The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Burnout and Suicidal Ideation among U.S. Medical Students
Abstract
BACKGROUND: Little is known about the prevalence of suicidal ideation among U.S. medical students or how it relates to burnout. OBJECTIVE: To assess the frequency of suicidal ideation among medical students and explore its relationship with burnout. DESIGN: Cross-sectional 2007 and longitudinal 2006 to 2007 cohort study. SETTING: 7 medical schools in the United States. PARTICIPANTS: 4287 medical students at 7 medical schools, with students at 5 institutions studied longitudinally. MEASUREMENTS: Prevalence of suicidal ideation in the past year and its relationship to burnout, demographic characteristics, and quality of life. RESULTS: Burnout was reported by 49.6% (95% CI, 47.5% to 51.8%) of students, and 11.2% (CI, 9.9% to 12.6%) reported suicidal ideation within the past year. In a sensitivity analysis that assumed all nonresponders did not have suicidal ideation, the prevalence of suicidal ideation in the past 12 months would be 5.8%. In the longitudinal cohort, burnout (P < 0.001 for all domains), quality of life (P < 0.002 for each domain), and depressive symptoms (P < 0.001) at baseline predicted suicidal ideation over the following year. In multivariable analysis, burnout and low mental quality of life at baseline were independent predictors of suicidal ideation over the following year. Of the 370 students who met criteria for burnout in 2006, 99 (26.8%) recovered. Recovery from burnout was associated with markedly less suicidal ideation, which suggests that recovery from burnout decreased suicide risk. LIMITATION: Although response rates (52% for the cross-sectional study and 65% for the longitudinal cohort study) are typical of physician surveys, nonresponse by some students reduces the precision of the estimated frequency of suicidal ideation and burnout. CONCLUSION: Approximately 50% of students experience burnout and 10% experience suicidal ideation during medical school. Burnout seems to be associated with increased likelihood of subsequent suicidal ideation, whereas recovery from burnout is associated with less suicidal ideation.
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“Burnout contributes to poor job satisfaction [14] and a negative impact on their mental and physical health [15,16].”
From Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis (2019) · cites this paper as [15]
In the citing paper
“Symptoms of overload and burnout are increasingly being reported, manifesting as depression, anxiety, fractured relationships, a rise in substance abuse and even an increased likelihood of subsequent suicidal ideation (7–9).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [7]
In the citing paper
“Burnout and depression among medical students have serious consequences, including suicidal ideation [1, 2], dropping out [3], substance abuse, poor sleep quality, decreased work engagement [4], decreased professionalism [5], decreased academic effectiveness, poor mental health overall [6, 7].”
Citations
Cites
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Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006) · Academic Medicine · doi:10.1097/00001888-200604000-00009 · Cited by 2,909
Self-citationSuicide Prevention Strategies: A Systematic Review
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Burnout and self-reported patient care in an internal medicine residency program
Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-5-200203050-00008 · Cited by 2,165
Self-citationUtility of a New Procedure for Diagnosing Mental Disorders in Primary Care: The PRIME-MD 1000 Study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.1994.03520220043029 · Cited by 1,873
Case-finding instruments for depression: Two questions are as good as many
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West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., & Shanafelt, T. D. (2006) · JAMA · doi:10.1001/jama.296.9.1071 · Cited by 1,454
Self-citationStress and depression among medical students: a cross-sectional study
Dahlin, M., Joneborg, N., & Runeson, B. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02176.x · Cited by 1,226
Cited by
Sorted by citations
Physician burnout: contributors, consequences and solutions
West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018) · Journal of Internal Medicine · doi:10.1111/joim.12752 · Cited by 2,768
Self-citationRotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., Sen, S., & Mata, D. A. (2016) · JAMA · doi:10.1001/jama.2016.17324 · Cited by 2,479
Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis
West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31279-x · Cited by 2,362
Self-citationDyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000134 · Cited by 2,040
Self-citationKrasner, M. S. (2009) · JAMA · doi:10.1001/jama.2009.1384 · Cited by 1,650
Metadata
- Authors
- Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D.
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2008-09-02
- Volume
- 149
- Issue
- 5
- Pages
- 334-341
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2163705978
- Cited by
- 1,532
- References
- 38
- Citations by year
- 2026: 47 · 2025: 78 · 2024: 90 · 2023: 119 · 2022: 105 · 2021: 225 · 2020: 146 · 2019: 143 · 2018: 77 · 2017: 103 · 2016: 79 · 2015: 60 · 2014: 57 · 2013: 59 · 2012: 51
- FWCI
- 59.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Keywords
- burnout, suicidal ideation, medical students, medical education, quality of life, depressive symptoms, burnout recovery, suicide risk, prevalence
- MeSH terms
- Adult, Burnout, Professional, Cross-Sectional Studies, Depression, Female, Humans, Longitudinal Studies, Male, Quality of Life, Stress, Psychological, Students, Medical, Suicide, United States, Prevalence
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- Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., Durning, S., Moutier, C., Szydlo, D. W., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2008). Burnout and Suicidal Ideation among U.S. Medical Students. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-149-5-200809020-00008
