The Association Between Burnout and Sociodemographic Characteristics with Medical School Attrition

Despite increased efforts to improve student well-being, burnout remains a substantial problem in medical education, and little is known about whether burnout is associated with attrition among medical students across sociodemographic characteristics.

To evaluate association between burnout and attrition from medical school across sociodemographic characteristics.

Retrospective cross-sectional study.

MD-granting US medical schools.

Enrolled medical students who completed the Association of American Medical Colleges (AAMC) Year 2 Questionnaire from 2015-2021.

Burnout, assessed using the Oldenburg Burnout Inventory for Medical Students and attrition from medical school.

Among 62,838 MD Year 2 students in the study cohort, 1,014 (1.6%) left medical school. Female students were less likely to report disengagement-related burnout (aRR:0.80, 95%CI: 0.77-0.83). Compared to White students, Asian (aRR:1.22, 95%CI:1.15-1.28), Black (aRR:1.12, 95%CI:1.05-1.21), and LGB students had a significantly higher risk of disengagement (aRR: 1.33, 95%CI: 1.27-1.40). Similar differences were found for exhaustion-related burnout, with the exception that female students were more likely than male students to be at high risk for exhaustion (aRR:1.37, 95%CI:1.32-1.42). Exhaustion and disengagement were significantly associated with attrition. Compared to the lowest quartile of reported burnout, students reporting exhaustion in the highest quartile were 2-times more likely to leave medical school and students with disengagement were 3-times more likely. Non-White and White female LGB, and non-White male LGB students reporting exhaustion and disengagement in the highest quartile were most likely to leave medical school.

The AAMC Year 2 Questionnaire historically has a response rate of 45-55%, which limits generalizability.

High levels of burnout is associated with twice the risk of attrition for all students. Female, non-White, and LGB students with high risk of burnout were significantly more likely to leave medical school. These findings highlight a need to improve well-being and retention for students at high risk for attrition, including female, non-White, LGB students with high risk for burnout.