Composition of the Current Academic Radiation Oncology Workforce in Comprehensive Cancer Centers

Gender and the Receipt of the Association of Residents in Radiation Oncology Educator of the Year Award

Purpose

We hypothesized that there may be a gender disparity in the receipt of the Association of Residents in Radiation Oncology (ARRO) Educator of the Year Award and sought to elucidate factors that contribute to differences in award receipt.

Methods and Materials

Using a database provided by the American Society for Radiation Oncology, award recipients were identified from 2010 to 2022. Publicly available websites were accessed to obtain data regarding gender, years since residency graduation, percentage of female faculty, size of residency program, and program director designation. A 1-sample Z-test was used to assess whether the proportion of female ARRO award winners, defined as the proportion of female radiation oncology faculty members in the nominating universities that year, was significantly less than the population average. Secondary analyses used univariable binary logistic regression to identify global associations between gender, year since gradation, or program size.

Results

The lowest proportion of female awardees occurred in 2013 (14.3%) and the greatest proportion in 2022 (30.6%). Compared with the proportion of female faculty members in nominating programs for the respective year, there were significantly fewer female awardees in 2010 (18% female awardees vs 32% female faculty members; P = .02) and 2013 (14% female awardees vs 31% female faculty members; P = .01). There was a statistically significant increase in female awardees during the study period (P < .01). On logistic regression analysis, large program size (≥10 residents) (odds ratio [OR], 6.86; 95% CI, 2.71-23.1; P < .001) and medium program size (5-9 residents) (OR, 4.05; 95% CI, 1.60-13.7; P < .001) were associated with a greater proportion of female awardees compared with small program size (1-4 residents). There was no association between awardee gender and years since graduation.

Conclusions

A gender disparity was present in the receipt of ARRO Educator Awards. Residency chiefs, program directors, and chairs should work to ensure that a diverse slate of faculty is considered annually for the ARRO Educator Award.

Oncology Physician Workforce Diversity: Rationale, Trends, Barriers, and Solutions

ABSTRACT

This chapter will discuss (1) the rationale for physician workforce diversity and inclusion in oncology; (2) current and historical physician workforce demographic trends in oncology, including workforce data at various training and career levels, such as graduate medical education and as academic faculty or practicing physicians; (3) reported barriers and challenges to diversity and inclusion in oncology, such as exposure, access, preparation, mentorship, socioeconomic burdens, and interpersonal, structural, systemic bias; and (4) potential interventions and evidence-based solutions to increase diversity, equity, and inclusion and mitigate bias in the oncology physician workforce.

Overcoming Burnout and Promoting Wellness in Radiation Oncology: A Report From the ACR Commission on Radiation Oncology

Burnout, defined by the presence of emotional exhaustion, depersonalization, and decreased sense of personal accomplishment, impacts a significant portion of radiation oncologists. This has been exacerbated by the COVID-19 pandemic, is notably worse for women, and has been identified as an international concern. Key contributors to burnout within radiation oncology include inadequate clinical and administrative support, imbalanced personal and professional lives including time with family and for self-care, decreased job satisfaction secondary to increased electronic medical record and decreased patient time, unsupportive organizational culture, lack of transparency from leadership and inclusion in administrative decisions, emotionally intensive patient interactions, challenges within the radiation oncology workforce, financial security related to productivity-based compensation and increasing medical training-related debt, limited education on wellness, and fear of seeking mental health services due to stigma and potential negative impacts on the trajectory of one's career. Limited data exist to quantify the impacts of these factors on the overall levels of burnout within radiation oncology specifically, and additional efforts are needed to understand and address root causes of burnout within the field. Strategies should focus on improving the systems in which physicians work and providing the necessary skills and resources to thrive in high-stress, high-stakes work environments.

Underrepresented Minority Composition of Invited Panelists at the 2021 ASTRO Annual Meeting

Purpose

The American Society for Radiation Oncology (ASTRO) Annual Meeting is one of the primary venues for radiation oncologists to present new research, network, and share innovations. In this brief report, we describe the racial representation of invited physician speakers at the Annual Meeting relative to the specialty.

Methods and Materials

The program list of all invited educational sessions and panel speakers in the ASTRO annual meetings from 2021 was accessed via the ASTRO website. Race was determined by a combination of facial recognition and Internet investigation. Speakers and panels were divided by race and specialty. Underrepresented in medicine (URiM) was defined as Black race and/or Hispanic ethnicity.

Results

We identified 182 cumulative speaking panels at the 2021 ASTRO annual meeting and 960 individuals who filled these panels. The majority of speakers were of White race (57%), followed by Asian race (34.2%). URiM speakers made up approximately 8.6% of speakers and were mostly congregated in diversity, equity, and inclusion in health care (DEI) panels. A total of 15.6% of panels were White-only, and 14.8% of panels had at least 1 URiM member. URiM race speakers were mostly congregated in DEI panels, comprising 44.9% of DEI speaker positions and 4.1% of non-DEI speaker positions; this difference reached statistical significance (P < .0001).

Conclusions

The proportion of underrepresented minorities receiving panel invitations at ASTRO remains minimal and is virtually nonexistent outside of DEI-related panels. Targeted efforts to increase URiM representation will be needed to make tangible progress on this issue, just as they have yielded progress on increasing gender diversity in panel invitations.

Gender Differences in the Research Productivity of Radiation Oncology Resident Graduates in the United States: 2015 to 2019

Purpose

It is well-documented that gender disparities exist in academic radiation oncology departments. The purpose of this study was to analyze gender differences in research productivity during residency among recent graduates of radiation oncology training programs in the United States (US).

Methods and Materials

We used several publicly available sources to create a database of US radiation oncology residents who graduated between 2015 and 2019. We systematically collected gender information from the National Plan and Provider Enumeration System National Provider Identifier Registry and Medicare claims registry. Postresidency employment information was collected using several publicly available sources. PubMed was queried to identify first-author publications of residents. A secondary analysis of metadata including impact factor, number of citations, modified Hirsch index (h index), and type of publication was performed. A multivariable linear regression was performed to evaluate the effect of gender on research productivity during residency.

Results

There were 910 total graduates identified during this period and who were entered into this database, of whom all had available gender information. Female trainees comprised 29.0% (n = 264) of RO residents and had fewer first-author publications and citations, had lower mean modified h index, and were published in journals with lower impact factors. On multivariable linear regression analysis, female gender was independently associated with decreased total number of publications (P = .005), mean number of citations (P < .001), and modified h index (P = .001) when controlling for residency size and advanced (PhD or master's) degrees.

Conclusions

In the US, female RO trainees had lower research productivity, which was not explained by advanced degrees or residency size. A significant gender gap in trainee research productivity persists, which has known implications in terms of academic achievement, promotions, and career trajectory. Future interventions to improve resident research productivity and mentorship are warranted.