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Medical Teacher Volume 33, 2011 - Issue 9
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The problems program directors inherit: medical student distress at the time of graduation

Liselotte N. DyrbyeMayo Clinic, USA; LISELOTTE N. DYRBYE, MD MHPE is a consultant in the division of Primary Care Internal Medicine and associate professor of medicine, Mayo Clinic, Rochester, Minnesota. Dr. Dyrbye is the Associate Director, Research Applications, Mayo Clinic's Program on Physician Well-being. She has published extensively in the area of trainee and physician well-being.Correspondence[email protected]
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Christine MoutierUniversity of California, USA; CHRISTINE MOUTIER, MD is the assistant dean for student affairs and associate professor of psychiatry, University of California San Diego School of Medicine. Dr. Moutier's areas of interest include refractory depression and medical student/physician wellness and suicide prevention.
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Steven J. DurningUniformed Services University of the Health Sciences, USA; STEVEN J. DURNING, MD is professor of medicine and pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
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F. Stanford Massie JrUniversity of Alabama School of Medicine, USA; F. STANFORD MASSIE JR., MD is associate professor of medicine, University of Alabama School of Medicine. Dr. Massie directs the Introduction to Clinical Medicine course.
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David V. PowerUniversity of Minnesota Medical School, USA; DAVID V POWER, MD MPH is associate professor of Family Medicine, University of Minnesota Medical School
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Anne EackerUniversity of Washington School of Medicine, USA; ANNE EACKER, MD is associate professor of medicine, University of Washington School of Medicine
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William HarperUniversity of Chicago, USA; WILLIAM HARPER, MD is associate professor of medicine, University of Chicago Pritzker School of Medicine. Dr. Harper directs the pre-clerkship clinical skills curriculum and is the Medical Director for the Program for Personalized Health and Prevention, University of Chicago Medical Center.
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Matthew R. ThomasMayo Clinic, USA; MATTHEW R. THOMAS, MD is a consultant in the division of Primary Care Internal Medicine and assistant professor of medicine, Mayo Clinic, Rochester, Minnesota. Dr. Thomas directs the Internal Medicine Clerkship and is Chair of Education, Division of Primary Care Internal Medicine, Mayo Clinic.
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Daniel SateleMayo Clinic, USA; DANIEL SATELE, MS is a statistician, Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota.
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Jeff A. SloanMayo Clinic, USA; JEFF A. SLOAN, PhD is professor of biostatistics and oncology, Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota. Dr. Sloan has extensive expertise in quality of life research.
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Tait D. ShanafeltMayo Clinic, USA; TAIT D. SHANAFELT, MD is a consultant in the division of Hematology and associate professor of medicine, Mayo Clinic, Rochester, Minnesota. Dr. Shanafelt is the Director of the Mayo Clinic's Program on Physician Well-being and has published extensively in the field of trainee and physician well-being.
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Pages 756-758 | Published online: 19 Aug 2011
 
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Abstract

Background: Distress is prevalent among residents and often attributed to rigors of training.

Aims: To explore the prevalence of burnout and depression and measured mental quality of life (QOL) among graduating medical students shortly before they began residency.

Method: Pooled analysis of data from 1428 fourth year medical students who responded to 1 of 3 multi-institutional studies. Students completed the Maslach Burnout Inventory, PRIME MD, and SF-8 to measure burnout, depression, and low mental QOL (defined as mean mental SF-8 scores ½ a standard deviation below the population norm) and answered demographic items.

Results: Shortly before beginning residency, 49% of responding medical students had burnout, 38% endorsed depressive symptoms, and 34% had low mental QOL. While no differences in the prevalence of distress was observed by residency specialty area, there were subtle differences in the manifestation of burnout by specialty. Medical students entering surgical fields had lower mean emotional scores, students entering primary care fields had lower mean depersonalization scores, and students entering non-primary care/non-surgical fields reported the lowest mean personal accomplishment scores (all p ≤ 0.03).

Conclusion: Our results indicate a high prevalence of distress among graduating medical students across all specialty disciplines before they even begin residency training.

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