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. 2022 Feb 1;5(2):e220115.
doi: 10.1001/jamanetworkopen.2022.0115.

Perceptions on Burnout and the Medical School Learning Environment of Medical Students Who Are Underrepresented in Medicine

Jamieson M O'Marr  1 , Shin Mei Chan  1 , Lake Crawford  1 , Ambrose H Wong  2 , Elizabeth Samuels  3 , Dowin Boatright  1   2
Affiliations

Perceptions on Burnout and the Medical School Learning Environment of Medical Students Who Are Underrepresented in Medicine

Jamieson M O'Marr et al. JAMA Netw Open. .

Abstract

Importance: Burnout is a highly prevalent issue among medical trainees, but there has been limited research characterizing burnout specifically among medical students from groups who are underrepresented in medicine (URIM).

Objective: To assess the association between components of the medical school learning environment and burnout among medical students who are URIM vs those who are not.

Design, setting, and participants: This retrospective cross-sectional survey study evaluated responses of allopathic medical students graduating from all US allopathic medical schools in 2016 and 2017 to the American Medical Colleges Graduation Questionnaire. Analysis was completed between December 1, 2019, and July 1, 2020.

Exposures: Self-identification as a medical student who is URIM.

Main outcomes and measures: Self-reported measures of medical student overall, disengagement, and exhaustion-related burnout using the Oldenburg Burnout Inventory for Medical Students.

Results: The American Medical Colleges Graduation Questionnaire had an 81% response rate, yielding 26 567 complete participant responses that were included the analysis. A total of 13 645 individuals (51.4%) were male, and 3947 (14.9%) identified as URIM (ie, Alaska Native, Black, Hispanic/Latinx, Native American, and/or Pacific Islander). Medical students who are URIM reported modestly higher levels of exhaustion-related burnout (mean [SD], 11.84 [3.62] vs 11.48 [3.61]; P < .001) and modestly lower mean burnout scores associated with disengagement (mean [SD], 9.24 [3.56] vs 9.36 [3.58]; P = .047). Medical students who are URIM also reported marginally less favorable student-faculty interactions in the learning environment (mean [SD], 14.09 [3.45] vs 14.29 [3.35]; P < .001). Medical students who are URIM were more likely to be in the top quartile of those who experienced exhaustion-related burnout (odds ratio, 1.19 [95% CI, 1.09-1.29]) but less likely to be in the top quartile for disengagement (odds ratio, 0.87 [95% CI, 0.80-0.94]). Regardless of URIM status, those who reported learning environment scores in the bottom quartile were more likely to experience higher rates of burnout as were those who experienced at least 1 episode of discrimination.

Conclusions and relevance: This survey study found that medical students who are URIM had a higher risk for exhaustion-related burnout. This burnout is likely multifactorial and could represent a resiliency or survival bias, the burden of increased responsibility, and/or recurrent discrimination. The learning environment can play a key role in mitigating burnout in both medical students who are URIM and those who are not and is deserving of further research.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Wong reported a research grant from SAEMF/Academy for Diversity and Inclusion in Emergency Medicine during the conduct of the study and grants from Agency for Healthcare Research and Quality (grant R01 HS028340-01), Robert E. Leet and Clara Guthrie Patterson Trust (Mentored Research Award), National Center for Advancing Translational Sciences (grant KL2 TR001862), and National Institute of Mental Health (grant K23MH126366) outside the submitted work. Dr Boatright reported grants from the National Institute of General Medical Sciences (grant R01GM137411) during the conduct of the study. No other disclosures were reported.

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