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Walter BL, Pratt RL. Effect of anatomical studies prior to medical school on medical school anatomy study success and residency choice. BMC MEDICAL EDUCATION 2024; 24:815. [PMID: 39075521 PMCID: PMC11287946 DOI: 10.1186/s12909-024-05642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/10/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION There is little research on how medical school matriculants' experiences prior to medical school effects their choice of specialty or performance in medical school. This research attempts to fill that gap in research in regards to surgical and radiological fields. METHODS An anonymous survey was sent to fourth year medical students asking them their background in anatomy studies prior to medical school and their anatomy grades in medical school and interest in surgical and radiological fields. Students were also asked whether they identified with under-represented demographic groups in those specialties. RESULTS Prior anatomy experience did not significantly affect performance in anatomy courses or Step 1 and Step 2 scores. However, students who applied to surgical specialties had higher performance in anatomical courses and higher Step 1 scores compared to those who did not apply to surgical specialties. There was interestingly no difference in under-represented and not under-represented student application to these fields. DISCUSSION For shareholders interested in increasing medical student performance, or interest in specific specialties, more information needs to be gathered.
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Affiliation(s)
- Brianna L Walter
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
| | - Rebecca L Pratt
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
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Corrigan KL, Bankston ME, Holliday EB, Shaitelman SF, Lee A, Goodman CR, Fuller CD, Chino FL, Thomas CR, Jagsi R, Ludmir EB. Disease Site Specialization in the Academic Radiation Oncology Workforce: Evidence of Gender Differences. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00736-3. [PMID: 38897359 DOI: 10.1016/j.ijrobp.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 06/05/2024] [Accepted: 06/09/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE Because some stakeholders within medicine seek to diversify and attain greater workforce equity, it is critical to understand gender-based divisions within specialization. Radiation oncology (RO) has one of the smallest proportions of women representation of all specialties, and to our knowledge, no prior studies have investigated gender differences in all the disease site specializations within RO. Thus, we analyzed the relationship between gender and disease site(s) treated in academic RO (ARO). METHODS AND MATERIALS Faculty gender and disease site(s) treated by faculty from ARO departments were collected via publicly available department websites in January 2020. X2 analyses were conducted to assess differences between the proportions of women faculty treating each disease site. RESULTS Of 1337 ARO faculty, 408 (30.5%) were identified as women. Breast, gynecology, and pediatrics had the largest proportions of women faculty (all >40%; P < .001). A majority (53%; P < .001) of women ARO faculty treated breast. Genitourinary, thoracic, and head and neck had the smallest proportions of women faculty (all <25%; P < .001). Women ARO faculty were twice as likely to treat breast and gynecologic malignancies compared with men faculty (risk ratio [RR] with 95% CI, 2.01 [1.75-2.50]; P < .001 and RR [95% CI], 2.06 [1.72-2.79]; P <.001, respectively). Men ARO faculty were 3 times more likely to treat genitourinary cancer compared with women faculty (RR [95% CI], 0.40 [0.34-0.48]; P < .001). There was no difference in the mean number of disease sites treated between women and men ARO faculty (2.63 vs 2.53; P = .29). CONCLUSIONS Gender differences in disease site specialization were observed in ARO. Future research into the drivers of disease site selection should be explored.
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Affiliation(s)
- Kelsey L Corrigan
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Mikaela E Bankston
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Emma B Holliday
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Simona F Shaitelman
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Anna Lee
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Chelain R Goodman
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas
| | - Fumiko L Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles R Thomas
- Department of Radiation Oncology, Dartmouth-Hitchcock Norris Cotton Center, Lebanon, New Hampshire
| | - Reshma Jagsi
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Ethan B Ludmir
- Department of Radiation Oncology, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas; Department of Biostatistics, The University of Texas UT-MD Anderson Cancer Center, Houston, Texas.
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Beltrán Ponce S, Gokun Y, Douglass F, Dawson L, Miller E, Thomas CR, Pitter K, Conteh L, Diaz DA. Disparities in outcomes and access to therapy options in hepatocellular carcinoma. J Natl Cancer Inst 2024; 116:264-274. [PMID: 37831897 DOI: 10.1093/jnci/djad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/10/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) disproportionately impacts racial and ethnic minorities and patients with lower socioeconomic status. These social determinants of health (SDH) lead to disparities in access to care and outcomes. We aim to understand the relationship between SDH and survival and locoregional treatment options in HCC. METHODS Using the National Cancer Database, we evaluated survival and access locoregional treatments including non-transplant surgery, liver transplant (LT), and liver-directed radiation therapy (LDRT) in patients with HCC diagnosed between 2004 and 2017. Variables including clinical stage, age, sex, race, income, rurality, year of diagnosis, facility type (FT), Charlson-Deyo score (CD), and insurance were evaluated. Cox proportional hazards multivariable regression and dominance analyses were used for analyses. RESULTS In total, 140 340 patients were included. Worse survival was seen with advanced stage, older age, Black race, rurality, public insurance, treatment at a nonacademic center, and lower income. The top predictors for survival included stage, age, and income. Completion of non-transplant surgery was best predicted by stage, FT, and insurance type, whereas LT was predicted by age, year of diagnosis, and CD score. LDRT utilization was most associated with year of diagnosis, FT, and CD score. CONCLUSION For patients with HCC, survival was predicted primarily by stage, age, and income. The primary sociodemographic factors associated with access to surgical treatments, in addition to FT, were insurance and income, highlighting the financial burdens of health care. Work is needed to address disparities in access to care, including improved insurance access, addressing financial inequities and financial toxicities of treatments, and equalizing care opportunities in community centers.
