Letters to the editor
Medwave 2016 May;16(4):e6446 doi: 10.5867/medwave.2016.04.6446

Burnout syndrome among medical students in Mexico: considerations about its measurement with the Maslach Burnout Inventory

Jesús Maticorena-Quevedo , Alexander Anduaga-Beramendi , Renato Beas

Dear editor:

We have read with interest the research article titled ''Burnout syndrome in first to sixth-year medical students at a private university in the north of Mexico: descriptive cross-sectional study'' (doi: 10.5867/medwave.2016.03.6432) of considerable importance for reporting the prevalence of this syndrome in a potentially susceptible population [1]. However, it is in our interest to make some commentaries on the methodological aspects.

Although, burnout syndrome was initially related to the environment of people who works with others, it is now known that is not limited to human services, making its identification in medical students an interesting topic [2]. Also, even though there are numerous forms to recognize individuals affected by this syndrome, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) remains as the gold standard for health personnel [2],[3],[4]. Maslach et al. proposed the identification of subjects suffering from burnout syndrome if they presented high values ​​in emotional exhaustion (EE) and depersonalization (DP) scales; in addition to low values ​​in personal accomplishment (PA) [2]. Asencio-Lopez et al. used the previously mentioned instrument in a group of their sample; however, we consider that it would be important to report the results of this group in this way, and not only considering two scales: emotional exhaustion and depersonalization [1],[2]. This could reveal a lower prevalence of the syndrome and improve its estimation. Likewise, grouping into low, moderate or deep burnout syndrome does not contribute to measure positive cases neither to reveal the prevalence of this syndrome, which is the main objective of the study.

On the other hand, it is important to mention that cutoff points used by the authors to identify low, moderate or high scores are not specified in the study, which represents a limitation considering the multiple ways existing for categorizing these values [5],[6]. We believe that using predetermined cutoff points proposed by the creators of the instrument is suitable until specific values are obtained for Mexican population.

In conclusion, we emphasize the importance of the study and its implications; nevertheless, we believe that the cutoff points and the form of identification of this syndrome proposed by creators of the Maslach Burnout Inventory should be considered in order to improve the external validity of the study.


From the editor
The authors originally submitted this article in Spanish and subsequently translated it into English. The Journal has not copyedited this version.

Conflicts of interest
Authors declare no conflicts of interest

The authors declare not having received any funding whatsoever for writing this letter.

  1. Asencio-López L, Almaraz-Celis GD, Carrillo Maciel V, Huerta Valenzuela P, Silva Goytia L, Muñoz Torres M, et al. Burnout syndrome in first to sixth-year medical students at a private university in the north of Mexico: descriptive cross-sectional study. Medwave 2016 Abr;16(3):e6432. | CrossRef |
  2. Maslach C, Leiter M, Schaufeli WB. Measuring burnout. The Oxford handbook of organizational well-being. 2008:86-108. | CrossRef |
  3. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual: The Scarecrow Press; 1996.
  4. Gil-Monte PR. Factorial validity of the Maslach Burnout Inventory (MBI-HSS) among Spanish professionals. Rev Saude Pública. 2005;39(1):1-8. | CrossRef |
  5. Schaufeli WB, Bakker AB, Hoogduin K, Schaap C, Kladler A. On the clinical validity of the Maslach Burnout Inventory and the Burnout Measure. Psychol Health. 2001;16(5):565-82. | CrossRef |
  6. Grau Martin A, Flichtentrei D, Suner R, Prats M, Braga F. [Influence of personal, professional and cross-national factors in burnout syndrome in Hispanic Americans and Spanish health workers (2007)]. Rev Esp Salud Publica. 2009;83(2):215-30. | CrossRef |


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