• Adnan Syed, Pari Shah Thibodeau, Nathalie Dieujuste, Christine D Jones, Kimiko S Dunbar, Adrienne Mann, and Tyra Fainstad.
• University of Colorado, School of Medicine, Aurora; Veterans Health Administration, Eastern Colorado Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Aurora. Electronic address: adnan.syed@cuanschutz.edu.
• Mayo Clin. Proc. 2024 Dec 1; 99 (12): 190519121905-1912.

ObjectiveTo examine the prevalence of moral injury and its association with burnout, impostor syndrome, and low self-compassion in physician trainees.MethodsThis is a secondary analysis of baseline data from 1017 female physician trainees across 26 institutions who volunteered for a randomized controlled trial of a well-being program in 2022. Participants completed the Moral Injury Symptom Scale-Healthcare Professionals (MISS-HP), Maslach Burnout Inventory, Young Impostor Syndrome Scale, and Neff Self-Compassion Scale-Short Form. Univariate and multivariate logistic regressions were used to assess outcomes.ResultsOf 1017 participants, 787 (77.4%) completed the MISS-HP, of whom 600 (76.2%) experienced moral injury (≥36 score). All models adjusted for postgraduate year and race. After additionally controlling for impostor syndrome and self-compassion, moral injury was associated with positive burnout (odds ratio [OR], 3.79; 95% CI, 2.55 to 5.66), high emotional exhaustion (OR, 2.96; 95% CI, 2.04 to 4.32), high depersonalization (OR, 4.28; 95% CI, 2.94 to 6.29), and low personal accomplishment (OR, 1.96; 95% CI, 1.34 to 2.88). Moral injury was also associated with positive impostor syndrome (OR, 1.71; 95% CI, 1.12 to 2.58) after controlling for burnout and self-compassion as well as with low self-compassion (OR, 3.35; 95% CI, 2.15 to 5.34) after controlling for burnout and impostor syndrome.ConclusionFemale medical trainees have a high prevalence of moral injury, which has significant associations with burnout, impostor syndrome, and low self-compassion. Effective interventions require further implementation and analysis to reduce moral injury among medical trainees.Published by Elsevier Inc.

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