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PLoS One. 2018 Mar 7;13(3):e0191746. doi: 10.1371/journal.pone.0191746. eCollection 2018.

Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors.

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Barretos School of Health Sciences, Dr. Paulo Prata, Barretos, São Paulo, Brazil.
Research Group on Palliative Care and Health-Related Quality of Life (GPQual) -Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Department of Clinical Oncology - Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil.



To evaluate the prevalence and possible factors associated with the development of burnout among medical students in the first years of undergraduate school.


A cross-sectional study was conducted at the Barretos School of Health Sciences, Dr. Paulo Prata. A total of 330 students in the first four years of medical undergraduate school were invited to participate in responding to the sociodemographic and Maslach Burnout Inventory-Student Survey (MBI-SS) questionnaires. The first-year group consisted of 150 students, followed by the second-, third-, and fourth-year groups, with 60 students each.


Data from 265 students who answered at least the sociodemographic questionnaire and the MBI-SS were analyzed (response rate = 80.3%). One (n = 1, 0.3%) potential participant viewed the Informed Consent Form but did not agree to participate in the study. A total of 187 students (187/265, 70.6%) presented high levels of emotional exhaustion, 140 (140/265, 52.8%) had high cynicism, and 129 (129/265, 48.7%) had low academic efficacy. The two-dimensional criterion indicated that 119 (44.9%) students experienced burnout. Based on the three-dimensional criterion, 70 students (26.4%) presented with burnout. The year with the highest frequency of affected students for both criteria was the first year (p = 0.001). Personal attributes were able to explain 11% (ΔR = 0.11) of the variability of burnout under the two-dimensional criterion and 14.4% (R2 = 0.144) under the three-dimensional criterion.


This study showed a high prevalence of burnout among medical students in a private school using active teaching methodologies. In the first years of graduation, students' personal attributes (optimism and self-perception of health) and school attributes (motivation and routine of the exhaustive study) were associated with higher levels of burnout. These findings reinforce the need to establish preventive measures focused on the personal attributes of first-year students, providing better performance, motivation, optimism, and empathy in the subsequent stages of the course.

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