Demographic Factors and Burnout Outcomes Associated With Disability Status Uncertainty in U.S. Medical Students.

Abstract

Purpose: Studies suggest that medical trainees often experience uncertainty regarding their alignment with institutional and legal definitions of disability, which is exacerbated by barriers to documentation, stigma-related concerns, and ableist societal perceptions. This study examines demographic characteristics and burnout outcomes among medical students uncertain about their disability status compared to those identifying as a person with a disability.

Method: The authors analyzed data from second-year medical students identifying as having a disability (N = 2438) or reporting not knowing if they had a disability (N = 496) among the 27,009 participants in the 2019 and 2020 Association of American Medical Colleges Year-Two Questionnaire cohorts. Burnout was measured using the Oldenburg Burnout Inventory for Medical Students. Demographic associations with disability status uncertainty and its relationship with burnout were examined through multivariable logistic regression.

Results: Compared to White students, those identifying as Asian (odds ratio [OR], 3.36; 95% confidence interval [CI], 2.56-4.39), Black/African American (OR, 2.49; 95% CI, 1.71-3.59), Hispanic/Latino/Spanish origin (OR, 1.65; 95% CI, 1.14-2.36), and multiracial (OR, 1.66; 95% CI, 1.22-2.24) had significantly higher odds of reporting disability status uncertainty. Asian students also had significantly higher odds than Hispanic/Latino/Spanish origin (OR, 2.03; 95% CI, 1.37-3.05), multiracial (OR, 2.02; 95% CI, 1.44-2.86), or other (OR, 2.64; 95% CI, 1.31-5.92) students. Male students had significantly higher uncertainty odds than females (OR, 1.31, 95% CI, 1.06-1.61). Disability status uncertainty associated with significantly greater odds of high burnout (OR, 1.28; 95% CI, 1.03-1.59).

Conclusions: Medical students uncertain about their disability status showed increased risk of burnout with differences by race, ethnicity, and gender underscoring the need for institutions to address structural and cultural barriers to seeking disability resources. Further research should investigate strategies for mitigating differences for medical students navigating disability and promoting well-being for all learners.