Imposter Syndrome, Burnout, and Maladaptive Perfectionism Among Oncology Professionals: A Global Cross-Sectional Study

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.