more often than residents who were not burned out.

What did the researchers find?

Three quarters of the residents were burned out, according to the definitions that the researchers used. Compared with non–burned-out residents, burned-out residents were more likely to say that they discharged patients early to make their work manageable, did not fully discuss treatment options or answer a patient's questions, or made medical errors. Neither depression nor alcohol use was associated with these patient care practices. More than half the burned-out residents were unhappy that they had decided to become a doctor; one quarter said that if they could start over, they were not sure whether they would choose to become a doctor again.

What were the limitations of the study?

The researchers studied residents at a single training program. These resident physicians may not be typical of residents in all training programs. The study is based on residents' self-report of patient care, and residents may report patient care practices inaccurately or inconsistently. The questionnaires were sent in February, a time of the year when resident morale is typically low.

What are the implications of the study?

Burnout is a common and serious problem among doctors during their training, and it is a different problem than depression or substance abuse. Burned out doctors in training were more likely to report practicing suboptimal patient care than those who were not burned out and also to report personal distress and career dissatisfaction.