Table 2.

Distress of US Fellows by Year of Training

Distress	First Year (n = 385)		Second Year (n = 486)		Third Year (n = 442)		P
	No.	%	No.	%	No.	%
Burnout indices*
High emotional exhaustion†	144	42.7	130	29.4	101	25.4	< .001
High depersonalization‡	62	18.5	71	16.1	54	13.6	.2061
Burnout§	146	43.3	140	31.7	112	28.1	< .001
QOL
Overall QOL‖							< .001
Mean	6.5		6.9		7.1
SD	2.0		1.9		1.7
Score < 6	101	30.2	103	23.4	61	15.3	< .001
Level of fatigue‖							< .001
Mean	5.1		5.5		5.9
SD	2.1		2.2		2.2
Score < 6	194	58.1	218	49.4	161	40.6	< .001
Satisfied with WLB	115	34.6	186	42.2	175	44.1	.0256
Career satisfaction
Would become physician again (career choice)	263	80.2	379	86.1	339	86.5	.0340
Would become oncologist again (specialty choice)	297	90.5	389	88.8	350	89.1	.7176

Abbreviations: MBI, Maslach Burnout Inventory; QOL, quality of life; ROC, receiver operating curve; SD, standard deviation; WLB, work-life balance.

^*As assessed using single-item measures for emotional exhaustion and depersonalization adapted from full MBI. Area under ROC curve for emotional exhaustion and depersonalization single items relative to that of their respective full MBI domain score in previous studies were 0.94 and 0.93, and positive predictive values of single-item thresholds for high levels of emotional exhaustion and depersonalization were 88.2% and 89.6%, respectively.^11,12

^†Individuals indicating symptoms of emotional exhaustion weekly or more often have median emotional exhaustion scores on full MBI of > 30 and have > 75% probability of having high emotional exhaustion score as defined by MBI (≥ 27).

^‡Individuals indicating symptoms of depersonalization weekly or more often have median depersonalization scores on full MBI of > 13 and have > 85% probability of having high depersonalization score as defined by MBI (≥ 10).

^§High score (≥ weekly) on emotional exhaustion and/or depersonalization scale.

^‖On 0- to 10-point Likert scale; higher scores favorable.