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Oncology fellows’ career plans, expectations, and well-being: do fellows know what they are getting into?

ABSTRACT: To evaluate the career plans, professional expectations, and well-being of oncology fellows compared with actual experiences of practicing oncologists.US oncology fellows taking the 2013 Medical Oncology In-Training Examination (MedOnc ITE) were invited to participate in an optional postexamination survey. The survey evaluated fellows’ career plans and professional expectations and measured burnout, quality of life (QOL), fatigue, and satisfaction with work-life balance (WLB) using standardized instruments. Fellows’ professional expectations and well-being were compared with actual experiences of US oncologists assessed simultaneously.Of the 1,637 oncology fellows in the United States, 1,373 (83.9%) took the 2013 MedOnc ITE. Among these, 1,345 (97.9%) completed the postexamination survey. The frequency of burnout among fellows decreased from 43.3% in year 1 to 31.7% in year 2 and 28.1% in year 3 (P < .001). Overall, the rate of burnout among fellows and practicing oncologists was similar (34.1% v. 33.7%; P = .86). With respect to other dimensions of well-being, practicing oncologists had lower fatigue (P < .001) and better overall QOL scores (P < .001) than fellows but were less satisfied with WLB (P = .0031) and specialty choice (P < .001). Fellows’ expectations regarding future work hours were 5 to 6 hours per week fewer than oncologists’ actual reported work hours. Levels of burnout (P = .02) and educational debt (P < or =.004) were inversely associated with ITE scores. Fellows with greater educational debt were more likely to pursue private practice and less likely to plan an academic career.Oncology fellows entering practice trade one set of challenges for another. Unrealized expectations regarding work hours may contribute to future professional dissatisfaction, burnout, and challenges with WLB.

SUBMITTER: Shanafelt TD

PROVIDER: S-EPMC4876315 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Oncology fellows’ career plans, expectations, and well-being: do fellows know what they are getting into?

Shanafelt Tait D TD Raymond Marilyn M Horn Leora L Moynihan Tim T Collichio Frances F Chew Helen H Kosty Michael P MP Satele Daniel D Sloan Jeff J Gradishar William J WJ

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20140901 27

<h4>Purpose</h4>To evaluate the career plans, professional expectations, and well-being of oncology fellows compared with actual experiences of practicing oncologists.<h4>Methods</h4>US oncology fellows taking the 2013 Medical Oncology In-Training Examination (MedOnc ITE) were invited to participate in an optional postexamination survey. The survey evaluated fellows’ career plans and professional expectations and measured burnout, quality of life (QOL), fatigue, and satisfaction with work-life b ...[more]

PMID: 25049326

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Project description:PurposeThe burnout rate among US radiation oncology residents was 33% in 2016. To our knowledge there are no published interventions addressing burnout among radiation oncology residents. We describe the implementation of a well-being curriculum, cocreated by a psychologist, a medical humanities professional, and radiation oncology attending and resident physicians.Methods and materialsRadiation oncology residents at our institution were surveyed to determine themes that induced burnout. A curriculum was developed, with monthly small group sessions focused on 1 identified topic. Sessions alternated between psychological tool-focused approaches and humanities exercises. These were led by a psychologist or medical humanities professional. Residents were given protected time to attend sessions during business hours. Participation was optional. Participants were assigned a random identifier, and the Stanford Professional Fulfillment Index (PFI) was assessed at baseline and 3-month intervals. PFI trends were analyzed after 1 year. At the end of the year, a focus group was held to evaluate work satisfaction and self-reported interactions with patients and coworkers. This information was used to improve the curriculum.ResultsAll 12 residents in the radiation oncology program participated in the curriculum. There was an equal number of residents of postgraduate years 2 through 5. Six of the participants were female. Of the participants, 11 completed the PFI. At baseline, 80% of residents met criteria for burnout. This decreased to 67%, 50%, and 33% at 3, 6, and 9 months, respectively. The proportion of residents meeting criteria for very good professional fulfillment was 30%, 56%, 38%, and 22% at baseline and 3, 6, and 9 months, respectively. On average, 9 of 12 residents attended each session.ConclusionsOur experience demonstrates the feasibility of collaborating with residents in the development of a well-being curriculum to cater programming to their needs, which we believe led to excellent engagement and attendance at each session.

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Oncology fellows’ career plans, expectations, and well-being: do fellows know what they are getting into?

Publications

Oncology fellows’ career plans, expectations, and well-being: do fellows know what they are getting into?

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