title: Stress and Burnout Among Residency Program Directors in United States Radiation Oncology Programs.
abstract: OBJECTIVE
  To evaluate stressors among radiation oncology residency program directors (PDs) and determine the prevalence and indicators of burnout.
  
  
  METHODS
  An anonymous, online, cross-sectional survey was offered to PDs of US radiation oncology programs in the fall of 2014. Survey content examined individual and program demographics, perceptions surrounding the role of PD, and commonly encountered stressors. Burnout was assessed using the validated Maslach Burnout Inventory-Human Services Survey.
  
  
  RESULTS
  In total, 47 of 88 PDs (53%) responded to the survey. Although 78% of respondents reported feeling "satisfied" or "highly satisfied" with their current role, 85% planned to remain as PD for <5 years. The most commonly cited stressors were satisfying Accreditation Council for Graduate Medical Education/Residency Review Committee requirements (47%), administrative duties (30%) and resident morale (28%). Three-quarters of respondents were satisfied that they became PDs. Overall, 11% of respondents met criteria for low burnout, 83% for moderate burnout, and 6% for high burnout. Not having served as a PD at a prior institution correlated with high depersonalization (OR 6.75, P=.04) and overall burnout (odds ratio [OR], 15.6; P=.04). Having more years on faculty prior to becoming PD correlated with less emotional exhaustion (OR, 0.44, P=.05) and depersonalization (OR, 0.20, P=.04). Finally, having dedicated time for PD duties correlated with less emotional exhaustion (OR, 0.27, P=.04).
  
  
  CONCLUSIONS
  Moderate levels of burnout are common in U.S. radiation oncology PDs with regulatory stressors being common. Despite this, many PDs are fulfilled with their role. Longitudinal studies assessing dynamic external factors and their influence on PD burnout would be beneficial.
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
authors.forename: Sonya
authors.initials: S
authors.lastname: Aggarwal
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle, Washington.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kusano
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
authors.forename: Justin Nathaniel
authors.initials: JN
authors.lastname: Carter
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
authors.forename: Laura
authors.initials: L
authors.lastname: Gable
authors.affiliation: Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Sciences University, Portland, Oregon.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California. Electronic address: dtchang@stanford.edu.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Chang
mesh_terms: D000288:Administrative Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D000328:Adult; D000704:Analysis of Variance; D002055:Burnout, Professional / Q000453:epidemiology* / Q000209:etiology; D002321:Career Choice; D003430:Cross-Sectional Studies; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D007588:Job Satisfaction; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D010549:Personal Satisfaction; D010563:Personnel Turnover / Q000706:statistics & numerical data; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D014481:United States / Q000453:epidemiology