Job satisfaction, stress, and burnout among Canadian gynecologic oncologists
Introduction
In 1991, the Royal College of Surgeons Canada accredited subspecialty training in gynecologic oncology. At its core, gynecologic oncology is a subspecialty that involves cancer surgery as it relates to the gynecologic tract and surgery for complicated benign gynecologic conditions such as endometriosis. In some instances, the subspecialists provide chemotherapy for these cancers. The subspecialists are involved in ongoing surveillance of women who have completed primary therapy. They are involved in the management of complications that are related to treatment or recurrent disease. Gynecologic oncologists are physicians who have 5 years of specialty training in Obstetrics and Gynecology and then a further 2–4 years of subspecialty training in gynecologic cancer surgery, principals of radiation oncology, delivery of chemotherapy, pathology, and often basic science or clinical research methods. Most Canadian gynecologic oncologists work within a university environment.
In the last decade, there have been stresses on the medical system in Canada with cutbacks of federal funding to the provinces for the delivery of health care. This comes at a time when costs for novel treatment strategies (laparoscopically assisted radical surgery and chemotherapeutic agents) are soaring. This has resulted in an era of hospital restructuring. Currently, there is a loss of control on one's workplace [1] and lack of adequate resources [2]. At the same time, the population is expanding. In addition, there is a population bulge in the number of senior citizens. Cancer is more common in the aging population, thus the health care system is attempting to cope with increasing numbers of patients with cancer. All of these factors impact the day-to-day work environment of the gynecologic oncologist who is one component of the system. There are reports in the laypress of physician burnout, decreased morale, high levels of stress, and staff leaving or decreasing their work hours [3]. We have conducted a survey to determine whether there is evidence to support or refute these reports in the Canadian gynecologic oncology community.
The specific objectives of this study were to outline the current job description of gynecologic oncologists in Canada and define any trends between the oncologist's initial and current job. This study will assess job satisfaction and job stress. We will measure the prevalence of burnout and psychological morbidity using validated instruments.
Section snippets
Methods
In the autumn of 2002, we conducted a confidential cross-sectional mailed survey of all gynecologic oncologists in Canada. The respondents were identified from the Society of Gynecologic Oncologists Canada, and input from key provincial sources. A total of 50 questionnaires were mailed. To maximize the response rate, a second survey was sent to non-respondents approximately 1 month after the initial mailing.
The study questionnaire consisted of the following:
A section addressing demographic
Demographics
Of the 50 gynecologic oncologists, 39 returned the questionnaire, and 35 questionnaires were complete and could be analyzed. Responses came from across Canada (British Columbia 1, Alberta 5, Winnipeg 3, Ontario 14, Quebec 8, Nova Scotia 2, and Newfoundland 1). Table 1 shows that the majority of gynecologic oncologists are in their fifth decade and are married.
Setting
Gynecologic oncologists practice in either hospital or cancer clinic (Table 2). There is a shift over time toward an increased number of
Discussion
In this paper, we have described the job profile of Canadian gynecologic oncologists. Their role is predominantly clinical with a minor component of administration and to a lesser extent, education or research. In the clinical role, 80% of the activity is focused on gynecologic cancer patients either in new patient assessment, surgery, chemotherapy, or follow-up. Although vacation and conference time is technically available, this appears to be under utilized. We can only speculate on
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