Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Curriculum and Instruction

Major Professor

Thomas E. Miller, Ed.D.

Committee Member

Judith A. Ponticell, Ph.D.

Committee Member

Jody Conway, Ph.D.

Committee Member

Kira K. Zwygart, Ph.D.


Licensure Exam, Stress, Undergraduate Medical Education, USMLE Step 1


Between their second- and third-years of medical school, students must pass the United States Medical Licensing (USMLE) Step 1 exam. This high-stakes exam is critical to the overall success of medical students; the score has been a determining factor for the student’s residency training and specialty choice. Because medical students are faced with the burden of studying and concept mastery of content for USMLE Step 1, concurrent to ongoing coursework in the medical school curriculum, students may develop symptoms of burnout and be ill-prepared to remain resilient. This study investigated the extent of the relationship between burnout and resilience in second- and third-year medical students, before and after taking their first major licensure exam, USMLE Step 1. This was accomplished by using survey data of two consecutive cohorts of medical students which measured their current self-reported behaviors of resilience and their feelings of burnout surrounding the exam. This quantitative study is built from data from the online administration of the Maslach Burnout Inventory and the Brief Resilience Scale. The Brief Resilience Scale is a unitary scale made up of six items to measure different aspects of resilience. It assesses an individual’s ability to bounce back or recover from stress (Smith et al., 2008). The Maslach Burnout Inventory is measured using three subscales to determine varying degrees of burnout: Exhaustion, Cynicism, and Professional Efficacy. A high degree of burnout is reflected in high scores on the Exhaustion and Cynicism subscales and a low score on the Professional Efficacy Subscale (Maslach, Schaufeli, & Leiter, 2001). The overall findings of this study contribute to the increased understanding of the complexities related to the importance of medical student resilience, specifically as they progress through more advanced and multifaceted concepts. It aims to bring light to the importance of burnout and its prevalence in healthcare professions. The findings, however, do not illustrate a statistically significant relationship between burnout and resilience in second- and third-year medical students from these two consecutive cohorts. The research contributes to the lack of research on the ways in which medical students, a group of individuals that enter their professional education program with lower burnout scores compared to their similarly aged peers pursuing other professions, quickly decline as their education ramps up. To promote resilience-building skills and reduce burnout, medical schools should continue, or begin to, create supportive medical school environments for mental and emotional well-being. It is increasingly important for medical students to have coping skills in order to feel successful in their current academic environment and future patient encounters.