Research suggests that half of all medical students may be affected by burnout during their medical education. Evidence also suggests that medical students are not inherently more susceptible to burnout than other age-similar individuals. In fact, upon entering medical school, medical students have lower burnout, less depression, and higher quality of life than college graduates pursuing other professions. By the second year of medical school, however, that pattern is reversed. By the time trainees start residency they report lower quality of life, higher rates of burnout, more depression, and less job satisfaction than their peers in other professions.

Medical students aren’t the only trainees experiencing burnout. Although more research is needed, evidence suggests that dental students and nursing students may also experience burnout.

For many, burnout occurs because of excessive workloads, undue competition and exposure to human suffering. It’s clear that burnout is not simply a deficiency of the individual. The symptoms of burnout are indicative of systemic problems in the learning environment that prevent trainees from thriving. Solutions are needed that address the systems in which trainees spend most of their time.

Pressure, Workload, and Lack of Time for Self-Care

The academic burden of clinical education can be intense. Trainees are expected to learn a vast array of material in a very short amount of time.  Medical school has been likened to drinking water from a fire hose. Medical students must grapple with high-volume school workloads while simultaneously attending clinical rounds, studying for national licensing exams and preparing applications for residency and fellowship programs. Nursing, pharmacy, and dental students find themselves in similar predicaments as they contend with the pressures of their academic workload in addition to finding time to study for licensing exams and preparing for jobs or postgraduate programs.

Outside of the classroom, trainees enter clinical settings in which they come face-to-face with sick and dying patients, often for the first time. Being surrounded by human suffering day in and day out can take its toll, especially when there are no programs in place to help trainees process the emotions they experience. Sadly, instead of receiving support, many medical students report mistreatment from supervisors and other senior clinicians.

The workload demands that are thrust onto trainees allow little time for everyday activities like spending time with family and friends, sleeping, and exercising. These demands make it virtually impossible for trainees to maintain balance in their lives. Student affairs offices within learning institutions play a critical role in enhancing trainee well-being and resources should be directed to ensure that programs to enhance trainee well-being are fully supported.

Competitive Environment and Cultural Aspects of Medicine and the Health Professions

By most accounts, the pressures placed on medical and other health sciences students can be brutal. Thousands of applicants compete each year for spots in medical schools but the average medical school accepts less than 7 percent of applicants each year. In addition, one out of three qualified applicants are rejected by nursing schools. In many ways, the competitive environment into which students are thrust may result in many trainees vying for perfection, which can lead to feelings of inadequacy. Reducing competition in the classroom may help enhance student well-being, and many medical schools have instituted pass-fail grading systems to help minimize stress and anxiety.

Aspects of the culture of medicine and medical education may contribute to burnout in trainees. For example, because medicine is a demanding profession, some believe that medical school must be equally demanding. If trainees are surrounded by those who believe that more pressure, more demand, and more hours lead to better educational outcomes, there is little space for trainees to express frustration and concerns without the fear of being chastised by superiors.