Improving Well-Being and Combating Burnout in Radiation Oncology Training

Crises in public health and social unrest have heightened the need to support trainee well-being. External factors coupled with oncology-specific factors, such as regularly facing mortality, balancing palliation with toxicity, the rapid pace of treatment advances, and engaging in emotionally charged conversations with patients, can lead to burnout. ¹ Burnout is characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment; it affects physicians and physicians-in-training at greater rates than the general population. ² Emotional exhaustion, depersonalization, and burnout affected 28%, 17%, and 33% of radiation oncology residents, respectively, in the United States in 2016. ³ Consequences may include inadequate patient care, professional ineffectiveness, and physician harm, including substance abuse, clinical depression, and suicidality. ⁴

Building community is important for increasing professional fulfillment, while decreasing burnout. A recent study described the implementation of a well-being curriculum for residents within a radiation oncology department, which allowed residents to openly discuss topics that cause distress in a supportive environment. ⁵ This intervention led to a decrease in burnout among residents.

Strong relationships among colleagues are essential to identify residents at risk for burnout or depression. Mayo Clinic has proposed 5 steps to recognize and support learners in distress: ⁶

With the changing state of radiation oncology and the challenges of the COVID-19 pandemic, residents are now more vulnerable than ever to burnout and stress. Establishing well-being programming and identifying learners in need are crucial steps to improve overall professional fulfillment and education.