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Acad Med. 2015 Jul;90(7):961-9. doi: 10.1097/ACM.0000000000000655.

The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students With Burnout.

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L.N. Dyrbye is professor of medicine and medical education, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. A. Eacker is associate professor of medicine, University of Washington School of Medicine, Seattle, Washington. S.J. Durning is professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Brazeau is professor of family medicine and psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey. C. Moutier was professor of psychiatry, University of California, San Diego School of Medicine, San Diego, California, at the time of this study. She is now chief medical officer, American Foundation for Suicide Prevention, New York, New York. F.S. Massie is professor of medicine, University of Alabama School of Medicine, Birmingham, Alabama. D. Satele is statistician, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. J.A. Sloan is professor of biostatistics and oncology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. T.D. Shanafelt is professor of medicine, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.



Because of the high prevalence of burnout among medical students and its association with professional and personal consequences, the authors evaluated the help-seeking behaviors of medical students with burnout and compared their stigma perceptions with those of the general U.S. population and age-matched individuals.


The authors surveyed students at six medical schools in 2012. They measured burnout, symptoms of depression, and quality of life using validated instruments and explored help-seeking behaviors, perceived stigma, personal experiences, and attitudes toward seeking mental health treatment.


Of 2,449 invited students, 873 (35.6%) responded. A third of respondents with burnout (154/454; 33.9%) sought help for an emotional/mental health problem in the last 12 months. Respondents with burnout were more likely than those without burnout to agree or strongly agree with 8 of 10 perceived stigma items. Respondents with burnout who sought help in the last 12 months were twice as likely to report having observed supervisors negatively judge students who sought care (odds ratio [OR] 2.06 [95% confidence interval (CI) 1.25-3.39], P < .01). They also were more likely to have observed peers reveal a student's emotional/mental health problem to others (OR 1.63 [95% CI 1.08-2.47], P = .02). A smaller percentage of respondents would definitely seek professional help for a serious emotional problem (235/872; 26.9%) than of the general population (44.3%) and age-matched individuals (38.8%).


Only a third of medical students with burnout seek help. Perceived stigma, negative personal experiences, and the hidden curriculum may contribute.

[Indexed for MEDLINE]

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