Career fulfillment and intent to leave among oncology physicians: A global survey.

9009 Background: Burnout among U.S. oncologists has risen from 34% (2013) to 59% (2023), with global estimates of 32–45%. However, burnout is often studied in isolation rather than alongside fulfillment, distress, and intent to leave, limiting understanding of workforce attrition. With ~20% of US oncologists leaving clinical roles over the past decade, factors driving workforce attrition require a precise evaluation across international settings. Methods: An anonymous, cross-sectional global survey distributed via professional email (Oct–Dec 2025) assessed burnout using validated Maslach Burnout Inventory (MBI) items and evaluated associations with professional fulfillment, career regret, and intent to leave clinical practice among oncology physicians. Descriptive statistics were performed, with χ²/Fisher’s exact tests for categorical comparisons and multivariable logistic regression to identify independent factors associated with fulfillment and intent to leave. Results: A total of 306 participants were included (156 non-U.S. and 150 U.S.). Clinical workload was substantial: 33.0% reported ≥5 clinic half-days per week, and 57.7% reported ≥5 inpatient service weeks annually. Administrative burden was also common, with 45.6% independently performing peer-to-peer appeals and 53.8% reporting feeling overwhelmed by this responsibility. Career satisfaction was reported by 70.6%, while job-related stress was highly prevalent (71.9%). Work frequently extended beyond scheduled hours, with 48.0% reporting moderate-to-excessive after-hours electronic medical record use. More than one-quarter of respondents (27.4%) expressed regret about pursuing a career in oncology, most attributed to poor work–life balance (69.3%) and burnout (65.3%). Despite these challenges, 50.5% reported frequent professional fulfillment and 21.7% reported very high fulfillment, particularly among U.S.-based vs. non-U.S. physicians (62.7% vs 25.0%, P < 0.001). Overall, 45% reported ever considering leaving practice; frequent intent to leave was higher among U.S.-based physicians (15.3% vs 7.1%, P = 0.034) Table 1. Conclusions: Oncologists experience a fulfillment–distress paradox, reporting meaningful professional fulfillment despite high stress, administrative burden, career regret, and intent to leave practice. This “professional dissonance” suggests that meaning and identity in oncology may persist despite insufficient institutional support but may remain fragile over time. Systems-level approaches addressing workload, professional culture, and identity formation are needed to improve physician well-being and workforce retention. Key outcomes by region. Outcome (often/always) Non-US(n=156) US(n=150) p-value Fulfillment high 39 (25.0%) 94 (62.7%) <0.001 Consider leaving high 11 (7.1%) 23 (15.3%) 0.034