Oncologists are liable to burnout syndrome due to the task of caring for cancer patients and their families, in addition to the psychological stressors related to their suffering [8, 9].
In this study, the overall prevalence of those experiencing burnout among oncologists was 32%. High burnout rates for the emotional exhaustion, depersonalization, and personal accomplishment subscales were found to be 30%, 30%, and 25%, respectively. This was consistent with the global frequency of burnout over the past decade for the medical oncologists in the USA, Australia, and Europe [2, 10,11,12]. In 2005, the study by Allegra et al. [9] of over 1700 medical oncologists found that nearly 62% of medical oncologists in the USA experienced specific symptoms of burnout, including three signs: frustration (78%), emotional exhaustion (69%), and lack of work satisfaction (50%). Also, 45% of the American Society of Clinical Oncology (ASCO) members have described experiencing EE and/or DP symptoms of burnout [2]. In Australia and Europe, burnout rates vary significantly, from 52 to 78% based on the tools used in screening, specialty of medical oncology, health care systems, and practice [10,11,12]. For example, in Australia, 57% wished to reduce work hours, 43% reported a desire to leave their current position, 36% of gynecologic oncologists showed a high degree of EE, and 29% considered retirement [12]. In France, a study of 340 medical and radiation oncologists using the Maslach Burnout Inventory (MBI) found that 44% believed burnout was prevalent, with a desire to stop working in medicine [11].
The same results were found in members of oncology center in a survey study in Turkey where 42% had high scores of emotional exhaustion, 20% had high scores of depersonalizations, and 35.6% had low scores of personal accomplishment [13]. Also, this was consistent with Elen et al. [14] who reported job stress and a high level of burnout in medical oncologists.
In this study, more than half of the included oncologists suffered from stress. This finding supported the concern that oncologists working in clinical oncology departments are experiencing high levels of distress which was the same for the majority of oncologist worldwide [15, 16].
Many specific individual risk factors are associated with burnout and workplace stress. The present study showed that factors like younger age (≤ 40 years), female gender, being single, with no children, junior physicians (residents or physicians <10 years in practice), with work time directed to both patients’ care and research, and those with more than 6 shifts per month were associated with high burnout and workplace stress.
This was consistent with a previous study which showed that risk factors associated with high burnout levels included younger age (≤ 55 years), female gender, junior oncologists (physicians ≤ 5 years from training or residents), and single oncologists [3].
Age was considered as a causal factor for burnout and job stress as the early years of the career may be the most difficult ones. In this study, younger oncologists showed higher levels of burnout and workplace stress. Several studies have also reported that younger physicians had experienced higher levels of burnout [10, 13, 17].
Additionally, oncologists with less than 10 years of practice and who are assigned more than 6 shifts per month showed significantly higher rates of workplace stress. These results could be explained by the fact that postgraduate study usually requires much physical and mental efforts. In Egypt, a postgraduate study needs about 3 years of study and research to get a master’s degree and another 5 years for a PhD degree. These heavy academic needs, in addition to the stressful job as an oncologist, explain the finding that young oncologists (< 10 years of practice) were the most vulnerable group to burnout and stress. Also, residents felt they do not have control over their decisions, which may cause a low score on a sense of PA and causes feelings of inadequacy. This may result in an increase in the workplace stress scale in juniors as well.
In this study, professors were less complaining of work stress, since they adapt to coping with stressors and burnout. They manage stressors better as they get older and have achieved good academic positions.
Having children and being married were found to be self-protective against all stages of burnout among cancer-care health professionals [10, 17,18,19,20,21]. Similarly in our study, the overall burnout positive oncologists was significantly higher in association with single marital status (p < 0.001) and also having children tends to be protective and statistically significant (p < 0.001) effect against burnout. Other studies suggested that the burnout is not related to marital status [22].
Studies assessing the impact of gender on burnout syndrome revealed debatable results. While numerous studies did not show gender as a significant factor for burnout, others found that females demonstrated higher burnout scores than males [10, 22].
In this study, the female oncologist had higher rates of burnout and workplace stress than the males. The suggested explanation for this is that most of the sample were female (60%) and that bringing up children is exhausting for female in Egypt and therefore affecting their development of depersonalization. This was not consistent with a Turkish study which showed that female oncologists have a higher personal accomplishment and lower depersonalization levels than males [23].
In this study, oncologists who work more than 6 different shifts per month had high statistically significant stress than others. This can be explained on the basis that oncologists who were overloaded by mental and physical loads were more stressed and had higher burnout levels.
These results were consistent with other studies. For example, a Turkish study conducted on medical oncologists revealed that those who had more shifts appeared to have higher risk for burnout [21]. In another study, the highest burnout scores among physicians may be related to extended working hours and work overloads [24].
In addition, 73% of oncologists in the present study reported that oncology work is boring. This can explain the higher rate of burnout in the present study in comparison to other studies.