Internal Medicine Subspecialty Burnout Rates
The available evidence does not identify a specific internal medicine subspecialty with the lowest burnout rates; within cardiology, all subspecialties showed equivalent burnout rates regardless of practice setting or subspecialty type, suggesting that burnout is driven more by work characteristics than by subspecialty choice. 1
Key Findings on Subspecialty Burnout
Cardiology Data
The most comprehensive subspecialty-specific data comes from cardiology, where:
- Burnout affects 27-43% of cardiologists, with more than one-quarter reporting burnout and almost 50% experiencing stress 1
- Subspecialty type does not impact burnout rates - within cardiovascular medicine, neither the type of practice setting nor the specific cardiovascular subspecialty showed differences in burnout prevalence 2, 1
- Only 23.7% of cardiologists reported enjoying their work 1
Comparison to Overall Medicine
- Overall physician burnout across all specialties is approximately 39.8%, with surgical and emergency specialties experiencing the highest rates 3, 1
- This suggests that internal medicine subspecialties generally fall in the middle range compared to other medical specialties 3
What Actually Drives Burnout (More Important Than Subspecialty Choice)
The evidence strongly indicates that work characteristics matter far more than subspecialty selection:
Primary Drivers
- Lack of control over workload is the single most important predictor of burnout across all internal medicine subspecialties 2, 1
- Time spent in direct clinical practice correlates with higher burnout regardless of subspecialty type 2, 1
- Hectic work environments and insufficient documentation time contribute significantly 1
- Misalignment between individual and organizational values increases burnout risk 2, 1
Protective Factors
- Regular performance feedback - residents receiving regular feedback were significantly less likely to develop burnout (87% vs 63%) 4
- Control over work schedule and workload protects against burnout more than subspecialty choice 2
- Social support and community at work reduces burnout risk 2
Clinical Implications for Career Planning
What Matters More Than Subspecialty
When considering internal medicine career paths to minimize burnout:
- Prioritize practice settings with controllable workload over specific subspecialty choice 2, 1
- Seek positions with adequate documentation time and efficient workflows 1
- Evaluate organizational culture and values alignment before subspecialty prestige 2
- Consider positions with less direct clinical time if burnout risk is a primary concern 2, 1
Career Stage Considerations
- Midcareer physicians report the highest burnout rates compared to early-career, fellows-in-training, or late-career physicians 2, 3
- First-year residents have a 75% incidence of developing new burnout within their intern year 4
- Women physicians report burnout more frequently than men across all subspecialties 2, 3
Important Caveats
The lack of comparative data across internal medicine subspecialties is a critical limitation - the available evidence focuses heavily on cardiology with minimal data on other subspecialties like endocrinology, rheumatology, infectious disease, or nephrology 2, 1. This represents a significant gap in the literature that prevents definitive recommendations about which subspecialty has the lowest burnout rates.
Perceived working conditions are more important than actual workload in explaining burnout variance, meaning two physicians in the same subspecialty can have vastly different experiences based on their specific practice environment 5.