Ten-Year Trends in Clinician Well-Being and Burnout Among Oncology Fellows in Training: An ASCO State of Cancer Care in America Study.

Abstract

To better understand burnout in oncology and clinician well-being along the career continuum starting with training, we sought to characterize the professional well-being of physicians training in medical oncology in 2023 and to identify trends over time comparing to fellows from a decade prior. All US medical oncology fellows taking the 2023 ASCO Medical Oncology In-Training Exam (ITE) were invited to complete an optional post-exam survey evaluating fatigue, satisfaction with work-life integration (WLI), emotional exhaustion and depersonalization. 2023 ITE survey responses were compared to the 2013 ASCO post-ITE survey (n=1345). Two sample <i>t</i> tests and analysis of variance tests (continuous variables) and Chi-square tests (categorical variables) were used to assess differences in well-being dimensions between groups. Of the 2217 fellows who took the 2023 ITE, 1589 (71%) answered the post-ITE survey's well-being items (33% first-year, 36% second-year, and 31% third-year fellows). In 2023, one in five fellows (20%) reported burnout (compared to 34% of fellows in 2013, <i>P</i> < .01) and 50% of fellows in 2023 reported satisfaction with WLI (<i>v</i> 34% in 2013, <i>P</i> < .01). High emotional exhaustion was reported in 18% of all fellows in 2023 with the highest among first years (21%), compared to third (17%) and second years (16%, <i>P</i> = .04). High depersonalization was reported by 11% of fellows in 2023 without a significant difference across the years. Finally, in 2023, 93% (n = 1459) of medical oncology fellows reported that they would choose oncology again as their field, increasing significantly from 89% (n = 1056) in 2013 (<i>P</i> < .01). Although US medical oncology fellows are doing better than in 2013, burnout and work-life integration continue to be issues. These findings underscore the significance of optimizing WLI and the need to better understand the drivers mediating a positive workplace experience and its evolution once in practice.