Radiation Oncology Corner: Preventing Resident Burnout
A new academic year is upon us and with it comes the excitement of new colleagues and mentors, advancement to a more senior level, and an increase in responsibilities. The effects of resident burnout have been well-documented in several journals and often linked to long hours in high-stress environments that we have little control over. The results of such emotional exhaustion, cynicism, and depersonalization are poor work performance, which can negatively affect patient care. Most of these studies have evaluated burnout in the fields of internal medicine, family medicine, and various surgical subspecialties. In oncology specifically, it has been noted that rates of physician burnout continue to be high.
The field of radiation oncology has its own challenges that can lead to burnout. The constant care of sick and dying patients can lead to mental and emotional exhaustion. I consider it both a blessing and a burden that in our field we treat not only the patient but in a sense their families as well. It is often a packed room for consults and follow-ups, which can take an emotional toll on our well-being. As rewarding as it can be to be a cheerleader for your patients going through radiation treatment, it can be increasingly difficult to deliver bad news to the patient and their families that the disease has progressed, or to ultimately have to decide to stop treatment and pursue end-of-life care.
One study looked at radiation resident burnout and surveyed current residents in radiation oncology. Out of the 232 responses received (approximately a one-third representation of radiation residents nationwide), the researchers found that 33 percent of those residents met pre-determined criteria for “burnout.” The rates of burnout appeared to increase with increasing PGY level. Overall, they found that rates of radiation oncology resident burnout were lower than other studies with a more diverse specialty population. However one-third of those reporting did report experiencing burnout, which is not insignificant.1 While burnout appears higher in residency, the American Society for Radiation Oncology found that roughly 15 percent of practicing radiation oncologists reported burnout as well.2
Everyone will develop their own strategies to prevent burnout and fatigue but maintaining a strong work-life balance can be key to ensuring health and well-being. Taking time for yourself and incorporating adequate sleep, good nutrition, exercise, and leisure time with friends and family can help counteract the more strenuous hours spent at work. It is important to develop your own method of separating work from home life, and for those of us in residency this is particularly challenging. I can personally attest to a number of sleepless nights worrying about the plan and next steps of a particularly sick patient. In addition, it is important to remember the value of your work and the positive impact you have on countless patients and families. Few people have the opportunity to elicit such change on the outcomes of patients’ lives. While it may seem unrewarding or underappreciated at times, it is important to remember that it is a privilege to have patients refer to us as their doctors — something that can help guide you through some of the tougher days of residency.
By Chelsea Miller, MD, radiation oncology resident at Loyola University of Chicago
- Ramey SJ, Ahmed AA, Takita C, et al. Burnout evaluation of radiation residents nationwide: results of a survey of United States residents. Int J Radiat Oncol Biol Phys 2017;99(3):530-538.
- Pohar S, Fung CY, Hopkins S, et al. American society for radiation oncology (ASTRO) 2012 workforce study: the radiation oncologists’ and residents’ perspectives. Int J Radiat Oncol Biol Phys 2013; 87:1135-1140.