Medical Student Burnout and Professionalism—Reply

In Reply: As Dr Ripp and colleagues state, although the MBI has been extensively tested in physicians and other health professionals,¹ validity data in medical students apparently have not been reported. Medical students are a unique population, with activities similar to that of a nonprofessional student during the preclinical years but more like that of a resident during the clinical years. In our study population of medical students, we confirmed the 3-factor structure (emotional exhaustion, depersonalization, and personal accomplishment) of the MBI. The reliability of the MBI in medical students is supported by Cronbach α for the emotional exhaustion, depersonalization, and personal accomplishment domains of 0.89, 0.78, and 0.81, respectively, nearly identical to the performance of the MBI in large population samples.¹ The MBI appeared to perform equally well among preclinical students and clinical students. We have also previously shown that burnout in medical students, as measured by the MBI, predicts subsequent suicidal ideation² and serious thoughts of dropping out,³ providing predictive validity evidence.