Physician Wellness: Impact of Stress, Burnout, and Depression on Medical Trainee Empathy



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Background: Medical schools and residency training programs are tasked with developing physicians that are compassionate, empathetic providers capable of providing evidenced-based, up-to-date care. With the numerous changes in healthcare, healthcare education, and increased stress, burnout, depression in medical trainees, empathy levels have declined, impacting patient health outcomes and physician well-being. Purpose: This study sought to understand the relationship between stress, burnout, depression and empathy in medical trainees. Using self-report scales, we sought to determine the impact career demands, stress, and a changing healthcare system has on medical trainees. This study captured elements of burnout and depression that impacted trainee empathy and compassion towards their patients, and ultimately patient outcomes. This study evaluated demographic data and characteristics that identified trainees that are more likely to be more burnt out, depressed, or less empathetic. Methods: Utilizing the Jefferson Scale of Physician Empathy, the Maslach Burnout Inventory, and the Patient Health Questionnaire-9, trainee self reports of empathy, stress/burnout, and depression were collected and analyzed for correlations between scales and with demographic data. Results: Numerous results were found, noting that students/residents have low empathy, which correlated with high rates of burnout and depression in both populations. Significant demographic correlations with high burnout, depression, and low empathy were seen in gender, specialty choice, and year in school/residency; our resident population trended high on each of these variables compared to students. Conclusion: These findings highlight significant trends in medical education that require intervention. Current training models are producing students and residents with poor empathy and increasingly high burnout, detachment, low performing behavior that affects self-care and patient outcomes. A new conceptual model was developed to indicate the role low empathy, burnout, and depression play on patient care and physician well-being, along with a discussion of potential changes needed in curriculum.



Empathy, Burnout, Depression, Stress, Medical education, Medical students, Residents, Medical school, Wellness, Physicians, Maslach burnout inventory, Jefferson scale, Physician empathy, Patient health questionnaire, Resilience