Risk of burnout, psychological growth, longevity of career and making sense of Covid‐19 in senior Australian radiation oncologists

Abstract

Introduction

Senior radiation oncologists in hospital/organisational settings, are repetitively and vicariously exposed to others' traumatic distress‐perpetuating risk of burnout. Little is known of the additional organisational burdens of the Covid‐19 pandemic on their mental well‐being for career longevity.

Methods

Using Interpretative Phenomenological Analysis, semi‐structured interviews provided positive and negative subjective interpreted data from five senior Australian radiation oncologists during Covid‐19 lockdowns.

Results

One superordinate theme, Vicarious risk, hierarchical invalidation, redefining altruistic authenticity, overarched four subordinate themes: (1) Vicarious contamination of caring, (2) The hierarchical squeeze, (3) The heavy burden of me and (4) Growth of authenticity. For these participants, juxtaposed challenges to career longevity and mental well‐being were ‘self’ as empathic carer to vulnerable patients, and ever‐increasing burdens of the organisation. Sensing invalidation, they experienced periods of exhaustion and disengagement. However, with experience and seniority, self‐care was prioritised and nurtured through intrapersonal honesty, altruism and relational connectedness with patients and mentoring forward junior colleagues. Focusing on mutual well‐being, a sense of life beyond radiation oncology became acceptable.

Conclusions

For these participants, self‐care became a relational joining with their patients separate from the lack of systemic support which heralded an early termination to their career for psychological well‐being and authenticity.

Senior radiation oncologists in hospital/organisational settings, are repetitively and vicariously exposed to other's traumatic distress‐perpetuating risk of burnout. Little is known of the additional organisational burdens of the Covid‐19 pandemic on their mental well‐being for career longevity. Focusing on mutual well‐being for themselves and their patients, a sense of life beyond radiation oncology became acceptable.

Introduction

Radiation oncologists play a vital role in the cancer journey. The necessary empathic support required in such a role places them among the many professions at risk of vicarious distress, compassion fatigue, burnout and related psychopathology. ¹ , ² , ³ , ⁴ , ⁵ Burnout mirrors the loss of professional effectiveness and increased vulnerability to negative inner experiences. ⁶ Conversely, the distress caused by both intrapersonal and interpersonal challenges of professional caring over time, are now recognised as offering a springboard to psychological well‐being including posttraumatic growth. ² , ⁷

Burnout is experienced as: (1) emotional exhaustion; (2) depersonalisation from the job; and (3) reduced professional accomplishment or efficiency. ⁸ It is often insidiously experienced through the demands of busy workloads and the degree of empathy required to maintain the working relationship leading to emotional exhaustion, ⁸ depersonalisation, cynicism and detachment from work, and key interactive people (both patients and co‐workers). ⁹ , ¹⁰ Ultimately, the third of the three burnout dimensions, reduced professional accomplishment, depicts growing feelings of incompetence and lack of accomplishment. ¹¹ , ¹²

Hesse ¹³ outlined that experiences of second‐hand trauma in the workplace created defences such as, denial, intellectualization, isolation of effect, dissociation and projection. Pre‐existing personal history of trauma distress has been inconclusive in the literature as a risk for burnout, ² , ¹⁴ however, from an organisational perspective, vicarious traumatic distress is a significant predictor of long‐term illness, work absenteeism and job dissatisfaction. ¹⁵ , ¹⁶

Experience is protective with younger more inexperienced therapists/carers appearing more susceptible to higher rates of burnout or symptoms of vicarious traumatisation. Supervision programmes have shown gains in reducing emotional exhaustion and burnout in professionals at risk ³ , ¹⁷ therefore, and in particular, for early practitioners, supervision is recommended to monitor cognitive disruptions, and support feeling of shame, incompetency and anxiety. ¹⁸ , ¹⁹ , ²⁰

