Career choice regret, specialty choice, and anxiety in medical school have been linked with elevated rates of burnout in resident physicians, according to research results published in JAMA.

Liselotte N. Dyrbye, MD, MPHE, of the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a prospective cohort study of 4732 resident physicians to assess the relationship among clinical specialty, educational debt, Step 1 Examination score, demographic characteristics and levels of anxiety, empathy, and social support in medical school.

Nearly 75% of participant physicians completed the questionnaire during their second year of residency (50.9% women; median age, 29 years). More than 40% of residents reported symptoms of burnout (95% CI, 43.6%-46.8%), but only 14.1% reported career choice regret (95% CI, 12.9%-15.2%).

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Multivariable analyses found that those who trained in urology, neurology, emergency medicine, and general surgery had higher relative risk for reported burnout symptoms (relative risk range: 1.24-1.48) compared with those who trained in internal medicine.

Female sex and elevated levels of reported anxiety during medical school were both linked with a higher risk for reported burnout symptoms (95% CI, 1.07-1.28 and 1.06-1.11, respectively). Higher levels of reported empathy were associated with lower risk for reported burnout symptoms (95% CI, 0.99-0.99).

“Findings suggest that the prevalence of burnout symptoms among resident physicians may be similar to that of practicing physicians,” Dr Dyrbye and colleagues wrote. “Symptoms of burnout among resident physicians were strongly associated with career and specialty choice regret.”

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The researchers concluded, “Symptoms of burnout and career choice regret were prevalent, but varied substantially by clinical specialty. Further research is needed to address these issues.”


Dyrbye LN, Burke SE, Hardeman RR, et al. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA. 2018;320(11):1114-1130.