The ASCO Education podcast continues the conversation on burnout, this time with a focus on how it affects trainees. This week's episode features Drs. Anna Laucis (University of Michigan) and Daniel Richardson (University of North Carolina). If you enjoy this episode, please subscribe or leave a comment. Subscribe: Apple Podcasts, Google Podcasts | Additional resources: elearning.asco.org | Contact Us Air Date: 7/14/2021   TRANSCRIPT [MUSIC PLAYING] ANNOUNCER: The purpose of this podcast is to educate and inform. This is not a substitute for medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] ANNA LAUCIS: Hello. And welcome to ASCO Education's podcast episode focused on the important and far-reaching effects of burnout among oncology trainees. My name is Dr. Anna Laucis, and I'm a radiation oncology resident physician at the University of Michigan. DANIEL RICHARDSON: And I'm Dr. Daniel Richardson. I'm an assistant professor and leukemia doc at the University of North Carolina. I recently completed my hematology-oncology fellowship here at UNC as well. ANNA LAUCIS: So, Dr. Richardson, what has been your personal experience with burnout in your medical training and your current professional role? DANIEL RICHARDSON: Well, that's a great question and something that I'm excited to talk about today. So burnout can really be expressed and experienced in numerous ways. Traditionally, we've segmented-- excuse me-- this into categories of emotional exhaustion, cynicism, and feelings of inefficacy. And one of the first things to mention is really the structure or the practice of medicine itself. I really see in most places that medicine continues to be very hierarchical and rigid. And this hierarchy and rigidity can lead to depersonalization. I feel like we have a tremendous opportunity to connect with patients so many times in their darkest days, but we're taught that we can't show vulnerability and we need to act in a certain way. We are conditioned really to place boundaries around ourselves to depersonalize as a way to get through rounds, as a way to improve efficiency. I know you've probably experienced this, but on the inpatient wards on morning rounds, we go from room to room. We listen to patient stories about the devastation that cancer has caused on them, but we don't talk about it, and we don't allow empathy really to come with us into rounds, and we exclude emotions altogether. I think about, as a leukemia doc, the challenges when some of my patients die, and we don't talk about that. We don't talk about those challenges. We don't talk about our own emotions as we go through that process. And I often comment to others that I walk through the Valley of the Shadow of Death with most of my patients, and this human connection that we can have in the midst of that is so important. It's truly a sacred space where we can invite our patients into. And this process of walking with patients through that can bring about great meaning and satisfaction. ANNA LAUCIS: Yeah. I fully agree. I think there are many ways in which we connect with patients. And I think that's really important, as oncologists, whether radiation oncologists or medical oncologists or surgical oncologists, is the ways in which we connect and empathize with our patients. It's not only, I think, the greatest gift and support we can give to patients, but also I think, unfortunately, can also really lead to burnout, especially it's difficult to set boundaries sometimes. We really invest in our patients, and we almost take personal responsibility for their outcomes as well, even though, as I've gotten further in my training, I've realized that, unfortunately, there's just really bad biology sometimes, just really bad