Certain professions attract individuals who convey high achiever traits ²¹ and who pride themselves on personal/professional success, often at the expense of their own well‐being. Conversely, the distress caused by both intrapersonal and interpersonal challenges of professional caring over time can offer a springboard to psychological well‐being including posttraumatic growth. ² , ⁷ Posttraumatic growth theory defines growth as both an outcome and a process, resulting from the cognitive struggle with highly challenging life circumstances. ²² , ²³ Conceptually, posttraumatic growth is a transformative engagement with the existential challenges of life specifically autonomy, relationships, personal growth, life purpose, mastery and self‐acceptance ²³ increasing psychological well‐being. ⁷ Given that career longevity and mental well‐being in professional carers has been found to be associated with greater experience leading to fewer disruptions in self‐trust, self‐intimacy and self‐esteem, ²¹ this phenomenological study sought the lived experience of senior radiation oncologists and whether changes to practice during the Covid‐19 pandemic impacted either positively or negatively on well‐being. Therefore, this study sought both positive and negative interpretations of senior Australian radiation oncologists' vicarious exposure to others' cancer‐related trauma, in a hospital setting, at the time, impacted by 2021 Covid‐19 state border lockdowns. It explored such influences on life choices and relationships, their maintenance of mental well‐being and career longevity.

Method

Participants

Following approval from the University of Newcastle's Human Ethics Research Committee (H‐2021‐0061), senior current Radiation Oncologists were recruited via radiation oncologist social/support networks. Participants all worked in hospital radiation oncology units and included four females and one male. Cut‐off for the study occurred following contact from the first five volunteers who met the criteria for ‘senior’, the criteria for inclusion in the study pre‐defined as having greater than 5 years' experience as a full‐time practicing radiation oncologist. As a homogenous sample, each participant provided specialised treatment to patients diagnosed with a wide range of cancer types (e.g., skin, lung, prostate, breast, colorectal, endometrial, brain tumours etc.). The participants actively contributed to research, education and training within radiation oncology networks and organisations. Though all met the criteria for inclusion having greater than five years as senior consultant, two participants worked as senior radiation oncologists and medical directors of radiation oncology with approximately 24 and 23 years of clinical experience. Three participants worked as radiation oncologists with approximately 7, 6, and 5 years of experience. Each participant reported vicarious exposure to a range of traumatic patient narratives and experiences as a result of cancer diagnosis/prognosis and treatment.

Procedure

Conducted during the second‐year wave of state border lockdowns for Covid‐19 in 2021, all recruitment, demographics, consent and data collection for the study was digitally sent and collected prior to interviews. Recruitment followed a purposive strategy, whereby vicarious exposure to patients acutely affected by cancer, was both relevant and held personal significance. Snowballing sourced participants using professional oncologist social/support networks. Interested potential participants received study information, consent and demographic questionnaires. According to Interpretative Phenomenological Analysis (IPA) protocols, those participants who met the criteria, received the semi‐structured interview schedule, 24 h prior to an arranged interview to allow equal time for subjective reflection. ²⁵ Data collection used a ‘funnelling’ technique to elicit general to specific responses. Prompts were used to guide flexibility and specificity around the phenomenon under investigation. ²⁵

The second author conducted and digitally recorded each interview via Zoom (online video conferencing tool) then transcribed each verbatim manually. The interviews varied in length from 50 to 75 min allowing for subjective reflexivity, exploratory prompting, clarification and empathic support. The interviewer and the participants engaged in reiterative reflexivity to explore rich and detailed accounts of both positive and negative interpretations of vicarious exposure to cancer narratives and care. All recorded interviews were de‐identified and allotted a pseudonym. Recordings were deleted from the device following analysis, and data and consents stored in accordance with university ethics requirements.

Epistemology

Interpretative Phenomenological Analysis is underpinned by several philosophical and theoretical constructs including phenomenology, symbolic interactionism and critical realism. ²⁴ IPA is therefore an appropriate methodology to capture the lived experiences of individuals' unique experience of a phenomenon and their subjective and symbolical meaning making. Using an idiographic approach, participants were encouraged to critique unique individual perceptions of events from the first‐person perspective. ²⁶

Analytical strategy

Interpretative Phenomenological Analysis provides a flexible set of guidelines which was suitable to explore the subjective lived experiences of senior radiation oncologists who had: (1) maintained work/life balance and strategies for mental well‐being over years of rigorous work demands associated with cancer management and (2) worked in organisations that are hierarchical and constrained by bureaucracy. Independent analyses were conducted by the first and second authors. In coming together, both authors engaged in robust discussion highlighting biases and preconceptions before arriving at agreed thematic findings. Audit trails from both authors provided analytic credibility ensuring that interpretations were grounded in the text. ²⁷ Table 1 provides the stages of this analytical process.

Table 1.

Stages of IPA analytical process.

