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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]
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“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].”
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“Introduction 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].”
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“First-onset suicidal ideation Suicidal ideation was measured by asking students: “Have you ever had thoughts of taking your own life?” (T0) and “During the past 12 months, have you had thoughts of taking your own life?” (T1) (37).”
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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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