ArticleBMJ (Clinical research ed.)2022
Marginalized identities, mistreatment, discrimination, and burnout among US medical students: cross sectional survey and retrospective cohort study.
Article in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
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Who cites it
55 citing papers in PubMed, 83 citations in OpenAlex.
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- Global gaps in how we assess undergraduate medical students' mental health: a scoping review protocol.BMJ open · 2026Article
- The first cut is the deepest: understanding learner trauma in the emergency medicine clerkship.BMC medical education · 2026Article
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- Disparities for Asian American Medical Students in Alpha Omega Alpha and Gold Humanism Honor Societies.JAMA network open · 2026Article
- Fairness-aware K-means clustering in digital mental health for higher education students: a generalizable framework for equitable clustering.JAMIA open · 2026Article
- Objective Biobehavioral Measures Reflect Burnout States and Temporal Changes in a Nursing Population: A Prospective Observational Assessment.Nursing reports (Pavia, Italy) · 2026Article
- Mentorship needs and satisfaction of MD-PhD and MD-MSc trainees with marginalized identities: the Canadian experience.BMC medical education · 2025Article
- The Culture of Academic Medicine Initiative (CAMi): Advancing Systems-Level Wellbeing in Medical Education Through a National Change Management Approach.Medical science educator · 2025Article
- Discrimination Experiences Among Medical Students.JAMA network open · 2025Article
- Introducing the intruder paradox: "It's not the imposter syndrome, it's you don't want me in the field".Medical education · 2025Article
- Race and Disability Characteristics and Accommodation Disparities on the USMLE Step 1.JAMA network open · 2025Article
- Adverse Childhood Experiences, Psychological Distress, and Resilience in Health Professions Students.Academic medicine : journal of the Association of American Medical Colleges · 2025Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo describe the association between mistreatment, burnout, and having multiple marginalized identities during undergraduate medical education.
designCross sectional survey and retrospective cohort study.
setting140 US medical schools accredited by the Association of American Medical Colleges.
participants30 651 graduating medical students in 2016 and 2017.
main outcome measuresSelf-reported sex, race or ethnicity, and sexual orientation groups were considered, based on the unique combinations of historically marginalized identities held by students. Multivariable linear regression was used to determine the association between unique identity groups and burnout along two dimensions (exhaustion and disengagement) as measured by the Oldenburg Burnout Inventory for Medical Students while accounting for mistreatment and discrimination.
resultsStudents with three marginalized identities (female; non-white; lesbian, gay, or bisexual (LGB)) had the largest proportion reporting recurrent experiences of multiple types of mistreatment (88/299, P<0.001) and discrimination (92/299, P<0.001). Students with a higher number of marginalized identities also had higher average scores for exhaustion. Female, non-white, and LGB students had the largest difference in average exhaustion score compared with male, white, and heterosexual students (adjusted mean difference 1.96, 95% confidence interval 1.47 to 2.44). Mistreatment and discrimination mediated exhaustion scores for all identity groups but did not fully explain the association between unique identity group and burnout. Non-white and LGB students had higher average disengagement scores than their white and heterosexual counterparts (0.28, 0.19 to 0.37; and 0.73, 0.52 to 0.94; respectively). Female students, in contrast, had lower average disengagement scores irrespective of the other identities they held. After adjusting for mistreatment and discrimination among female students, the effect among female students became larger, indicating a negative confounding association.
conclusionIn this study population of US medical students, those with multiple marginalized identities reported more mistreatment and discrimination during medical school, which appeared to be associated with burnout.
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