Wellbeing and burnout among oncology fellows compared to prior fellows and current practicing oncologists: An ASCO State of Cancer Care in America (SOCCA) trend analysis.

Abstract

47 Background: Burnout impacts oncology clinicians across their professional lifecycle. To better understand clinician wellbeing and the role of fellowship training, we characterized trends in oncology fellows’ burnout and perception of preparedness during training. Methods: As an ASCO SOCCA initiative, all medical oncology fellows taking the 2023 ASCO Medical Oncology In-Training Exam (ITE) were invited to complete an optional post-ITE professional wellbeing survey. Fellows were asked 1 item on fatigue (on a 0-10 Likert scale, 10 = “as bad as can be”), 1 item on satisfaction with work-life integration (WLI) and 2 Maslach Burnout Inventory (MBI) items on emotional exhaustion (EE) and depersonalization (DP), each scored on a 1-7 scale, >5 being high. Per convention, respondents with a high EE and/or DP were categorized as having burnout. 2023 ITE responses were compared to (1) 2013 ASCO Fellows Post-ITE survey (n=1345),1 (2) 2012-13 ASCO survey of practicing oncologists (n=1117),2 and (3) 2023 ASCO survey of practicing oncologists (n=328; 26% tagged as early career, using age <40 as proxy; 64% in academia). Results: 2231 fellows who took the ITE in 2023. Responses from 1568 first (33%), second (36%) and third year (31%) fellows who responded to at least one wellbeing item are included in this analysis. Compared to 10 years prior, oncology fellows in 2023 reported less burnout (20% in 2023 vs 34% in 2013, p<.001) and higher satisfaction with WLI (50% in 2023 vs 34% in 2013; p<.001). Fellows across both 2013 and 2023 studies reported higher satisfaction with WLI with advancing fellowship year (1-3). The 2013 analyses found no statistically significant difference in EE, DP or overall burnout between fellows and practicing oncologists. However, in 2023, the prevalence of high EE, DP and burnout was significantly lower in fellows vs both all and early career practicing oncologists (all p<.005, Table). Most (72%) fellows in 2023 felt their training is adequately preparing them to manage burnout in future practice. Conclusions: Oncology fellows in 2023 reported significantly less burnout and higher WLI satisfaction than fellows in 2013 and current practicing oncologists. Most fellows felt prepared to manage burnout in future practice. The higher prevalence of burnout in early career oncologists vs fellows suggests a gap between expectations of practice during training and the actual experience of oncology practice. (1) Shanafelt et al: JCO 32(27), 2014. (2) Shanafelt et al: JCO 32(11), 2014. [Table: see text]