The prevalence of medical student mistreatment and its association with burnout

Abstract

Purpose: 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.

Method: 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.

Figure 1

Frequency of self-reported medical student mistreatment by faculty and by residents in a nationally representative sample of third-year medical students (n = 562). The infrequent mistreatment category included students who reported mistreatment “once or twice” or “a few times”. The recurrent mistreatment category included students who reported mistreatment “several times” or “numerous times”.

Figure 2

Prevalence of high burnout in a nationally representative sample of third-year medical students by degree of reported mistreatment by faculty and by residents (n = 561) Burnout assessed by validated two-item version of Maslach Burnout Inventory. Mistreatment categorized by student self-report. The infrequent mistreatment category included students who reported mistreatment “once or twice” or “a few times”. The recurrent mistreatment category included students who reported mistreatment “several times” or “numerous times”.