Skip to main content
SpringerLink
Log in

Comparison of Burnout and Empathy Among Millennial and Generation X Residents and Fellows: Associations with Training Level and Race but Not Generation Affiliation

  • In Brief Report
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objective

The authors examine the associations of generational affiliation on empathy and burnout in a sample of millennial (born between 1982 and 2000) and Generation X (born between 1965 and 1981) residents and fellows.

Methods

At a single large institution during the 2013–2014 academic year, residents and fellows were asked to complete the Jefferson Scale of Physician Empathy and Maslach Burnout Inventory (MBI). Responses were combined with GME database content. Multivariable regression analysis included generation affiliation, race, gender, and post-graduate year (PGY) as covariates.

Results

The study sample included 388 millennial (mean age = 29.3) and 200 Generation X trainees (mean age = 34.6), with the response rate being 96.5%. Groups were statistically different by gender (p < 0.001) and PGY level (p < 0.001). After adjustment for gender, race, and PGY level, no statistically significant differences were found between millennial and Generation X groups in mean scores of empathy or burnout. Empathy was associated with PGY level (p = 0.0008) and race (p < 0.0001), with decreased empathy in advanced training levels and increased empathy in Hispanic/Latino race. Burnout rate was associated with PGY level (p = 0.001) but not generational affiliation (p = 0.6). The MBI depersonalization subscale was associated with PGY level (p < 0.001) and race (p = 0.0034), with decreased depersonalization in advanced training levels and Hispanic/Latino race. The emotional exhaustion and personal accomplishment MBI subscales did not demonstrate any significant associations in the multivariable regression model.

Conclusions

In a compared sample of millennial and Generation X residents and fellows, PGY level and Hispanic/Latino race (though not generation affiliation) were significantly associated with both empathy and MBI depersonalization subscale scores, while only PGY level was significantly associated with burnout rate. This study presents further evidence of de-escalating burnout and declining empathy over the course of medical residency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Jain, SH. Do we have a millennial physician problem? Forbes. 2016 Jun 11. https://www.forbes.com/sites/sachinjain/2016/06/11/do-we-have-a-millennial-physician-problem/#2f26c929682b. .

  2. Lindheim SR, Nouri P, Rabah KA, Yaklic JL. Medical professionalism and enculturation of the millennial physician: meeting of the minds. Fertil Steril. 2016;106(7):1615–6.

    Article  Google Scholar 

  3. Gallagher A, Jago R. Understanding professional misconduct: snowflakes, stoics or organizational culture? Nurs Ethics. 2018;25(4):415–7.

    Article  Google Scholar 

  4. Miller NM. Millennial physicians sound off on the state of medicine today. AMA. 2017 Mar 27. https://www.ama-assn.org/practice-management/physician-health/millennial-physicians-sound-state-medicine-today. .

  5. United States Census Bureau. Millennials outnumber baby boomers and are far more diverse. Census Bureau Reports (Release No. CB15-113). 2015 Jun 25. https://www.census.gov/newsroom/press-releases/2015/cb15-113.html. .

  6. Borges NJ, Manuel RS, Elam CL, Jones BJ. Comparing millennial and generation X medical students at one medical school. Acad Med. 2006 Jun;81(6):571–6.

    Article  Google Scholar 

  7. Borges NJ, Manuel RS, Elam CL, Jones BJ. Differences in motives between millennial and generation X medical students. Med Educ. 2010 Jun;44(6):570–6.

    Article  Google Scholar 

  8. Maslach CJ, Susan E, Leiter MP. Maslach Burnout Inventory manual. 3rd ed. Mindgarden; 2010.

  9. Hojat M. Empathy in health professions education and patient care: Springer; 2016.

  10. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89:443–51.

    Article  Google Scholar 

  11. Chaukos D, Chad-Friedman E, Mehta DH, Byerly L, Celik A, McCoy TH Jr, et al. Risk and resilience factors associated with resident burnout. Acad Psychiatry. 2017;41:189–94.

