From idealism to disillusionment: professional fulfillment, burnout, and retention across the multidisciplinary radiation oncology workforce.

Professional fulfillment for radiation oncology team members is at risk for gradual erosion across training and career continuum with increasing administrative burden, clinical complexity, and evolving workforce dynamics impacting workplace culture. Warning signs for burnout and declining career satisfaction have been observed from schooling through independent practice, highlighting key inflection points where professional identity and engagement are most vulnerable. In this commentary, we describe how early idealism can transition into realism and sometimes disengagement across the radiation oncology career pipeline and propose a framework identifying opportunities for intervention across training, drawing on recent ESTRO quantitative and qualitative workforce retention analyses.