Mayo Clinic Proceedings - Physician Distress and Burnout, the Neurobiological Perspective (March 1, 2021)

One of the premier peer-reviewed clinical journals in general and internal medicine, Mayo Clinic Proceedings is among the most widely read and highly cited scientific publications for physicians, with a circulation of approximately 125,000. Mayo Clinic Proceedings is published by Elsevier and sponsored by Mayo Clinic and the Mayo Foundation for Medical Education and Research. The mission of Mayo Clinic Proceedings is to promote the best interest of patients by advancing the knowledge and professionalism of the physician community. Since 2009 the Journal has offered CME credit for specific articles from both the Mayo Clinic for Concise Review for Clinicians and specially commissioned Symposia articles (comprehensive coverage on one topic).  

Participation in this activity consists of reviewing articles and responding to a short online test. It is estimated that this activity will take approximately one hour per article.  There is no charge for participating in this Journal CME activity.

To receive CME credit, please do the following:

  • Click Take Course
  • Complete quiz and evaluation (There is a required 80% pass rate in order to earn credit, with 1 retake allowed.)
  • Print your Record of Attendance



Target Audience

The target audience for Mayo Clinic Proceedings is primarily internal medicine physicians and other clinicians who wish to advance their current knowledge of clinical medicine and who wish to stay abreast of advances in medical research.

Learning Objectives

On completion of this article, you should be able to: (1) differentiate the neurobiology of how uncontrolled stress, but not controlled stress, contributes to burnout; (2) recognize how the impact of chronic stress on prefrontal cortex regulation may explain several challenges associated with burnout in physicians including reduced motivation, unprofessional behavior, and suboptimal communication with patients; (3) describe how organizational efforts to restore control to physicians may be particularly helpful for reducing burnout.

Course summary
Available credit: 
  • 1.00 ABIM
  • 1.00 AMA PRA Category 1 Credit
Course opens: 
Course expires: 

All travel and lodging expenses are the sole responsibility of the individual registrant.

Disclosure Summary 

As a provider accredited by Joint Accreditation Interprofessional Continuing Education, Mayo Clinic College of Medicine and Science (Mayo Clinic School of CPD) must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course Director(s), Planning Committee Members, Faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity.  Safeguards against commercial bias have been put in place.  Faculty also will disclose any off label and/or investigational use of pharmaceuticals or instruments discussed in their presentation.  Disclosure of these relevant financial relationships will be published in activity materials so those participants in the activity may formulate their own judgments regarding the presentation.

Listed below are individuals with control of the content of this program who have disclosed…

Planning Committee, Editorial Board Members and Staff
No relevant financial relationships:
Thomas J. Beckman, M.D.
Terry Jopke
Karl A. Nath, M.D.
Authors Disclosure Summary: 
Authors:  Amy F.T. Arnsten, PhD, and Tait Shanafelt, MD
Affiliations: Department of Neuroscience, Yale University School of Medicine, New Haven, CT (A.F.T.A.); and the Department of Medicine, Stanford University School of Medicine, Stanford, CA (T.S.).
Conflict of Interest Disclosure: Dr. Arnsten and Yale University receive royalties from the USA sales of Intuniv from Shire/Takeda Pharmaceuticals. They do not receive royalties for nonUSA or generic sales. Dr. Arnsten often lectures on the neurobiology of prefrontal cortex and the stress response, and receives honoraria for some of these activities. She also consults with Lundbeck Pharmaceuticals in the development of potential cognitive protecting agents. Dr. Shanafelt is co-inventor of the Physician Well-being Index, Medical Student Well-being Index, Nurse Well-being Index, the Well-being Index and Participatory Management Leadership Index.  Mayo Clinic holds the copyright to these instruments and has licensed them for use outside Mayo Clinic.  Mayo Clinic pays Dr Shanafelt a portion of royalties they receive. As an expert on the topic of health care professional well-being, Dr. Shanafelt often presents grand rounds/keynote lecture presentation as well as advises health care organizations.  He receives honoraria for some of these activities.

Funding/Support: Dr. Arnsten is funded by NIH grants R01 AG061190-01, MH093354-05 and MH108643-01, and by an endowed chair honoring Albert E. Kent to Yale University. Dr. Shanafelt’s research is funded by an endowed chair honoring Jeanie and Stewart Ritchie to Stanford University. 

Off-label drugs:  None.
For disclosure information regarding Mayo Clinic School of Continuous Professional Development accreditation review committee member(s), please go here

Accreditation Statement
In support of improving patient care, Mayo Clinic College of Medicine and Science is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Statement(s):

Mayo Clinic College of Medicine and Science designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity enables the participant to earn up to 1 Medical Knowledge MOC point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC points.

Participation information will be shared with ABIM through PARS. 

Other Healthcare Professionals
A certificate of attendance will be provided to other healthcare professionals for requesting credits in accordance with state nursing boards, specialty societies, or other professional associations.

For disclosure information regarding Mayo Clinic School of Continuous Professional Development accreditation review committee member(s), please go here.

Available Credit

  • 1.00 ABIM
  • 1.00 AMA PRA Category 1 Credit
Please login or register to take this course.

Cancellation and Refund Policy:

Request for cancellations must be submitted in writing to When cancelling a registration for a course 14 days or more before the course start date, a full refund (minus a $75 administrative fee) will be issued in the same form of payment the registration was received. No refunds are granted less than 14 days before the course start date.

Any use of this site constitutes your agreement to the Terms and Conditions of Online Registration.