Symptoms of burnout were highly prevalent in a cohort of osteopathic medical students (OMSs) in the United States, according to study data published in the Journal of the American Osteopathic Association. Among surveyed students, burnout was independently associated with sleep quality and smartphone use.

Investigators conducted a cross-sectional study of students enrolled at Ohio University Heritage College of Osteopathic Medicine in Athens, Ohio, during the 2017-2018 academic year. Participants completed an anonymous, electronic questionnaire that captured sociodemographic factors, school year, school campus, and health factors. The questionnaire also administered the Maslach Burnout Inventory-Human Services Survey, which assigns scores for 3 distinct dimensions of burnout: emotional exhaustion (EE), depersonalization (DP), and low sense of personal accomplishment (PA). Perceived stress, sleep quality, and smartphone use were also captured. Chi-squared tests and variance analyses were conducted to assess differences in burnout across sociodemographic and health strata. Linear regression analyses were performed to assess the extent to which burnout was affected by stress, sleep quality, and smartphone use.

Of 906 osteopathic medical students enrolled at the 3 campuses of Ohio University, 385 provided complete survey data. Mean student age was 25.4 (2.4) years, 208 (54%) were women, and 286 (74.3%) identified as white. A significant proportion (80.5%) of respondents reported feeling a low sense of personal achievement. Additionally, 67 (17.4%) and 9 (2.3%) endorsed high levels of DP and EE, respectively. Per χ2 tests, burnout rates differed significantly by sex and year in medical school: men more frequently reported low PA compared with women (P =.022), and DP was more prevalent among year 3 students compared with year 1 students (P =.004). Overall, 66.2% of participants met the criteria for poor sleep quality, and 22.3% qualified for smartphone addiction. A significant proportion also reported moderate (53.0%) to high (9.6%) perceived stress levels. In linear regression models, higher perceived stress (P <.001), poorer sleep quality (P =.001), and higher smartphone addiction scores (P <.001) were each associated with higher levels of EE. Similarly, DP was significantly associated with high stress (P <.001), poor sleep quality (P =.001), and smartphone addiction (P =.001). However, only higher perceived stress was significantly associated with low PA (P <.001). 

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In a cohort of osteopathic medical students in the Midwestern United States, burnout was predicted by high stress, poor sleep quality, and excessive smartphone use. Because cross-sectional survey data collected from just 1 institution, results may not be generalizable to the rest of osteopathic medical students in the United States. Likewise, the researchers note that further study of burnout in more diverse student populations is needed. Even so, the results of the present study support the development of interventions that target the modifiable predictors of burnout, including sleep deprivation and smartphone addiction.


Brubaker JR, Beverly EA. Burnout, perceived stress, sleep quality, and smartphone use: a survey of osteopathic medical students. J Am Osteopath Assoc. 2020;120(1):6-17.