Stage	Process
1	Repetitive listening and verbatim transcription of each recorded interview
2	Initial impressions and preliminary ideas/thoughts recorded on the right‐hand margin of each transcript
3	Interpretation of transcript by paraphrasing and summarising participant's phenomenological hermeneutic experiences, followed by annotation of emerging themes
4	Review of each transcript, allowed thematic analysis to identify emerging themes, highlight exerts form the transcripts that represented these themes
5	Stages 1, 2, 3, and 4 were repeated for all transcripts, followed by a search for convergence, divergence, and clustering of themes
6	A comparison of themes across all transcripts was conducted, whereby themes were arranged to reflect connectedness
7	Steps 2 to 6 were performed independently by each researcher so that both authors did an independent audit of the data in order to establish first order validity of themes as a requisite of IPA
8	Meticulous discussion commenced between authors to concur and illuminate on emerging themes, argue biases and preconceptions, and decipher the meanings attributed to each participant's experiences. A final set of themes was then developed through collaboration
9	Exploration of the overarching superordinate theme ‘Vicarious risk, hierarchical invalidation, redefining altruistic authenticity’
10	Further examination of the superordinate theme, assessing its connections to agreed subordinate themes
11	Clustering of themes throughout concepts and theories
12	Analysis continues throughout write‐up. Attention to both authors’ bias and presuppositions likely to impinge or enhance interpretation
13	Narrative accounts embedded with each data extracts to validate and link thematic analysis to themes and interpretation

Credibility and trustworthiness

As emphasised by Lincoln and Guba (1986), ²⁷ credibility acts as the most critical criterion when establishing trustworthiness within a qualitative study and is confirmed through findings and their apparent links to the data. Validity and reliability within research governed by IPA is assured due to the adherence of stringent analytical steps underpinned by the philosophical constructs of such method (see Table 1). ²⁵ Rich subjective data drives this phenomenological method, ²⁸ seeking interpretative thematic data from both convergent (across all transcripts) and divergent (within one transcript) themes. ²⁵

Authors' perspective

The first author is an experienced IPA researcher and a clinical psychologist whose research and clinical work is at the interface of complex trauma and posttraumatic growth. The second author is a clinical post graduate student who has a particular interest in trauma‐related phenomena and has been trained in IPA. The third author is a senior radiation oncologist with an interest in supporting junior professionals in self‐care and exploring strategies to aid career longevity.

Results

One superordinate theme emerges: Vicarious risk, hierarchical invalidation, redefining altruistic authenticity, which overarches four subordinate themes, Vicarious contamination of caring, Hierarchical squeeze, The heavy burden of me, Growth of authenticity (see Table 2). Throughout these narratives, the participants present a multitude of layers that both threaten and preserve the integral driving passion of their professional selves. Despite the risk of Vicarious contamination of caring, they hold firm perspectives of themselves as compassionate and empathic senior professionals able to provide ‘that human contact between doctor and patient at that very vulnerable time’. However, it is the Hierarchical squeeze that is perceived the greater threat to fragmentation of the core altruist. Tension and conflict, organisational overload and endlessly corporate driven and middle management demands, precariously hover over their well‐being and a finite wall of exhaustion and disengagement from the other parts of their lives. A gradual creep of non‐clinical workload and keeping up with their professional development brings a collision of others and self‐expectations and is the greater Risk to altruistic and responsible integrity. Although vicariously exposed to others' trauma responses, a philosophical empowerment emerges overtime through efforts to positively redefine the private person, the career drive and the pressures of a demanding and hierarchical organisation. By embracing ongoing change and growth at an individual‐level longevity of career, a reconnection with their altruistic identity, and authenticity as a professional redefines commitment to best life or death, not the institution.

Table 2.

Overarching subordinate theme: vicarious risk, hierarchical invalidation, redefining altruistic authenticity.

