Academic Achievement, Professionalism, and Burnout in Family Medicine Residents

Author:

Davis Caitlin1,Krishnasamy Meenu2,Morgan Zachary J.3,Bazemore Andrew W.34,Peterson Lars E.35

Affiliation:

1. University of Maryland/Sheppard Pratt Psychiatry Residency Program, Baltimore, MD

2. College of Medicine, University of Kentucky, Lexington, KY

3. American Board of Family Medicine, Lexington, KY

4. and the Center for Professionalism and Value in Healthcare, Washington, DC

5. and Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY

Abstract

Background and Objectives: Physician burnout has been shown to have roots in training environments. Whether burnout in residency is associated with the attainment of critical educational milestones has not been studied, and is the subject of this investigation. Methods: We used data from a cohort of graduating family medicine residents registering for the 2019 American Board of Family Medicine initial certification examination with complete data from registration questionnaire, milestone data, in-training examination (ITE) scores, and residency characteristics. We used bivariate and multilevel multivariate analyses to measure the associations between four professionalism milestones ratings and ITE performance with burnout. Results: Our sample included 2,509 residents; 36.8% met the criteria for burnout. Multilevel regression modeling showed a correlation between burnout and failure to meet only one of four professionalism milestones, specifically professional conduct and accountability (OR 1.41, 95% CI 1.07-1.87), while no statistically significant relationship was demonstrated between burnout and being in the lowest quartile of ITE scores. Other factors negatively associated with burnout included international medical education (OR 0.60, 95% CI 0.48-0.76) and higher salary compared to cost of housing (OR 0.62, 95% CI 0.46-0.82). Conclusions: We found significant association between self-reported burnout and failing to meet expectations for professional conduct and accountability, but no relationship between burnout and medical knowledge as measured by lower ITE performance. Further investigation of how this impacts downstream conduct and accountability behaviors is needed, but educators can use this information to examine program-level interventions that can specifically address burnout and development of physician professionalism.

Publisher

Society of Teachers of Family Medicine

Subject

Family Practice

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