Purpose
To examine whether female medical students continue to exhibit higher levels of empathy compared to their male peers after the transition of USMLE Step 1 to pass/fail, and to investigate the relationship between empathy and burnout among medical students.

Methods
A cross-sectional study was conducted using anonymous surveys distributed via a third-party platform. The Oldenburg Burnout Inventory for Medical Students Scale was used to collect all data, assessing both burnout and empathy levels. Participants self-identified their gender. Independent t-tests compared mean empathy and burnout scores between genders, and Pearson correlation coefficients analyzed the association between empathy and burnout dimensions. The Oldenburg Burnout Inventory consists of two subscales measuring exhaustion and disengagement, with 16 items split evenly between these dimensions.

Results
Female participants demonstrated significantly higher levels of empathy compared to males. However, these elevated empathy scores were associated with higher rates of exhaustion and overall burnout among female students. Interestingly, while empathy levels were higher in female students, there was no significant difference in disengagement scores between genders. The study revealed a complex relationship between empathy and burnout, particularly in female medical students, where higher empathy may contribute to increased exhaustion without necessarily affecting levels of engagement.

Conclusions
Female medical students exhibit higher levels of empathy compared to their male peers. This heightened empathy may paradoxically be a contributor to burnout among women in medicine. Medical schools should implement strategies to help students, particularly women, maintain healthy levels of empathy while protecting against empathy-related exhaustion. Balancing empathy cultivation with emotional self-care is crucial for fostering student success and preventing burnout in future healthcare professionals. Further research with larger, multi-institutional samples is needed to confirm these findings and develop targeted interventions.