Prevalence and causes of burnout amongst oncology residents: a comprehensive nationwide cross-sectional study.

BACKGROUND: Burnout syndrome occurs frequently amongst oncology healthcare workers. It has a detrimental effect on the patient-physician relationship. Little is known about the prevalence and causes of burnout amongst junior doctors in oncology. METHODS: An anonymous questionnaire was sent out to every medical or radiation oncology or haematology resident in France (n=340). It included: demographical data, burnout level (Maslach Burnout Inventory), sources of stress, sense of equity at work, sources of support, and general health questions. Validated scales were used when available. Two reminder e-mails were sent to increase the response rate. RESULTS: Questionnaires were despatched during Spring 2009. The response rate was 60% (204/340). Emotional exhaustion (EE) and Depersonalisation (DP), the major components of burnout, were reported, respectively, by 26% (n=53) and 35% (n=72) of the residents. Burnout prevalence was 44% (n=89), defined as a severely abnormal level of either EE or DP. Eighteen percent of the residents (n=36) had severely abnormal levels of both EE and DP. The burnout level was not significantly different between the three specialties, but was higher amongst residents who do not feel adequately rewarded for their work (p<0.001). Burnout was associated with a lower perception of one's general health status (p<0.001) and the desire to quit Medicine or to change specialty (p<0.001). CONCLUSION: The burnout level is high amongst oncology residents. It probably discourages vocations for oncology. Interventions are needed and could include support groups, more intense coaching by senior physicians, training programmes on 'breaking bad news' and teaching of stress management skills.

Why do residents choose the medical oncology specialty? Implications for future recruitment--results of the 2007 French Association of Residents in Oncology (AERIO) Survey.

BACKGROUND: The aim of this study was to analyze demography, motivation behind the choice of the medical oncology specialty, career plans, and the quality of training in medical oncology and to provide guidance to candidates for boosting the number of oncologists. METHODS: In 2007, the French Association of Residents in Oncology conducted a nationwide study of all medical oncology residents in France. RESULTS: The strongest factors that had influenced their decision to become a medical oncology specialist were an interest in medical oncology (98%), exposure to this branch of medicine during graduate training as a medical student (83%), interest in research (81%), and the diversity of the activity (75%). The mean score for the quality of training was 6 (0-10). More time for reading during working hours as well as for attending staff meetings and greater availability of teaching oncologists would improve the quality of training. The most popular career choice was working in a public hospital but most residents stated that they had not received adequate information about the different career plans. CONCLUSIONS: No data are available regarding how training in medical oncology is perceived. This study provides useful data for future policies to boost the number of oncologists.

[Prognosis and predictive factors in prostate cancer]. / Facteurs pronostiques et prédictifs du cancer de la prostate.

Prostate carcinoma represents a major public health issue and an important share of the oncological practice. As well as for other types of carcinoma, the therapeutic strategy might be guided by the identification of prognosis factors. For a localized prostate cancer, 3 pretherapeutic factors are often used: evaluation of the clinical stage, Gleason's score on prostatic biopsies and prostate specific antigen (PSA). Their combination is at the origin of multiple prognosis classifications and allowed the elaboration of statistical models, such as nomograms. These different tools are suitable for pretherapeutic evaluations of the histologic stage as well as for the evaluation of recurrence's risk. In case of metastastic disease, other clinical and biological prognosis factors state for the tumor's activity. Currently the identification of biomolecular markers through the techniques of tissue micro-array, the analysis of biological markers of angiogenesis as well as the analysis of circulating tumor cells could contribute to a better definition of the prognosis and predictive factors of this pathology.