KEY POINTS
- The ESTRO Early Career Committee conducted an international cross-sectional survey between May and August 2025. After data cleaning, 788 professionals from 53 countries contributed descriptive data and 696 answered the intent-to-leave question; radiation therapists represented 45.6% of respondents.
- 360/696 respondents (51.7%) reported having considered leaving their current position during the preceding 12 months. Another 42.4% answered no and 5.9% preferred not to answer.
- Better team culture and collaboration was the strongest independent workplace correlate of lower intent to leave (OR 0.35 per one-point improvement, 95% CI 0.22–0.55; p<0.001), followed by wellbeing (OR 0.37, 95% CI 0.24–0.57; p<0.001) and career development (OR 0.61, 95% CI 0.43–0.86; p=0.004). All remained significant after Bonferroni correction.
- Adding workplace factors substantially improved prediction compared with demographics alone: area under the curve increased from 0.59 to 0.862, with McFadden pseudo-R² increasing from 0.018 to 0.331. Resources, leadership connection, and recognition/value were not independently significant once the other factors were included.
- Radiation therapists had almost twice the adjusted odds of considering departure compared with radiation oncologists (OR 1.78, 95% CI 0.98–3.22), although this narrowly missed statistical significance (p=0.057).
- Respondents most often reported shortages of radiation therapists: 63% believed a shortage existed and 55% said it was already negatively affecting their department. The leading self-reported reasons to leave were poor work-life balance (73%), workload (72%) and limited promotion opportunities (69%).
- Country estimates varied enormously — from 16.7% to 92.3% among countries with at least six responses — but should not be read as national prevalence estimates. Sampling was voluntary and heavily imbalanced geographically, with 29% of all respondents from the UK, and the authors acknowledge that dissatisfied professionals may have been more likely to participate.
CLINICAL TAKEAWAY
The strongest retention signals were organizational rather than individual: team culture, wellbeing and credible career progression mattered far more than demographic characteristics. Departments can act on those factors, but the headline 51.7% figure should not be interpreted as proof that half of the entire radiation oncology workforce is about to leave.