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Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low
personal accomplishment. Little is known about burnout in residents or its relationship
to patient care.
To determine the prevalence of burnout in medical residents and explore its relationship
to self-reported patient care practices.
Cross-sectional study using an anonymous, mailed survey.
University-based residency program in Seattle, Washington.
115 internal medicine residents.
Burnout was measured by using the Maslach Burnout Inventory and was defined as scores
in the high range for medical professionals on the depersonalization or emotional
exhaustion subscales. Five questions developed for this study assessed self-reported
patient care practices that suggested suboptimal care (for example, "I did not fully
discuss treatment options or answer a patient's questions" or "I made...errors that
were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol
use were assessed by using validated screening questionnaires.
Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared
with non-burned-out residents, burned-out residents were significantly more likely
to self-report providing at least one type of suboptimal patient care at least monthly
(53% vs. 21%; P = 0.004). In multivariate analyses, burnout--but not sex, depression,
or at-risk alcohol use--was strongly associated with self-report of one or more suboptimal
patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When
each domain of burnout was evaluated separately, only a high score for depersonalization
was associated with self-reported suboptimal patient care practices (in a dose-response
Burnout was common among resident physicians and was associated with self-reported
suboptimal patient care practices.