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Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students

Jackson, Eric R.; Shanafelt, Tait D. MD; Hasan, Omar MBBS, MPH, MS; Satele, Daniel V.; Dyrbye, Liselotte N. MD, MHPE

doi: 10.1097/ACM.0000000000001138
Research Reports

Purpose To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students.

Method In 2012, the authors completed a national survey of medical students from the American Medical Association’s Physician Masterfile containing validated items assessing alcohol abuse/dependence, burnout, depression, suicidality, quality of life (QOL), and fatigue. Descriptive and comparative statistical analyses were computed, including chi-square and multivariate logistic regression, to determine relationships between variables.

Results Of the 12,500 students, 4,402 (35.2%) responded. Of these, 1,411 (32.4%) met diagnostic criteria for alcohol abuse/dependence. Students who were burned out (P = .01), depressed (P = .01), or reported low mental (P =.03) or emotional (P = .016) QOL were more likely to have alcohol abuse/dependence. Emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse/dependence. On multivariate analysis, burnout (OR 1.20; 95% CI 1.05–1.37; P < .01), having $50,000 to $100,000 (OR 1.21 versus < $50,000; CI 1.02–1.44; P < .05) or > $100,000 (OR 1.27 versus < $50,000; CI 1.08–1.48; P < .01) of educational debt, being unmarried (OR 1.89; CI 1.57–2.27; P < .001), and being younger (for every five years, OR 1.15; CI 1.02–1.28; P = .01) were independently associated with increased risk for alcohol abuse/dependence.

Conclusions Burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk. A multifaceted approach addressing burnout, medical education costs, and alcohol use is needed.

E.R. Jackson is a third-year medical student, Mayo Medical School, Rochester, Minnesota.

T.D. Shanafelt is professor of medicine, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.

O. Hasan is vice president for improving health outcomes, American Medical Association, Chicago, Illinois.

D.V. Satele is statistician, Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.

L.N. Dyrbye is professor of medicine, Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota.

Funding/Support: Funding for this study was provided by the American Medical Association (AMA) and the Mayo Clinic Department of Medicine Program on Physician Well-being.

Other disclosures: None reported.

Ethical approval: The Mayo Clinic institutional review board approved the study.

Correspondence should be addressed to Liselotte N. Dyrbye, 200 First Street SW, Department of Medicine, Mayo Clinic, Rochester, MN 55905; telephone: (507) 284-2511; e-mail:

© 2016 by the Association of American Medical Colleges