Radiation Oncology: More Women Now, but Numbers Still Low

Over the past two decades, more of the senior positions with radiation oncology (such as associate or full professors) have been filled by women, but there are still very few minorities in these positions.

Nevertheless, compared to other specialties, “radiation oncology has some of the lowest numbers” for female minority senior faculty, say the authors of a new analysis.

The findings come from a review of Association of American Medical Colleges physician sex, race, ethnicity, and faculty rank data from 2000–2019, reported in a research letter published January 11 in JAMA Network Open.

The investigators were led by James Janopaul-Naylor, MD, a radiation oncology resident Emory University’s Winship Cancer Institute, Atlanta.

The team looked into the issue because the number of female and minority medical students who pursue radiation oncology is disproportionately low compared with other oncology specialties. Given the role senior faculty play in training and encouraging future physicians, they were curious about senior faculty demographics.

Overall, there were 853 senior radiation oncology faculty in 2019, 24.03% of them women.

Almost 60% were White, about a third were Asian, 1.52% were Black, and 1.3% were of Hispanic, Latino, or Spanish origin. About 5% were Native Hawaiian, other Pacific Islander, American Indian, Alaskan Native, unknown, multiracial, multiethnic, or of other background.

Across 18 major medical specialties, radiation oncology had the fourth lowest and lowest proportion of Black men (0.82%) and Hispanic men (0.94%) in senior faculty positions.

Radiation oncology also had some of the lowest proportions of Hispanic women (0.35%), White women (13.25%), and Black women (0.70%).

When the team looked back to see patterns over the past two decades, they saw senior faculty in radiation oncology was composed mostly (68.03%) of White males in 2000, and this decreased to 47.36% in 2019. During the same time, the proportion of White females increased from 10.30% to 13.55%.

The yearly increase in female senior faculty (0.69%) in radiation oncology outstripped that seen in both general surgery (0.48%) and radiology (0.44%).

The proportion of Asian male senior faculty in radiation oncology also increased substantially, from 13.95% to 24.82%, along with the proportion of Asian female senior faculty, from 2.15% to 8.63%.

However, unlike the changes that were seen in general surgery, internal medicine, and radiology, the findings for radiation oncology show that “proportions of senior faculty who were members of underrepresented minority groups did not significantly change from 2000 to 2019,” the authors reported.

Janopaul-Naylor and colleagues research letter concluded that “addressing physician workforce diversity calls for re-evaluation of the entire pipeline from early education to faculty promotion…. Programs that facilitate mentoring, networking, and leadership opportunities may be associated with improved representation in radiation oncology, as may substantive policies that address systemic exclusion of women, members of underrepresented minority groups.”

The main study limit was the lack of information on who, when, or why individuals were hired, promoted, or left academia.

The work was funded by the Winship Cancer Institute of Emory University and the National Cancer Institute. Janopaul-Naylor reported grants from Genentech and Pfizer and consulting fees from OncoHealth; another author reported grants from Novocure and Denovo Biopharma; and another author reported holding stock in Imagilin Technology.

JAMA Netw Open. Published online January 11, 2022. Full text

M. Alexander Otto is a physician assistant with a master’s degree in medical science, and an award-winning medical journalist who has worked for several major news outlets before joining Medscape. He is an MIT Knight Science Journalism fellow. Email: [email protected].

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