Nearly three-quarters of oncologists surveyed experienced symptoms of burnout prior to the COVID-19 pandemic, according to a Canadian study published in JCO Oncology Practice

The study quantified burnout among practicing cancer care physicians in Ontario, Canada, at the end of 2019. It also revealed drivers of burnout, including working in a chaotic atmosphere, feeling unappreciated on the job, and poor or marginal control over workload.

Ontario is the largest province in Canada, with a population exceeding 14.5 million, and it has a single-payer, publicly funded cancer system.

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To address burnout in Ontario’s medical oncology system, researchers conducted an online survey. They assessed burnout using the Maslach Burnout Inventory, which measures emotional exhaustion, depersonalization, and personal accomplishment.

From November to December 2019, 418 physicians completed the survey. The group included medical oncologists, surgical oncologists, hematologists, radiation oncologists, and physicians in fields deemed relevant to oncology, such as radiology or palliative care.

Survey Results

Overall, 73% of respondents had symptoms of burnout, with high burnout scores. The mean score was 30.8 for emotional exhaustion, 9.9 for depersonalization, and 37.2 for personal accomplishment.

The following factors were associated with higher odds of burnout:

  • A hectic or chaotic work atmosphere — odds ratio (OR), 15.5 (95% CI, 3.4-71.5; P <.001)
  • Always feeling unappreciated or used on the job — OR, 7.9 (95% CI, 2.9-21.3; P <.001)
  • Poor or marginal control over workload — OR, 8.0 (95% CI, 2.6-24.9; P <.001)
  • Being uncomfortable talking to peers about workplace stress — OR, 3.0; (95% CI, 1.1-7.9; P =.03).

Conversely, older age was associated with lower odds of burnout. The odds of burnout were lower among physicians age 56 years or older compared with those age 45 years or younger (OR, 0.16; 95% CI, 0.1-0.4; P <.001).

“The number of participants meeting criteria for burnout is striking, given the known impact of burnout on provider mental health, patient safety, and quality of care,” the study authors wrote. “The presence of system-wide burnout represents the failure of a health system to tackle key drivers such as poor job autonomy, inefficient practices, increased work demands, and a culture not attuned to well-being.”

The authors suggested that “creating richer peer-to-peer and leadership engagement opportunities among early- to mid-career individuals may be a worthwhile organizational strategy.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Singh S, Farrelly A, Chan C, et al. Prevalence and workplace drivers of burnout in cancer care physicians in Ontario, Canada. JCO Oncol Pract. Published online September 10, 2021. doi:10.1200/OP.21.00170