Subordinate themes

Vicarious contamination of caring

The hierarchical squeeze

The heavy burden of me

Growth of authenticity

Vicarious contamination of caring

Interpersonal relations formed between the participants and their cancer patients are expressed as complex and intense, oscillating between sadness and hope. Empathy and integrity connect the carer and patient despite the core uncertainty of cancer. In fact, it is the relational connectedness of their role as radiation oncologists that brings warmth to the ‘darkness’ associated with cancer diagnosis/prognosis:

We can't always make someone's cancer go away, we can usually make them feel a bit better in some way … sometimes it's just listening to them and going, ‘yeah this is really shitty. I can't actually do anything here, you are going to die’. (Heather)

Drawing on the insight of longevity of practice, Lydia makes an explicit connection with the psychological fear of cancer in their patients and her own ability to be present and comfortable with vulnerability:

We interact with patients at a very vulnerable time … even in a situation where there may not be a lot of therapeutic options – is just to give them a bit of comfort. (Lydia)

However, there is evidence that robustness is challenged by repetitious cancer care and can precipitate a chronic state of sadness and burnout:

It is very draining … there have been times where you feel you've given so much of yourself away, that the tank is pretty empty (Loralie)

As senior oncologists, they are prepared for those moments of collision with patients around expectations. Recognising that they have ‘faced these situations, you know, hundreds of thousands of times but for that individual patient, that's the first time they face that situation’ is an important prelude to delivering news to their patients:

I found it quite motivating to sort of actually be that person that has the opportunity to help someone in the worst day that they're ever going to have … you can really make a big difference. (Peter)

However, they are never far from being vicariously triggered. Peter recognises that certain patients ‘eat away at you… your mind just flicks over to … did I do this? Should I have done this?’ Age in particular is an insidious and distractive prompt to self‐questioning:

If you have an eight‐year‐old with some terrible tumour and they're clearly going die … if you have someone that's twenty‐five in a terrible place … you might say, we need to try because you're 25, you've got a six‐month‐old or whatever it is … Those ones are the really hard ones. (Peter)

The fatigue of compassion is painful. At its worst, images and transference aggressively force them to confront their own existential reality and personal meaning‐making:

We don't know if he's going to die abruptly … and he had three small children … and his only hope was to, (oh I'm going to cry) was to come home and at least have one normal day with his boys. I still find it difficult to cope when the kids are involved. (Marta)

The hierarchical squeeze

Frustratingly, ‘the encroachment’ of non‐medical tasks drain their emotion and time and contribute to a sense of not being valued as radiation oncologists compared to other more lucrative areas of medicine:

Constant advocating can weigh you down … I know that the treatment I have is really good, … then you have a medical oncology wanting to give very expensive drugs that are very full of side effects (Loralie)

There is a sense with these participants that poor institutional support is responsible for their growing sense of underachieving, self‐deprecation and burnout:

‘Expecting more of you … you start to feel resentful (Lydia)

They speak of ‘lip service’ from institutions that ignores their growing exhaustion and stress and threatens derailment:

The system … we're working too hard … overwork, exhaustion, not being listened to. Not feeling appreciated for what you do that all leads to burnout. (Loralie)

There is a strong sense of ‘self’ being eroded by organisational underappreciation in these participants who speak of cyclical self‐questioning in their clinical ability and doubt in longevity of career:

I can't keep going on this tight rope balancing act for much longer, … it's not the patients, it's the network around work that isn't supporting me, it's just killing me. That's why I will go, I'll just be exhausted. (Loralie)

Covid‐19 brings an avalanche of technical communication, internet caring and a ‘tsunami’ of change, fatigue and fear:

Organizationally … a real sense of fatigue … the constant never knowing what's around the next corner with regard to COVID. (Loralie)

Conversely, COVID isolation allows time to think, for careers to flourish in different ways. Interpersonal relations are celebrated, as communicating with colleagues, and providing caring support becomes more valued:

It's sort of given us a lot of time to sort of be us, be by ourselves in isolation, forcing us to think … like friendships and the relationships … or … debrief with your colleague … make some extra effort to make some meaningful connections with people. … I don't have to be running around like a headless chicken. (Lydia)

The heavy burden of me

Compounding their exhaustion and sense of powerlessness is a described perfectionist trait necessary to survive a medical career:

Inherent in my personality is strive to work really hard and be the best I can … so, it's not necessarily the career that's done it, it's my personality that's done it to myself. (Loralie)

Underachieving brings a lack of self‐fulfilment:

I always feel like I'm underachieving because I'm always underachieving against my own goals. (Lydia)

This duality of personal and organisational pressure is a burden for personalising failure and undermining their professional competence:

I'm exhausted at the present time, and really questioning how much longer I've got to give. … I've just been beating myself up about, have I done enough, am I doing the right thing, more senior roles have taken on? Am I doing a good enough job … I'm thinking I'm going to have to step away. (Loralie)

