Professional burnout among medical students: Systematic literature review and meta-analysis

Abstract

Background: This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students.

Methods: The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS).

Results: Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI–HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology.

Conclusion: This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students’ mental health impairment to enable more meaningful comparisons and adequate prevention strategies.

Glossary

Professional burnout: Is a permanent, negative, work- or study-related state of mind. This is characterized by exhaustion, accompanied by restlessness and tension, a feeling of reduced efficiency and motivation.

Maslach C, Jackson SE, Leiter MP. 1996. MBI: Maslach burnout inventory: CPP, Incorporated.

Schaufeli W, Enzmann D. 1998. The burnout companion to study and practice: A critical analysis: CRC press.

Acknowledgments

We thank Katrin Ziser for excellent proofreading. We thank Sophie Schink for her support with the layout of the manuscript and references. We thank Kaltrina Gashi supporting us in creating the Forest Plot.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This review was co-funded by the “Competence Centre for the Prevention of Mental and Psychosomatic Disorders in Work and Educational Settings (PPAA)”, supported by the Federal State of Baden-Wuerttemberg.

Notes on contributors

Rebecca Erschens

Rebecca Erschens, Diplom, is a graduate psychologist, research officer and lecturer of the Department for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen.

Katharina Eva Keifenheim

Katharina Eva Keifenheim, MD, is a specialist physician and scientist of the Department for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen. She is responsible for projects that focus on Peer-Assisted History-Taking Groups, doctor-patient encounters and video feedback in communication classes for medical students.

Anne Herrmann-Werner

Anne Herrmann-Werner, MD, MME, is a Senior Physician for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen, and the head of the medical faculty’s skills lab for medical students. She is mainly responsible for undergraduate medical student’s communication training, coordination of OSCE, and teaching projects that focus on peer-assisted learning and communication classes.

Teresa Loda

Teresa Loda, MS, is a psychologist and scientist at of the Department for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen.

Juliane Schwille-Kiuntke

Juliane Schwille-Kiuntke, MD, is a resident physician and scientist of the Department for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen.

Till Johannes Bugaj

Till Johannes Bugaj, MD, is a physician and scientist in the Department of General Internal and Psychosomatic Medicine at the University of Heidelberg Medical Hospital, Germany.

Christoph Nikendei

Christoph Nikendei, MD, MME, is Professor of General Internal Medicine and Psychosomatics at the University Hospital Heidelberg. He is responsible for skills-lab training, stress prevention programs, final year, and international students’ education at the University of Heidelberg. He was honored with AMEE`s 2008 Miriam Friedman Ben-David Award.

Daniel Huhn

Daniel Huhn, Diplom, is a graduate psychologist, psychotherapist in training and scientist in the Department of General Internal and Psychosomatic Medicine at the University of Heidelberg Medical Hospital, Germany.

Stephan Zipfel

Stephan Zipfel, MD, is a Professor for Psychosomatic Medicine and Psychotherapy and the Director of the Department for Psychosomatic Medicine and Psychotherapy at the University Medical Hospital Tübingen, and Dean for Student Affairs at the Faculty of Medicine of Tübingen University.

Florian Junne

Florian Junne, MD, is Deputy Head of the Department for Psychosomatic Medicine and Psychotherapy at University Medical Hospital Tübingen. He is the project head and coordinator for studies with medical students within the Competence Centre for the Prevention of Mental and Psychosomatic Disorders in Work and Educational Settings (PPAA).