    Article  Google Scholar 

  12. Schaufeli WB, Bakker AB, Hoogduin, Schaap C, Kladler A. On the clinical validity of the Maslach Burnout Inventory and the burnout measure. Psychol Health 2001; 16:565–582.

  13. Howell LP, Joad JP, Callahan E, Servis G, Bonham AC. Generational forecasting in academic medicine: a unique method of planning for success in the next two decades. Acad Med. 2009;84(8):985–893.

    Article  Google Scholar 

  14. Aaron M, Levenberg P. The millennials in medicine: tips for teaching the next generation of physicians. J Acad Ophthalmology. 2014;7:e17–20.

    Article  Google Scholar 

  15. Neumann M, Edelhauser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86(8):996–1002.

    Article  Google Scholar 

  16. Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine. Acad Med. 2005;80(2):164–7.

    Article  Google Scholar 

  17. Mangione S, Kane GC, Caruso JW, Gonnella JS, Nasca TJ, Hojat M. Assessment of empathy in different years of internal medicine training. Med Teach. 2002;24(2):370–3.

    Article  Google Scholar 

  18. Boissy A, Windover AK, Bokar D, Karafa M, Neuendorf K, Frankel RM, et al. Communication skills training for physicians improves patient satisfaction. J Gen Intern Med. 2016;31(7):755–61.

    Article  Google Scholar 

  19. Thrush CR, Guise JB, Gathright MM, Messias E, Flynn V, Belknap T, et al. A one-year institutional view of resident physician burnout. Acad Psychiatry. 2019;43(4):361–8.

    Article  Google Scholar 

  20. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306(9):952–60.

    Article  CAS  Google Scholar 

  21. Elmore LC, Jeff DB, Jin L, et al. National survey of burnout among US general surgery residents. J Am Coll Surg. 2016;223(3):440–51.

    Article  Google Scholar 

  22. Afzal KI, Khan FM, Mulla Z, Akins R, Ledger E, Giordano FL. Primary language and cultural background as factors in resident burnout in medical specialties: a study in a bilingual US city. South Med J. 2010;103:607–15.

    Article  Google Scholar 

  23. Dyrbye LN, Burke SE, Hardeman RR, Herrin J, Wittlin NM, Yeazel M, et al. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA. 2018;320(11):1114–30.

    Article  Google Scholar 

  24. Gallo LC, Penedo FJ, Espinosa de los Monteros K, Arguelles W. Resiliency in the face of disadvantage: do Hispanic cultural characteristics protect health outcomes? J Pers 2009;77(6):1707–1746.

  25. Updegraff KA, Umana-Taylor AJ, Zeiders KH, et al. Familism values across the transition to adolescent motherhood: links to family functioning and Mexican-origin adolescent mothers’ adjustment. Dev Psychopathol. 2018;30:1589–609.

    Article  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Amy Windover, PhD, for her guidance in use of the Cleveland Clinic Center for Excellence in Healthcare Communication’s registry.

Author information

Authors and Affiliations

  1. Northwestern University, Chicago, IL, USA

    Brandon Hamm

  2. Cleveland Clinic, Cleveland, OH, USA

    Matthew Karafa, Pei Chun Yu, Susannah Rose & Kathleen Neuendorf

Authors
  1. Brandon Hamm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew Karafa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pei Chun Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susannah Rose
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kathleen Neuendorf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brandon Hamm.

Ethics declarations

Disclosure

Susannah Rose has received speaker fees and travel expenses from the Siemens Healthineers and PanAgora for presentations on patient experience. On behalf of all other authors, the corresponding author states that there is no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hamm, B., Karafa, M., Yu, P.C. et al. Comparison of Burnout and Empathy Among Millennial and Generation X Residents and Fellows: Associations with Training Level and Race but Not Generation Affiliation. Acad Psychiatry 44, 388–393 (2020). https://doi.org/10.1007/s40596-020-01226-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40596-020-01226-9

Keywords

Search

Navigation