Results:

Main study outcomes were symptoms of burnout and career and specialty regret.

Burnout symptoms were assessed using 2 single-item measures adapted from the Maslach Burnout Inventory previously shown to stratify burnout risk. Burnout symptoms were attributed to those who admitted to emotional exhaustion or depersonalization ≥once weekly.

• Of all second-year residents, 45.2% reported ≥1 symptom of burnout at least weekly.
• Internal medicine residents reported 42.6% prevalence of burnout. Internal medicine, the most common specialty, was utilized as the reference standard for comparison with other specialties.
• Residents in urology (63.8%), neurology (61.6%), emergency medicine (53.8%), and general surgery (53.8%) were more likely than those in internal medicine to admit symptoms of burnout.
• Residents in dermatology (29.6%) and pathology (34.7%) were less likely to admit symptoms of burnout.
• Increased symptoms of burnout were associated with female sex (48.8%) and higher anxiety scores in year 4 of medical school; a decreased rate of burnout was associated with higher empathy scores in year 4 of medical school.

Career choice regret was expressed by residents who responded “definitely not” or “probably not” to the question “If you could revisit your career choice, would you choose to become a physician again?”

• 14.1% of all residents and 12.2% of internal medicine residents expressed career choice regret.
• Residents in pathology (32.7%) and anesthesiology (20.6%) were more likely to express career choice regret.
• Burnout symptoms were strongly associated with career choice regret (23.0%, relative risk [RR] 3.20) after controlling for other factors.
• Career choice regret was associated with higher anxiety scores in year 4 of medical school.

Specialty choice regret was expressed by residents who responded “definitely not” or “probably not” to the question “If you could revisit your specialty choice, would you choose the same specialty again?”

• 7.1% of all residents and 10.6% of internal medicine residents expressed specialty choice regret.
• Residents in anesthesiology, emergency medicine, family practice, pediatrics, psychiatry, ophthalmology, and orthopedic surgery were less likely to report specialty choice regret (range 3.3-6.0%).
• Burnout symptoms were strongly associated with specialty choice regret (12.0%, RR 3.29) after controlling for other factors.
• Increasing age was associated with specialty choice regret (RR 1.08 per 1 year older) after controlling for other factors. Factors associated with a lower risk of specialty choice regret included non-Hispanic ethnicity, higher empathy scores, and higher emotional social support scores.

Demographic characteristics were similar to those of all US resident physicians.