Burnout and Depression in MS1 and MS3 Years: A Comparison of Cohorts at One Medical School

Abstract

Background: Losses of idealism, empathy, and professionalism over the course of medical education have been described previously in the literature. A 2012 national survey of medical students estimated 37%-44% with burnout, 58% screen positive for depression, and 9.4% with suicidal ideation in the past 12 months. Given changes in related traits, we sought to explore whether burnout and symptoms of depression change over time. The objectives of this study were to assess the differences in medical student burnout and symptoms of depression between first year (MS1) and third-year (MS3) medical students at one medical college.

Methods: Students were administered the modified Maslach Burnout Inventory (MBI) and the Patient Health Questionnaire-2 (PHQ-2) depression screening instrument as an optional part of a mandatory annual survey administered by the medical college near the end of the academic year (March-May, 2015). Anonymous responses from MS1s and MS3s were analyzed to estimate trends in burnout and possible depression over time and to examine the relationship between the two measures.

Results: Possible depression (Total PHQ2 equal or greater than 3) was present in 28.5% of all respondents. MS3s had significantly higher levels of Emotional Exhaustion (EE) and Depersonalization (DP), and lower levels of Personal Accomplishment (PA), than MS1s. When PHQ2, gender, and campus/program effects were controlled via regression, MS3s tended to record EE and DP scores over 2 points higher than MS1s and PA scores over 2 points lower. Regrets about entering medicine were also higher in MS3s in the controlled models. PHQ2 scores were also positively associated with all subscales except for PA.

Conclusions: Students appear to be at slightly greater risk for burnout as they temporally progress through medical school. These findings are consistent with similar measurements of decreasing empathy and idealism when comparing cohorts of early versus late medical students.