The Importance of Belonging
by Adam D. Quick, M.D. | April 18, 2025
Article Citation: Leep Hunderfund AN, Saberzadeh Ardestani B, Laughlin-Tommaso SK, Jordan BL, Melson VA, Montenegro MM, Brushaber DE, West CP, Dyrbye LN. Sense of Belonging Among Medical Students, Residents, and Fellows: Associations With Burnout, Recruitment Retention, and Learning Environment. Acad Med 2025 Feb 1;100(2):191-202. DOI: 10.1097/ACM.0000000000005892
What is this article about?
This article examines the sense of belonging (belongingness) among a large population of learners at various stages of training. A sense of belonging was defined as, “—a subjective experience that people often describe as feeling welcomed, accepted, included, understood, connected, and valued within a particular setting or group. A cross-sectional survey was conducted of medical students, residents and fellows (n=2257 with 1,261 respondents) at multiple sites in the Mayo Clinic system to assess their sense of belonging across three social contexts (1) school/program, (2) organization and (3) surrounding community. The study also assessed how belonging was associated with learner burnout, recruitment and retention indicators and 5 modifiable learning environment factors that included ratings of:
- Social support
- Faculty relationships
- Diversity
- Equity and inclusion climate
- Frequency of harmful personal bias experiences
- Leadership representation.
Demographic information assessing the number of historically marginalized identities in study participants was also collected. The number of learners who reported a sense of belonging was highest in the school or program, followed by the organization and finally the surrounding community. Belongingness decreased as the number of historically marginalized identities increased. Learners with a sense of belonging had much lower odds of burnout and higher odds of being likely to recommend the organization to other learners or to accept a job offer with the organization. All 5 learning environment factors were strongly associated with school, program, organization and community belongingness.
Why should you read the article?
The feeling of belonging refers to a subjective sense of being welcomed, accepted, understood, connected and valued. Belongingness significantly impacts people’s life satisfaction, sense of identity and meaning. The perception of belonging for a person correlates with positive outcomes including better physical health, mental health, resilience, relationship formation, motivation and performance. There is limited data about the benefits of belongingness in medical trainees and how this varies with the different social identities of the learner. Studying this could allow UME and GME programs to understand what kind of interventions and efforts work best at enhancing the sense of belonging.
How can you use this article?
The results have multiple potential implications for medical schools. It is easier for learners to develop a sense of belonging in their school than in the associated organization or community. Thus, efforts to enhance belongingness have the greatest impact at the school level rather than at the larger organization or community level. Programs that enhance belongingness also have important intrinsic benefits for learner wellness by reducing burnout and instrumental benefits for the organization by enhancing the chance that learners will recommend the school or organization to peers. Provision of social support for learners appears to be a particularly promising strategy for enhancing belongingness based on the strong, independent associations observed between social support and school or program belongingness.
Review Author: Adam D. Quick, M.D., Associate Professor of Neurology and Clerkship Director, The Ohio State University College of Medicine, Columbus, OH. Organization: Consortium of Neurology Clerkship Directors