• Promoted by the +MIR Spanish Society of Medical Oncology (SEOM) Residents and Young Oncologists Committee, a study published in ESMO Open has evaluated the prevalence of burnout in young oncologists before and after the onset of the SARS-CoV-2 pandemic.
  • Results from the online surveying of oncology residents and young oncology specialists in Spain revealed that a quarter of the them had doubts about their medical vocation, three-quarters were resigned to COVID-19 care throughout the pandemic, and 85% of residents missed part of their training rotations.
  • The authors conclude that the pandemic has had a serious impact on burnout and call for the close monitoring of both the physical and mental well-being of young oncologists to define effective detection and prevention strategies.

While the ever-advancing landscape of precision medicine in oncology undoubtedly brings fresh hope for patients, it also poses many yet unanswered questions as to how we move forward, without the real risk of burnout of those who treat them – particularly with regards to the up-and-coming generation of young oncologists. Added to this already heavy burden are the many challenges posed by the current COVID-19 era which have inevitably taken a heavy toll.

Burnout in young oncologists is nothing new. Several studies have been reported in the literature which shine important light on this widespread problem and called for urgent action to identify real solutions matched to the needs of junior colleagues to relieve the burden they face and thus avert the real threat of some of the brightest future talents ultimately exiting from oncology. As an example, an ESMO study (1) of professional burnout in young European oncologists showed that it is common in this population, although rates vary across regions. It also reported that achieving a good work-life balance, access to support services and adequate vacation time may reduce burnout levels.

A new study, now published in ESMO Open (2), sought to assess the prevalence of burnout in our junior colleagues in Spain before and after the onset of the SARS-CoV-2 pandemic. Led by Elena Élez, Medical Oncologist and Clinical Investigator of VHIO’s Gastrointestinal & Endocrine Tumors Group and coordinator of the +MIR SEOM Residents and Young Oncologists Committee which is devoted to identifying and addressing specific concerns of young oncologists in Spain, research aimed at characterizing burnout levels and determinants in young oncologists and the effects of the COVID-19 pandemic on their health and training.

“It is well recognized that young oncologists are at particular risk of professional burnout, mainly due to their direct contact with seriously ill patients and their families and the continuously evolving medical landscape. Left unchecked, this significant threat to healthcare systems, can also jeopardize the delivery of optimal patient care”, observed Elena Élez, corresponding author of this present study which was conducted on behalf of the Spanish Society of Medical Oncology (SEOM) and the +MIR.

“The COVID-19 pandemic has had a profound impact on the causes of burnout and consequently exacerbated the situation. To assess professional burnout and its root causes before the pandemic and analyze its impact on healthcare organization, training, physical and mental health, we conducted two online surveys aimed at residents and medical oncologists in their first five years post-residency”, added Elena Élez.

First authored by Pablo Jiménez Labaig, Member of +MIR SEOM and Medical Oncologist at the Cruces University Hospital, Barakaldo, Bizkaia, findings show that almost one out of four young oncologists surveyed had doubts concerning their medical vocation. This statistic serves as a stark reminder that young medical professionals must be looked after, listened to, and better served through the adoption of concrete prevention strategies against professional burnout. Early detection is also crucial. Results from the first survey show that 28.2% of respondents were effected by burnout, increasing to 35.7% in residents in their second year of training. It also identified other issues that can lead to professional exhaustion including the perceived lack of vacation and leisure time and struggle to strike a better work-life balance.

Taking a toll on trainings as well as mental health

Almost 84.3% of survey participants confirmed that they had missed part of their training rotations and medical stays at other hospitals in Spain and abroad. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care in challenging work conditions, and 17.2% of this population reported that they had contracted COVID-19; these statistics are higher than those generally reported elsewhere in Europe, as well as figures reported for other specialties.

Regarding the state of mental health, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. “Added to this alarming mix, 64.2% respondents confirmed that they had no access to psychological support at the workplace. These worrisome findings raise an alarm concerning the lack of measures aimed at reducing burnout suffered by many of our young professionals”, said first author Pablo Jiménez Labaig, who also added that the accumulative effect of constant work overload and lack of training can further add to the damaging effects of the pandemic in young oncologists.

A Call to Act

Based on the results of these two surveys as well as next-step suggestions proposed by participants in the second one, SEOM’s +MIR proposes a series of measures to tackle professional burnout in oncology. First, to prevent it, contractual working hours must not be extended in order to guarantee the right to vacation and leisure time.

To more effectively detect, target and manage burnout, they propose increased mentorship during the critical stages of residency, such as the second year, and the nurturing of young oncologists during their progressive integration into the respective medical oncology services. They also call for the implementation of psychological support programs for those who need them.

“Regarding the current state of the COVID-19 pandemic, the specialized training of our young oncologists must not be interrupted nor compromised. They must be fully equipped to keep patients who are infected with the virus safe. We should also consider how the efforts of young medics who are serving on the front line during this pandemic are recognized and awarded”, noted Elena Élez, who also highlighted the importance of guaranteeing a work-life balance for young oncologists, as well as providing them with the necessary support to better manage stress.

She concluded, “Collectively, these measures will help to improve their mental and physical health, enable them to be the very best that they can be, as well as ensure the sustained, optimal treatment and care for cancer patients”.

References:

  1. Banerjee S, Califano R, Corral J, de Azambuja E, De Mattos-Arruda L, Guarneri V, Hutka M, Jordan K, Martinelli E, Mountzios G, Ozturk MA, Petrova M, Postel-Vinay S, Preusser M, Qvortrup C, Volkov MNM, Tabernero J, Olmos D, Strijbos MH. Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey. Ann Oncol. 2017 Jul 1;28(7):1590-1596.
  2. Jiménez-Labaig, V. Pacheco-Barcia, A. Cebrià, F. Gálvez, B. Obispo, D. Páez, A. Quílez, T. Quintanar, A. Ramchandani, J. Remon, J. Rogado, D.A. Sánchez, M. Sánchez-Cánovas, E. Sanz-García, A. Sesma, N. Tarazona, A. Cotés, E. González, J. Bosch-Barrera, A. Fernández, E. Felip, R. Vera, Á. Rodríguez-Lescure, E. Élez. Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM). ESMO Open. Volume 6, Issue 4, 2021. https://doi.org/10.1016/j.esmoop.2021.100215.

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