Positive feelings of daily accomplishment, role clarity, and academic balance may protect against stress and burnout in oncology.

Abstract

53 Background: Burnout and stress have negative effects on physician well-being, workforce retention, and patient outcomes. Work overload, lack of control, and value mismatch are known drivers of burnout, but protective factors remain unclear. Methods: National data from the Association of American Medical Colleges (AAMC) StandPoint Faculty Engagement Survey, conducted 2020-2022 (overall response rate 58%) was analyzed. Job satisfaction questions assessed faculty autonomy (“I am satisfied with my autonomy at work”), accomplishment (“My day-to-day activities give me a sense of accomplishment”), clear roles (“My role here is clear to me”), institutional alignment (“I feel personally driven to help this medical school succeed”), and academic balance (“My effort assigned to service, teaching, and research, accurately reflects how my time is actually spent in the workplace”) with “agree”/“strongly agree” considered positive. Burnout measures included: “I enjoy my work”, “I am under stress”, or self-reported (at least) “one or more symptoms of burnout”. Faculty demographics included gender, race/ethnicity, sexual orientation, and rank. Multivariate analysis (MVA) identified factors associated with physician stress and burnout. Results: Of 1306 academic oncologists surveyed, most were male (56%), White (65%), and identified as heterosexual (96%); 7% were considered underrepresented in medicine by race or ethnicity. Of 814 (62% of sample) who self-assessed job satisfaction, most endorsed positive autonomy (82%), accomplishment (82%), clear roles (79%), institutional alignment (80%), and academic balance (59%). Of assessed demographics, women had slightly less institutional alignment (76% vs 83% men, p=0.026) and academic balance (55% vs 62% men, p=0.032). Of 751 (58% of sample) who self-assessed burnout, only 25% enjoyed their work; the rest were either under stress (46%) or had at least one symptom of burnout (29%). Of assessed demographics, women were more likely to report burnout (34% vs 25% men, p=0.0013). On MVA, women (OR=1.6, 95%CI 1.1-2.4) were more likely to be either under stress or endorse burnout. Any faculty (regardless of gender) who reported feelings of job accomplishment (OR=0.36, 95%CI 0.14-0.96), clear roles (OR=0.31, 95%CI 0.13-0.78), and academic balance (OR=0.32, 95%CI 0.20-0.51) were less likely to report stress or burnout. Conclusions: In a large mid-pandemic national survey of academic oncologists, the vast majority were either under stress or had symptoms of burnout, with women being at highest risk. Faculty who endorsed a sense of accomplishment, reported they had clear roles, and whose academic effort was aligned with their actual time at work had one-third the risk of stress and burnout as those who did not. Implementing programs to improve these vital aspects of academic work should be part of essential burnout mitigation efforts.