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Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program

Tait D. Shanafelt, MD; Katharine A. Bradley, MD, MPH; Joyce E. Wipf, MD; and Anthony L. Back, MD
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From University of Washington, Veterans Affairs Northwest Health Services Research and Development Center of Excellence, and Veterans Affairs Puget Sound Health Care System, Seattle, Washington.


Note: Views expressed in this article are those of the authors and do not necessarily represent the views of the University of Washington, Department of Veterans Affairs, the Robert Wood Johnson Foundation, the National Institute of Alcohol Abuse and Alcoholism, or the Project on Death in America.

Acknowledgments: The authors thank the Internal Medicine residents and the chief medical residents at the University of Washington-affiliated hospitals and Drs. James F. Wallace and William Bremner for their support of this project. They also thank Ms. Amee Epler for assistance with data analysis and manuscript preparation.

Grant Support: By the University of Washington Internal Medicine Residency Program and the Veterans Affairs Northwest Center of Excellence for Health Services Research and Development. Dr. Bradley is a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar and is currently supported by U.S. National Institute of Alcohol Abuse and Alcoholism grant K23AA00313. Dr. Back is a Faculty Scholar of the Project on Death in America.

Requests for Single Reprints: Anthony L. Back, MD, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way (S-111), Seattle, WA 98108; e-mail, tonyback@u.washington.edu.

Current Author Addresses: Dr. Shanafelt: Department of Hematology, Mayo Clinic, West 10, 200 First Street SW, Rochester, MN 55905.

Drs. Bradley, Wipf, and Back: Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108.

Author Contributions: Conception and design: T.D. Shanafelt, K.A. Bradley, J.E. Wipf, A.L. Back.

Analysis and interpretation of the data: T.D. Shanafelt, K.A. Bradley, J.E. Wipf, A.L. Back.

Drafting of the article: T.D. Shanafelt, K.A. Bradley, J.E. Wipf, A.L. Back.

Critical revision of the article for important intellectual content: T.D. Shanafelt, K.A. Bradley, J.E. Wipf, A.L. Back.

Final approval of the article: T.D. Shanafelt, K.A. Bradley, J.E. Wipf, A.L. Back.

Provision of study materials or patients: T.D. Shanafelt.

Statistical expertise: K.A. Bradley.

Obtaining of funding: J.E. Wipf.

Administrative, technical, or logistic support: T.D. Shanafelt, K.A. Bradley, A.L. Back.

Collection and assembly of data: T.D. Shanafelt, J.E. Wipf.


Ann Intern Med. 2002;136(5):358-367. doi:10.7326/0003-4819-136-5-200203050-00008
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Of the 151 eligible residents, 115 (76%) returned surveys in February or March 2001. Participation decreased by residency year (the response rates were 90% among the 1st-year residents, 71% in 2nd-year residents, and 62% in 3rd-year residents; chi-square test for trend, P = 0.001). However, in bivariate analyses, resident responses to questions about burnout, depression, substance use, or patient care practices did not differ significantly by year of postgraduate training. Therefore, for the remaining analyses, we combined data for participants from all years of residency training.

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Figure.
Relationship of burnout to self-reported suboptimal patient care practices and attitudes.

In each pair, the top bar represents residents who did not meet criteria for burnout (n = 27), and the bottom bar represents residents who met criteria for burnout (n = 87). The chi-square statistic compared residents who met criteria for burnout with those who did not on rates of each practice self-reported to occur at least several times per year. *P < 0.05.

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Summary for Patients

Do Medical Residents Experience Burnout?

The summary below is from the full report titled “Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program.” It is in the 5 March 2002 issue of Annals of Internal Medicine (volume 136, pages 358-367). The authors are TD Shanafelt, KA Bradley, JE Wipf, and AL Back.

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