A Mayo Clinic study involving seven major medical schools shows a majority of medical students surveyed suffer from burnout and that those students were more likely to cheat or be dishonest in relation to patient care. The findings appear in this week's issue of JAMA.

The study was based on anonymous responses from 4,400 students. Just over half (53 percent) the students responding were found to have burnout. Academic cheating was relatively rare, but roughly 40 percent of third- and fourth-year students admitted to some form of unprofessional conduct in relation to patient care, such as reporting a physical examination finding as normal when they had not performed the examination. The researchers say that the students know the behavior is inappropriate and that fact may indicate "some elements in the learning process" foster dishonesty.

The findings also showed that burned-out medical students were less likely to hold altruistic attitudes about a doctor's role in society including a lower likelihood of wanting to provide medical care for the underserved.

"Our findings suggest future physicians' altruism, professionalism, and commitment to serve society are eroded by burnout," says Liselotte Dyrbye, M.D., Mayo Clinic internist and first author of the study. "This is concerning since burnout is a pervasive problem among medical students, residents, and physicians in practice. As our nation reforms its health care system, it is essential that physicians advocate for patients, promote the public health, and reduce barriers to equitable health care. Burnout appears to be a threat to this process"

Little Understanding of Conflict of Interest

At a time when issues concerning professional conflicts are a national focus, the researchers discovered that only 14 percent of the students had opinions on relationships with industry that aligned with the American Medical Association policy regarding appropriate interactions between physicians and pharmaceutical companies. The authors suggest that schools could "do a better job teaching students about conflict of interest and appropriate relationships with industry."