Is alcohol use your solution for emotional exhaustion and burnout depersonalization? As medical students know, burnout is common in medical school and some factors such as Medical Student Age, Debt & Marital Support are out of their control. Some students may utilize alcohol as a coping mechanism for stress. When alcohol use rises to the level of risky drinking students have two problems to deal with.
There is a chance that you are compensating for burnout by drinking alcohol. Consider taking our survey about Stresses And Coping Mechanisms.
In a study of medical students, Jackson et al. (2016) found high rates of alcohol use disorder as well as a strong correlation between burnout and alcohol use disorder.
Jackson Eric R, Shanafelt Tait D, Hasan Omar, Satele Daniel V, Dyrbye Liselotte N. Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students. Acad Med. March 1, 2016. doi:10.1097/ACM.0000000000001138.
Correlation is not causation, so it is unclear if burnout causes alcohol use or alcohol use causes burnout or both are caused by some external factor (say depression). Hopefully, future research will tease out the details so we can obtain clear advice regarding interventions to decrease burnout/alcohol use.
My own personal bias is to see alcohol use as a natural consequence of burnout. Certainly, alcohol is commonly used as a means for stress reduction. So, to me, the most likely association is that folks who are more burned out are more likely to drink alcohol to counter negative feelings (depersonalization, emotional exhaustion, anxiety, doubt, sadness, isolation, etc.).
In any case, given the correlation, it is safe to say that reducing or eliminating alcohol use can be beneficial. If burnout is a problem, altering alcohol use patterns is a reasonable strategy – try exercise instead.
Of greater concern is when depression rises to the level of suicidal ideation. In this group they 9.4% reported suicidal ideation, a finding consistent with other studies. It is unclear if this number is underreporting such feelings, nor is it assessing the intensity or frequency of such feelings.
The study also showed that suicidal ideation did NOT correlate with alcohol use, and that suicide IS correlated with burnout. Again causation is unclear, but blaming burnout for suicidality does seem logical. A reasonable assumption is that suicidality should be addressed by addressing burnout and reducing any potential impact of burnout on suicidality.
Although in this study there was no correlation of suicide with alcohol use, the potentiating effect of alcohol use in terms of the lethality of suicidal ideation are well-established. That is, it is essential to address this combination of burnout and alcohol to decrease the potential for completed suicide. Alcohol increases the risk of impulsive acts and reduces the ability to implement cognitive strategies that would decrease suicidal behavior.
The topic also highlights the need to query burned out students about suicidal ideation. We are used to asking our patients about alcohol use and suicidality. We need to extend this good practice to medical students as well and more clarity about the causes and effects; more research and examination is needed in the area. We also need to create interventions that prevent burnout either through environmental changes or by better preparing students for situations and environments that are intrinsic to medicine and are unlikely to change such as dealing with life/death situations, hostile patients, ambiguity, or the challenge of weighing cost vs. benefit in a health decision-making model.
We seek to educate medical students about the issue of burnout and alcohol use through game-based learning.
In BurntOut, medical students are immersed in a virtual reality environment where they practice coping strategies to improve resilience. The BurntOut role-playing experience delivers targeted, realistic narratives and hands-on scenarios to deepen medical student understanding of how to address and overcome burnout during game-play and beyond.
Currently, we are recruiting medical students to test the BurntOut prototype and provide us feedback, as well as provide us with information on their own burnout experiences while in medical school. The data we collect from this experience can help further the research on both medical student burnout and physician burnout by identifying these issues early on and addressing them early on in the medical provider’s career. You can learn more about the role-playing experience and how to get involved at the BurntOut website.