Burnout and Educational Debt Affect Medical Knowledge Among IM Residents (measured by exam scores)

Doctors are not impervious to stresses of daily life. Physician distress is common and has been associated with negative effects on patient care.

This JAMA study of internal medicine residents used data collected during 2008-2009 Internal Medicine In-Training Examination (IM-ITE). Participants were 16,000 IM residents, representing 74% of all eligible US internal medicine residents - approximately 7700 US medical graduates and 8500 international medical graduates (IMGs).

Quality of life was rated “as bad as it can be” or “somewhat bad” by 15% of residents.

Burnout, emotional exhaustion and depersonalization were reported by 51%, 46%, and 29% of residents, respectively.

Burnout was less common among international medical graduates than among US medical graduates (45% vs 59%),

Greater educational debt was associated with the presence of at least 1 symptom of burnout (61% vs 44%; for debt greater than $200 000 relative to no debt).

Residents reporting QOL “as bad as it can be” and emotional exhaustion daily had exam scores 2.7 points and 4.2 points lower than those with QOL “as good as it can be” and no emotional exhaustion, respectively.

Residents reporting debt greater than $200,000 had exam scores 5 points lower than those with no debt.

Suboptimal QOL and burnout were common among IM residents. Burnout was associated with higher debt and was jess frequent among international medical graduates (IMGs).

Low QOL, emotional exhaustion, and educational debt were associated with lower IM-ITE scores.


Quality of Life, Burnout, Educational Debt, and Medical Knowledge Among Internal Medicine Residents. JAMA, 2011;306(9):952-960. doi: 10.1001/jama.2011.1247
Stress overdose for doctors. Star Tribune.
Image source: OpenClipArt.org, public domain.

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