• William J Crump, Craig Ziegler, and Steve Fricker.
• Baptist Health Deaconess Madisonville Family Medicine Residency, Madisonville, KY, and University of Louisville School of Medicine Trover Campus at Baptist Health Deaconess, Madisonville, Madisonville, KY.
• Fam Med. 2022 Sep 1; 54 (8): 640-643.

Background And ObjectivesThe issue of declining empathy and increasing burnout among residents is of concern for most programs. Numerous studies have shown these changes in both medical students and residents. However, the sequence of empathy decline and increasing burnout is unresolved and most studies have been cross sectional. This paper reports an individually-paired longitudinal analysis intended to clarify the sequence of these changes.MethodsBeginning in 2017, 35 family medicine residents across all 3 years of training at a rural program completed an established empathy survey and a previously-validated single burnout question at the start of each year and at the midpoint. First, the empathy score for each resident was aligned with the next following burnout measure, and then the reverse sequence was followed, with burnout aligned with the following empathy score.ResultsWith 125 responses to 133 survey opportunities, we saw a 94% response rate. Empathy scores across residency years decreased slightly and then improved almost to baseline. However, the analysis of variance test for quadratic trend was not significant. The burnout measure increased significantly over the residency years (J-T Statistic=4.89, P<.001). The correlation of the empathy score changing first showed a nonsignificant correlation (Rs=-.150, P=.133). The Spearman's ρ of the burnout measure changing first was significant (Rs=-.300, P=.006).ConclusionsIn this group of residents, changes in burnout occurred before changes in empathy. If further research supports this finding, residency programs could focus more on efforts to address burnout to mitigate decreases in empathy.

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