Impact of COVID-19 on Burnout in Clerkship Medical Students

Document Type : Short Communication

Authors

1 Baylor, Scott & White Health, Houston, TX, USA

2 Paul L Foster School of Medicine, Texas Tech Health Sciences Center El Paso, TX, USA

3 Dr. Kiran C. Patel College of Allopathic Medicine. Nova Southeastern University, FL, USA

Abstract

Burnout among physicians is more prevalent than other fields and begins as early as medical school. The aim of this study was to characterize the impact of COVID-19 on different aspects of burnout in third-year medical students at a minority-serving medical school at the U.S.-Mexico border. A Comparative study was conducted in 2022. Participants included those in the classes of 2019 through 2023. Data from the classes of 2019-2021 represented the period before COVID-19 curriculum changes and was compared to classes 2022-2023, which represented the period after the onset of COVID-19. The data on the classes of 2023 was compared between the two integrated rotation blocks to evaluate if non-COVID-related experiences might contribute to an increase in burnout in one block versus the other. Lastly, all data were compared to a general population sample to screen for the possibility of systemic deficiencies relative to other health professions. 
The Maslach Burnout Inventory Human Services Survey (MBI-HSS), which determines the scores for emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), was administered to third-year medical students during their clinical rotations. 
Data were analyzed using a paired or unpaired t-test if they followed a normal distribution or the Mann-Whitney test if this was not the case. Scores for EE (P<0.0001), DP (P<0.0001), and PA (P=0.02) decreased after the onset of COVID-19. No statistically significant differences were found between the rotation blocks. However, when we compared the individual rotation blocks to the general population, the OBGYN/Pediatrics/Surgery blocks had a higher EE score (P=0.0003) than the Internal Medicine/Family Medicine/Psychiatry block. Before COVID-19, EE (P<0.01), DP (P<0.0001), and PA (P<0.05) appeared to be improved compared to the general population. After the onset of COVID-19, EE was less than the general population (P<0.0001). A broader assessment of burnout in medical students across the nation is warranted. Identification of specific COVID-19 influences and clerkship-related factors would prompt targeted actions to reduce burnout in this medical student population. Interventions are suggested to be designed to lessen the degree of burnout in clerkship students, possibly in other medical schools experiencing similar challenges.

Keywords

References

  1. De la Cerda-Vargas MF, Stienen MN, Campero A, Perez-Castell AF, Soriano-Sanchez JA, Nettel-Rueda B, et al. Burnout, Discrimination, Abuse, and Mistreatment in Latin America Neurosurgical Training During the Coronavirus Disease 2019 Pandemic. World Neurosurg. 2022;158:e393-e415.10.1016/j.wneu.2021.10.188.PMID.PMC8574080.
  2. Serrano F, Mejia C, Garnica L, Lizacno-Gomez A, Hernandez Caicedo A, Cruz Y, et al. Burnout syndrome, according to the year of study, in medical students from eight countries in Latinoamerica, 2016-2017. CIMEL. 2020;26(1):22-9.PMID.
  3. Grau Martin A, Flichtentrei D, Suner R, Prats M, Braga F. [Influence of personal, professional and cross-national factors in burnout syndrome in Hispanic Americans and Spanish health workers (2007)]. Rev Esp Salud Publica. 2009;83(2):215-30.10.1590/s1135-57272009000200006.PMID.
  4. Yates SW. Physician Stress and Burnout. Am J Med. 2020;133(2):160-4.10.1016/j.amjmed.2019.08.034.PMID.
  5. Frajerman A, Morvan Y, Krebs MO, Gorwood P, Chaumette B. Burnout in medical students before residency: A systematic review and meta-analysis. Eur Psychiatry. 2019;55:36-42.10.1016/j.eurpsy.2018.08.006.PMID.
  6. Erschens R, Keifenheim KE, Herrmann-Werner A, Loda T, Schwille-Kiuntke J, Bugaj TJ, et al. Professional burnout among medical students: Systematic literature review and meta-analysis. Med Teach. 2019;41(2):172-83.10.1080/0142159X.2018.1457213.PMID.
  7. Hansell MW, Ungerleider RM, Brooks CA, Knudson MP, Kirk JK, Ungerleider JD. Temporal Trends in Medical Student Burnout. Fam Med. 2019;51(5):399-404.10.22454/FamMed.2019.270753.PMID.
  8. Thun-Hohenstein L, Hobinger-Ablasser C, Geyerhofer S, Lampert K, Schreuer M, Fritz C. Burnout in medical students. Neuropsychiatr. 2021;35(1):17-27.10.1007/s40211-020-00359-5.PMID.PMC7954737.
  9. Gil-Calderon J, Alonso-Molero J, Dierssen-Sotos T, Gomez-Acebo I, Llorca J. Burnout syndrome in Spanish medical students. BMC Med Educ. 2021;21(1):231.10.1186/s12909-021-02661-4.PMID.PMC8063293.
  10. Zis P, Artemiadis A, Bargiotas P, Nteveros A, Hadjigeorgiou GM. Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health. Int J Environ Res Public Health. 2021;18(1).10.3390/ijerph18010349.PMID.PMC7796433.
  11. Bolatov AK, Seisembekov TZ, Askarova AZ, Baikanova RK, Smailova DS, Fabbro E. Online-Learning due to COVID-19 Improved Mental Health Among Medical Students. Med Sci Educ. 2021;31(1):183-92.10.1007/s40670-020-01165-y.PMID.PMC7673686.
  12. Compton S, Sarraf-Yazdi S, Rustandy F, Radha Krishna LK. Medical students’ preference for returning to the clinical setting during the COVID-19 pandemic. Med Educ. 2020;54(10):943-50.10.1111/medu.14268.PMID.PMC7300867.
  13. Ishak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach. 2013;10(4):242-5.10.1111/tct.12014.PMID.
  14. Elkins C, Plante KP, Germain LJ, Morley CP. Burnout and Depression in MS1 and MS3 Years: A Comparison of Cohorts at One Medical School. Fam Med. 2017;49(6):456-9.PMID.
  15. Kim JW, Ryu H, Park JB, Moon SH, Myung SJ, Park WB, et al. Establishing a Patient-centered Longitudinal Integrated Clerkship: Early Results from a Single Institution. J Korean Med Sci. 2020;35(50):e419.10.3346/jkms.2020.35.e419.PMID.PMC7769701.
  16. Brown MEL, Whybrow P, Kirwan G, Finn GM. Professional identity formation within longitudinal integrated clerkships: A scoping review. Med Educ. 2021;55(8):912-24.10.1111/medu.14461.PMID.
  17. O’Doherty J, Hyde S, O’Connor R, Brown MEL, Hayes P, Niranjan V, et al. Development and sustainment of professional relationships within longitudinal integrated clerkships in general practice (LICs): a narrative review. Ir J Med Sci. 2022;191(1):447-59.10.1007/s11845-021-02525-2.PMID.
Interdisciplinary Journal of Virtual Learning in Medical Sciences
Volume 14, Issue 4 - Serial Number 55
December 2023
Pages 337-344

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