Purpose To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students. Method In 2012, the authors completed a national survey of medical students from the American Medical Association's Physician Masterfile containing validated items assessing alcohol abuse/dependence, burnout, depression, suicidality, quality of life (QOL), and fatigue. Descriptive and comparative statistical analyses were computed, including chi-square and multivariate logistic regression, to determine relationships between variables. Results Of the 12,500 students, 4,402 (35.2%) responded. Of these, 1,411 (32.4%) met diagnostic criteria for alcohol abuse/dependence. Students who were burned out (P =.01), depressed (P =.01), or reported low mental (P =.03) or emotional (P =.016) QOL were more likely to have alcohol abuse/dependence. Emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse/dependence. On multivariate analysis, burnout (OR 1.20; 95% CI 1.05-1.37; P <.01), having $50,000 to $100,000 (OR 1.21 versus < $50,000; CI 1.02-1.44; P <.05) or > $100,000 (OR 1.27 versus < $50,000; CI 1.08-1.48; P <.01) of educational debt, being unmarried (OR 1.89; CI 1.57-2.27; P <.001), and being younger (for every five years, OR 1.15; CI 1.02-1.28; P =.01) were independently associated with increased risk for alcohol abuse/dependence. Conclusions Burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk. A multifaceted approach addressing burnout, medical education costs, and alcohol use is needed.
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