Single Item Measures of Emotional Exhaustion and Depersonalization Are Useful for Assessing Burnout in Medical Professionals

  • Colin P. WestEmail author
  • Liselotte N. Dyrbye
  • Jeff A. Sloan
  • Tait D. Shanafelt
Brief Report



Burnout has negative effects on work performance and patient care. The current standard for burnout assessment is the Maslach Burnout Inventory (MBI), a well-validated instrument consisting of 22 items answered on a 7-point Likert scale. However, the length of the MBI can limit its utility in physician surveys.


To evaluate the performance of two questions relative to the full MBI for measuring burnout.


Cross-sectional data from 2,248 medical students, 333 internal medicine residents, 465 internal medicine faculty, and 7,905 practicing surgeons.


The single questions with the highest factor loading on the emotional exhaustion (EE) (“I feel burned out from my work”) and depersonalization (DP) (“I have become more callous toward people since I took this job”) domains of burnout were evaluated in four large samples of medical students, internal medicine residents, internal medicine faculty, and practicing surgeons. Spearman correlations between the single EE question and the full EE domain score minus that question ranged from 0.76–0.83. Spearman correlations between the single DP question and the full DP domain score minus that question ranged from 0.61–0.72. Responses to the single item measures of emotional exhaustion and depersonalization stratified risk of high burnout in the relevant domain on the full MBI, with consistent patterns across the four sampled groups.


Single item measures of emotional exhaustion and depersonalization provide meaningful information on burnout in medical professionals.


burnout measurement graduate medical education medical practice 



This work was supported by a grant from the Saint Marys Hospital Sponsorship Board. The authors wish to acknowledge the participation of the American College of Surgeons, particularly Charles M. Balch, MD, Gerald J. Bechamps, MD, and Thomas R. Russell, MD, and the site leaders for each medical school, Steven J. Durning, MD (Uniformed Services University of the Health Sciences), Anne M. Eacker, MD (University of Washington School of Medicine), William Harper, MD (University of Chicago Pritzker School of Medicine), F. Stanford Massie, MD (University of Alabama School of Medicine), Christine Y. Moutier, MD (University of California, San Diego), David V. Power, MD (University of Minnesota Medical School), and Matthew R. Thomas, MD (Mayo Clinic).

Conflict of Interest

None disclosed.

Supplementary material

11606_2009_1129_MOESM1_ESM.doc (25 kb)
Figure 1 a Pooled risk of high emotional exhaustion burnout and 95% confidence intervals by level of response to “I have become more callous toward people since I took this job”. b Pooled risk of high depersonalization burnout and 95% confidence intervals by level of response to “I have become more callous toward other since I took this job.” (DOC 25 KB)


  1. 1.
    Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.Google Scholar
  2. 2.
    Thomas NK. Resident burnout. JAMA. 2004;292:2880–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among US medical students. Ann Intern Med. 2008;149:334–41.PubMedGoogle Scholar
  4. 4.
    Golub JS, Johns MM, Weiss PS, Ramesh AK, Ossoff RH. Burnout in academic faculty of otolaryngology-head and neck surgery. Laryngoscope. 2008;118:1951–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Sharma A, Sharp DM, Walker LG, Monson JR. Stress and burnout among colorectal surgeons and colorectal nurse specialists working in the National Health Service. Colorectal Dis. 2008;10:397–406.CrossRefPubMedGoogle Scholar
  6. 6.
    Soler JK, Yaman H, Esteva M, Dobbs F. Burnout in European family doctors: the EGPRN study. Fam Pract. 2008;25:245–65.CrossRefPubMedGoogle Scholar
  7. 7.
    Trufelli DC, Bensi CG, Garcia JB, et al. Burnout in cancer professionals: a systematic review and meta-analysis. Eur J Cancer Care. 2008;17:524–31.Google Scholar
  8. 8.
    Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.PubMedGoogle Scholar
  9. 9.
    West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Thomas MR, Dyrbye LN, Huntington JL, et al. How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med. 2007;22:177–83.CrossRefPubMedGoogle Scholar
  11. 11.
    Gopal R, Glasheen JJ, Miyoshi TJ, Prochazka AV. Burnout and internal medicine resident work-hour restrictions. Arch Intern Med. 2005;165:2595–600.CrossRefPubMedGoogle Scholar
  12. 12.
    Rosen IM, Gimotty PA, Shea JA, Bellini LM. Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns. Acad Med. 2006;81:82–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Maslach C, Jackson SE. The measurement of experienced burnout. J Occ Behav. 1981;2:99–113.CrossRefGoogle Scholar
  14. 14.
    Gil-Monte PR. Factorial validity of the Maslach Burnout Inventory (MBI-HSS) among Spanish professionals. Rev Saude Publica. 2005;39:1–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Kanste O, Miettunen J, Kyngas H. Factor structure of the Maslach Burnout Inventory among Finnish nursing staff. Nurs Health Sci. 2006;8:201–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Vanheule S, Rosseel Y, Vlerick P. The factorial validity and measurement invariance of the Maslach Burnout Inventory for human services. Stress Health. 2007;23:87–91.CrossRefGoogle Scholar
  17. 17.
    Shanafelt TD, West CP, Sloan JA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169:990–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Shanafelt TD, Balch CM, Bechamps G et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009; In press.Google Scholar

Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Colin P. West
    • 1
    • 2
    • 5
    Email author
  • Liselotte N. Dyrbye
    • 3
  • Jeff A. Sloan
    • 2
  • Tait D. Shanafelt
    • 4
  1. 1.Division of General Internal MedicineMayo ClinicRochesterUSA
  2. 2.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  3. 3.Division of Primary Care Internal MedicineMayo ClinicRochesterUSA
  4. 4.Division of HematologyMayo ClinicRochesterUSA
  5. 5.Department of MedicineMayo ClinicRochesterUSA

Personalised recommendations