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Background: Palliative care (PC) has been shown to benefit patients with metastatic cancer by managing symptoms, improving quality of life, and facilitating advance care planning. Despite this, PC is often misunderstood and underutilized. Objective: To deepen our understanding of PC barriers seen among the spine metastasis population. Design/Setting: Between March 2021 and August 2022, people with metastatic spine tumors (MSTs) at a multidisciplinary oncology clinic were administered a survey on PC prior to their scheduled appointment. These responses were compared with the Health Information National Trends Survey 5 (HINTS 5), which is a validated survey created by the National Cancer Institute between February and June of 2020. Chi-squared statistical analysis was used. Results: Fifty-six people with MST were compared with 3795 patients from the HINTS 5 database. People with MST reported a significantly higher baseline understanding of PC when compared with the general population (GP) (chi-squared = 34.4, p = <0.0001). People with MST had a higher frequency of disagreement with the statement "PC is equivalent with death" when compared with the GP (chi-squared = 12.8, p = 0.0124). Over 25% of the MST group reported no understanding of PC. Conclusion: MST patients are often referred to PC services due to the extreme symptom burden of their disease. Based on this study, in comparison to the GP, people with MST tended to have a more accurate and well-adjusted perception of the goals and functions of PC. Although reassuring, there remains a high proportion of patients who have no knowledge of PC, and groups erroneously associated PC with hospice status.

Background: Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbeing during residency., Objective: We examined the prevalence and associations between burnout, depression, and grief among a national sample of psychiatry resident physicians., Methods: A survey including validated scales for burnout (Modified Maslach Burnout Inventory-Health Services Survey [MBI]), depression (Patient Health Questionnaire-9 [PHQ-9]), and grief (Traumatic Grief Inventory Self Report [TGSIR]) was distributed to 296 psychiatry program directors in January 2023 for dispersal to their respective residents., Results: Fifty-seven participants completed the survey out of 245 participants who opened and started the survey (23.3%). All participants were current psychiatry residents. MBI scores averaged 21.2 (SD 6.5, range 11-40); 11 participants reported high levels of burnout (scores >27; 19.3%). PHQ-9 scores averaged 3.42 (SD 3.0, range 0-14), with 8 responses meeting the criteria for moderate depressive symptoms (scores >10-14; 14.0%). Suicidal ideation was reported by 5 of 57 participants (8.7%). TGISR scores averaged 12.2 (SD 11, range 0-43); no participants met the criteria for pathologic grief. TGISR scores were correlated with MBI (r = .30; P = .02) and PHQ-9 scores (r = .53; P < .0001). MBI scores were also correlated with PHQ-9 scores (r = .54; P < .0001)., Conclusions: Non-pathological grief was correlated with burnout and depression. 14% to 20% of psychiatry residents reported clinically significant levels of burnout and depression. Future studies should aim to further characterize burnout, depression, and grief in larger samples of trainees., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.