JCO Oncology Practice, 2026 (SCI-Expanded, Scopus)
PURPOSE – This study aimed to examine the prevalence and predictors of imposter syndrome (IS), burnout, and maladaptive perfectionism (MP) among oncology professionals to better understand their inter-relations and impact on clinician well-being.METHODS – A global cross-sectional survey was conducted with oncology professionals across 55 countries. Participants completed validated scales: Clance Impostor Phenomenon Scale (CIPS), Maslach Burnout Inventory, and Short Almost Perfect Scale (SAPS). Sociodemographic and occupational data were analyzed. Multivariate regression using a causal framework explored the controlled direct effects (CDEs) and natural direct effects on burnout.RESULTS – Among 542 participants, 34.1% had high CIPS scores, 56.1% met criteria for burnout, and 38% were identified as maladaptive perfectionists. Younger age (P = .006), female sex (P = .001), and not having children (P = .007) were associated with high CIPS scores. Burnout was most prevalent among participants younger than 40 years, particularly those younger than 30 years (64.6%) and age 30-39 years (58.3%; P = .010). Longer working hours were significant predictors of higher burnout rates (P < .001). In the CDE analyses, higher CIPS and greater SAPS-Discrepancy increased burnout risk (P < .001); higher SAPS-Standards (P < .001), higher academic title (P ≤ .044), private hospital setting (P = .010), and higher income (P < .001) reduced burnout risk. Parenthood (P = .013) and formal/semiformal mental health training (P < .001) were protective. The CDE for age was nonsignificant (P = .495): any apparent protective effect of age operates primarily through indirect (mediated) pathways.CONCLUSION – Burnout is prevalent among oncology professionals, with contributions from both structural factors and psychological pathways. In our European-centric cohort, higher impostor phenomenon (CIPS) and greater perfectionistic discrepancy (SAPS) increased burnout risk, especially in early-career clinicians. Therefore, targeted, evidence-based interventions that pair structural measures are warranted to reduce excessive workload with brief skill programs that address imposter cognitions and discrepancy while preserving high standards.