Background: At 45%, emergency medicine (EM) has a high rate of burnout, though there is little research examining its relationship with medical knowledge.
Study Objectives: The authors sought to determine if EM resident performance on the In-Training Examination (ITE) is associated with resident burnout and if ITE scores are affected by the implementation of a wellness curriculum.
Methods: The Maslach Burnout Inventory (MBI) is the gold standard in the measurement of physician burnout, consisting of three scales: emotional exhaustion, depersonalization, and personal accomplishment. In February 2017, the MBI was administered at 10 EM residency programs. At 5 intervention sites, a multi-faceted year long wellness curriculum was introduced in March 2017 while 5 control sites agreed not to introduce new wellness initiatives during the study period. The MBI was re-administered at all sites in February 2018. The ITE is a validated instrument for medical knowledge assessment and per convention was administered in February 2017 and February 2018.
Results: A total of 296/382 (77.5%) residents had scores reported for the 2017 ITE and 304/386 (78.8%) residents had scores reported for the 2018 ITE. In the subset of 172 residents who also completed the 2017 and 2018 MBI, there were no correlations between MBI results and changes in scores on the ITE. There were nearly no significant differences in mean ITE scores between intervention and control sites in 2017 or 2018. Finally, there were no significant changes in mean ITE scores from 2017 to 2018 between intervention and control groups.
Conclusion: In this study of EM residents, burnout as measured by the MBI was not associated with performance on the ITE. In addition, there were no significant differences in ITE scores between intervention and control sites following introduction of a wellness curriculum. Despite effects of burnout on career satisfaction and longevity, burnout levels are not associated with resident medical knowledge.