Others expectation of the ‘fix‐it’ medical model collides with what they can reasonably provide. Overshadowing this complex mix of self and other expectations, is the patient:

The expectation of the public is that actually, the doctor is capable of fixing any disease. And that's a problem because then the patient expectation is very different of what you can provide, and managing the expectations is actually also a very important part of our role but … very difficult for both the doctor and for the patient. Some people just are in such denial, it's impossible to get through it. (Marta)

Growth of authenticity

The interviews are alive with change as participants sense a need to limit the external factors. This means prioritising tasks and maintaining empathic self‐respect. They offered a re‐evaluation of their altruistic identity that redefines authenticity and a need to ‘work smarter not harder’:

Before the burnout experience, I felt that I could achieve anything I want … the model has changed … I cannot break every single wall, I just need to be careful, in what I'm committing to not to kill myself to achieve the goal. (Marta)

As such, there is a conscious valuing of the relational connection with their clients despite the trauma associated with cancer:

What they do appreciate is that way of dealing with them as a person … to actually deal with the person rather than the tumour. (Peter)

Similarly, focusing on endeavours that have personal significance rather than endeavours expected by institutions, are lightbulb moments. Lydia identifies a life trying to climb a corporate ladder in a ‘rat race that doesn't have purpose’. She questions her future and the desire to ‘not live the institution or somebody else's prescribed life’:

I would like for my future to concentrate on the things that matter to me as a doctor rather than fulfilling this sort of not status quo, but the expectations of institutions. (Lydia)

Throughout the interviews there were live moments that highlight wisdom for gifting their trainees coming behind:

I always tell the trainees to get to know the ones that walk around with a smile on their face. Rather than … an amazing CV, because often the people who have achieved a lot aren't necessarily the happiest people. … it's really important for registrars to have a good role model who have a balanced life (Lydia).

Peter reflects, ‘it's a no brainer’ mentoring trainees but that:

Some sort of leadership qualities and training should be part of our curriculum. (Peter)

Similarly, Marta's own experience of burnout brings a conscious responsibility for others:

I'm trying to help them avoid the burnout that I had … that they are not made of iron and steel (Marta)

That wisdom stretches to the intrapersonal relations with patients are recognised as a universal process:

What I've learned … life is finite, and everyone dies at some point. And there is such thing as good death. And if I feel like I've assisted in that. Then, it gives me some satisfaction. (Lydia)

An existential shift occurs when reflecting on end‐of‐life treatment – ‘as a junior doctor it's very hard to say no for treatment to the patient, it's still hard … especially when it's near the end of their life, it's much easier for me’. As senior practitioners, end‐of‐life dilemmas are more often a humble acceptance of their role in a patient's life:

I actually learned to say ‘no’ to treatment much more … because I believe that the quality time with their family's more important than to spend a few days in our department. (Marta)

Achieving longevity in this work parallels their philosophical shift with death where courage, acceptance and an advocacy for peace and comfort should be their last act prior to death:

I think I'm much more accepting of death as being a natural outcome, which is crazy like we all should know that everyone will die eventually … I'm much more accepting that sometimes you need to give some sedation and just make the person comfortable. (Marta)

Discussion

One superordinate theme, Vicarious risk, hierarchical invalidation, redefining altruistic authenticity overarched layers of professional and personal career fatigue over a career lifetime in radiation oncology. Vicarious exposure to others' cancer narratives, poor self‐care in the early phase of their careers and systemic pressures, including the uncertainty of Covid‐19, impacted psychological well‐being. Increasingly, there was a disjoint between organisational expectations and self‐worth as professionals agitating risk of burnout, self‐questioning and resentment towards hierarchical medical systems. Longevity of career was only maintained through authentic reconnection with an earlier sense of purpose that repositioned the importance of their role in providing a good death for their patients during a ‘very vulnerable time’ juxtaposed with mentoring a balanced life for their trainees, and a focus on better self‐care and importantly, a career end‐by‐date.

‘Vicarious contamination of caring’, captured a complex and intense personal struggle over years of journeying with cancer where chronic states of sadness and impending burnout hovered. Insidious and distractive ruminations meant leaving the profession for a period of time for one participant. Over time, each welcomed changes in attitudes, new strategies for minimising trauma exposure, and a greater appreciation for life similar to findings by Hesse. ¹³ As they matured both personally and professionally and engaged in reflecting on the value of their broader life goals, they joined with their patients more as collaborators on a journey.

