Across Europe, more than 70% of young cancer specialists are showing signs of burnout, the largest survey of its kind has revealed. The results, reported at the Congress of the European Society for Medical Oncology (ESMO 2014) in Madrid, have prompted calls for serious action to address the issue at all levels.
"Oncology is an exceptionally rewarding career, but it can be demanding and stressful at times," said Dr Susana Banerjee, lead author of the study and a consultant medical oncologist at The Royal Marsden NHS Trust in London, UK.
"Oncologists make complex decisions about cancer management, supervise the use of toxic therapies, work long hours, and continually face patients suffering and dying," she said. "Furthermore, young oncologists are now facing increased administration, complaints/medico-legal issues, increasing expectations and workload with reduced resources. Taken together, these factors make oncologists at risk of developing burnout, a syndrome characterised by emotional exhaustion, depersonalisation (treating people as if they are objects), and loss of meaning or purpose in work."
Banerjee and other members of the ESMO Young Oncologists Committee surveyed 595 oncologists under the age of 40 from across Europe and they report that 71% of participants showed burnout.
"The ESMO Young Oncologists Committee burnout survey has shown that burnout is a common, universal problem for young oncologists today," Banerjee said.
Burnout could lead to serious personal consequences for the doctor such as anxiety, depression, alcohol or substance abuse and suicide, she noted. Doctors suffering burnout might also face professional consequences including challenges when it comes to delivering compassionate, high-quality patient care.
In addition, there is a risk that oncologists who experience burnout may leave clinical practice sooner than planned, with potential impact on the oncology workforce and ultimately patient care.
Differences across Europe
The survey showed that rates of burnout varied significantly across Europe. They were highest in central Europe, affecting 84% of respondents, and lowest in Northern Europe including the UK, where 52% of respondents were affected.
Factors significantly linked to higher risk of developing burnout were poor work/life balance, inadequate vacation time. Personal factors include not being in a relationship, living alone and not having children. Hospital factors included having a small workforce, higher numbers of patients and no access to support services.
Although there was no significant difference in burnout between men and women, men were found to have higher depersonalisation scores than women (60 vs 45%).
Banerjee said that the first step in addressing burnout is to recognise the extent and implications of the problem for the current and future generations of oncologists.
"I believe as a profession, doctors have a duty to try and address this growing issue at all levels - from universities, individual hospitals and professional societies such as ESMO," she said. "Burnout should not be stigmatised as a weakness. We need to support colleagues by focusing on recovery and prevention."
Strategies including promoting a philosophy of good work/life balance, having the opportunity to discuss stressful aspects of work as well as access to support services should be encouraged, she added.
Achieving a good work/life balance is vital, she said. "This can include interests outside daily clinical practice such as research, teaching and mentoring students as well as interests outside of work such as hobbies, exercise and spending time with family and friends.
Achieving job satisfaction and enjoying being an oncologist is likely to have a positive impact in improving patient care, communication and relationships with colleagues.
"Although it is important to recognise this issue, the ESMO Young Oncologists Committee believes that by no means should these results discourage young colleagues who want to become medical oncologists," said Dr Raffaele Califano, Chair of the Ccommittee. "This specialty remains one of the most fascinating and rewarding where physicians can make a huge difference in patients outcomes and quality of life."