‘The hierarchical squeeze’ reflects organisational pressures to ‘fix’ or cure patients despite the challenges associated with supporting vulnerable patients. They spoke of poor organisational support, time constraints, financial discrepancies, exploitative work‐loads, self‐doubt and underachieving exhaustion. A rumbling and cyclical self‐questioning of clinical ability threatened whether they could continue in the profession. Feelings of failure and vulnerability bred frustration at organisational preference for outcomes and ‘lip service’. Burnout symptoms of overwhelm, sense of incompetency, emotional exhaustion, depersonalisation and a reduced sense of personal accomplishment ²¹ , ²⁹ were present in these participants noted in the literature as common risks for radiation oncologists engaged in the complexity of caring. ³ , ⁴ , ⁵ Systems change initiated by the Covid‐19 pandemic raised genuine fear and anxiety to another level as participants became fatigued with the constant unknowing and increased workload. ³⁰

‘The heavy burden of me’, identifies juxtaposed outcomes from specific traits and high achieving characteristics. Though essential for longevity in their career such traits risk vulnerability to burnout, exhaustion, self‐doubt and anxiety through striving for perfection. Additionally, by feeling underappreciated, experiencing self‐doubt and anxiety in the workplace, individuals precipitate occupational health problems including psychosocial vulnerability. Similarly, McCormack and Joseph ³¹ defined altruistic identity disruption in those high in altruism following exposure to others' traumatic events. Essentially, without adequate organisational support, altruistic identity disruption is experienced as: (1) feelings of isolation; (2) questioning personal career role and its value; and (3) engaging in self‐blame when the employing organisation is not perceived to validate or effectively support their efforts.

‘The growth of authenticity’ highlights the participants' reconnection with their altruistic identities, therapeutic integrity and commitment to effective mentoring of their trainees, and patient care, whilst assertively implementing personal/professional boundaries as they matured as professionals. Maintaining altruistic drives as part of maintaining psychological well‐being have been described as domains of growth identified in previous research. ¹ , ² , ³² , ³³ , ³⁴ Prioritising level of self‐care and job satisfaction deflected risk of burnout. Best care practice, despite constraints, became a mantra for relational connection with their junior staff and patients. It brought reciprocity from their junior colleagues where ‘my registrars are looking after my wellbeing too!’ For all participants, redefining longevity of career brought new philosophical beliefs including end‐of‐life treatment. They seized opportunities to holistically engage with patient and families, creating a shift in end‐of‐life experiences including death.

Clinical implications

This qualitative study provides an alternate perspective to positivist methods by engaging with the ‘lived’ experience and subjective interpretations of individual participants. Thus, we are unable to generalise our findings to other populations, nor infer cause and effect relationships. ²⁷ Strict adherence to the protocols of IPA underpinned meticulous discussion to concur and illuminate subjects' interpretation by the first and second authors to identify bias and presuppositions.

Study strengths and limitations

Given the predicted shortfall in radiation oncologists in Australia, ³⁴ further research is warranted in intrapersonal/interpersonal relations and extraneous roles across genders in senior radiation oncologists. The awareness of risks associated with life imbalance and burnout in these participants may be reflective of pressures specific to female radiation oncologists who were the majority in this present study. A greater insight by male radiation consultants would be invaluable given that the 2018 Australian census revealed that there are 59% male to 41% female radiation consultants.

Conclusion

For these participants, empathic support and effective cancer treatment, juxtaposed challenges to personal well‐being from vicarious exposure to other's traumatic distress. Perfectionist traits were highlighted as providing both positive and negative impacts on career longevity, personal, professional and psychological health over time. In their senior years, altruistic identities re‐emerged for best care/best death practice despite organisational expectations that risked healthy schemas, beliefs and values. Similarly, poor self‐actualisation and chronic psychopathology was associated with inadequate organisational support particularly during the Covid‐19 lockdowns. However, participants acknowledged positive opportunities to realign current well‐being, personal/professional goals, expectations and career success from Covid‐19 imposed changes. Finally, these participants reflected on the need for early career mentorship programmes in radiation oncology to prioritise psychological well‐being, career longevity and mitigate against burnout.

Conflict of Interest

The authors declare no conflict of interest.

Data Availability Statement

Data was collected confidentially and only available to the current research team.