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Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yevgeniya Gokun
- Secondary Data Core, Center for Biostatistics, The Ohio State University Wexner School of Medicine, Columbus, OH, USA
| | | | - Laura Dawson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Eric Miller
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
| | - Charles R Thomas
- Department of Radiation Oncology, Dartmouth Geisel School of Medicine, Hanover, NH, USA
| | - Kenneth Pitter
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
| | - Lanla Conteh
- Division of Hepatology, Department of Gastroenterology, The Ohio State University Wexner School of Medicine, Columbus, OH, USA
| | - Dayssy A Diaz
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
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Deville C, Charles-Obi K, Santos PMG, Mattes MD, Hussaini SMQ. Oncology Physician Workforce Diversity: Rationale, Trends, Barriers, and Solutions. Cancer J 2023; 29:301-309. [PMID: 37963363 DOI: 10.1097/ppo.0000000000000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
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.
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Affiliation(s)
- Curtiland Deville
- From the Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Patricia Mae G Santos
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Syed M Qasim Hussaini
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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Iheagwara UK, Patel S, Diaz DA, Yom SS, Goodman KA, Barry PN. Promoting Women and Historically Excluded Minorities in Medicine as Essential Leaders of Research. Adv Radiat Oncol 2023; 8:101301. [PMID: 37457820 PMCID: PMC10344684 DOI: 10.1016/j.adro.2023.101301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/11/2023] [Indexed: 07/18/2023] Open
Abstract
Women and historically excluded minorities are underrepresented in clinical research. At the ASTRO 2021 annual meeting, the authors reviewed several strategies to improve on this issue. Implementation of such strategies should not only improve their visibility but also provide increased opportunities for their advancement and work in clinical research.
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Affiliation(s)
- Uzoma K. Iheagwara
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
| | - Shilpen Patel
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Radiation Oncology, Good Samaritan Hospital, San Jose, California
| | - Dayssy A. Diaz
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio
| | - Sue S. Yom
- Department of Radiation Oncology, University of California, San Francisco, California
| | - Karyn A. Goodman
- Department of Radiation Oncology, Icahn School of Medicine and Mt. Sinai, New York, New York
| | - Parul N. Barry
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
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Fagerstrom JM, Windsor C, Zaks D. Equity, diversity, and inclusion topics at a medical physics residency journal club. J Appl Clin Med Phys 2023; 24:e14126. [PMID: 37583276 PMCID: PMC10476978 DOI: 10.1002/acm2.14126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/09/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
A journal club program was initiated in a clinically focused, geographically distributed medical physics therapy residency program. This program currently supports two residents at different clinical sites, who regularly present at the new journal club. For one of the sessions, residents were assigned to present on topics related to the broad themes of equity, diversity, and inclusion (EDI) in the context of medical physics, radiation oncology, or medical oncology. As in other journal club sessions, residents were responsible for choosing their respective articles within required criteria and with approval from the program director. The session was executed in late 2022, with both residents leading and facilitating discussion for the residents, the residency program director, and all residency faculty members. This education case report will include the learning objectives for the journal club session, a description of the content covered in the session, discussion regarding the session's alignment with the original learning objectives, and ideas for program directors intending to include evidence-based EDI topics in journal clubs.
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Affiliation(s)
| | | | - Daniel Zaks
- Northwest Medical Physics CenterLynnwoodWashingtonUSA
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Beltrán Ponce S, Franco I, Paradis KC, Mattes MD. Challenges and Solutions for Establishing Robust Diversity, Equity, and Inclusion Efforts in US Academic Radiation Oncology Departments. Adv Radiat Oncol 2023; 8:101182. [PMID: 36941954 PMCID: PMC10024140 DOI: 10.1016/j.adro.2023.101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Corresponding author: Sara Beltrán Ponce, MD
| | - Idalid Franco
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Kelly C. Paradis
- Department of Radiation Oncology, Michigan Medicine, Ann Arbor, Michigan
| | - Malcolm D. Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
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Cetnar AJ, DiCostanzo DJ, Weldon M, Swanson AE, Mathews J, Gupta N. Blinding of Residency Applications in Medical Physics: Promises and Pitfalls. Adv Radiat Oncol 2023; 8:101242. [PMID: 37250285 PMCID: PMC10209683 DOI: 10.1016/j.adro.2023.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/31/2023] [Indexed: 05/31/2023] Open
Abstract
Purpose The feasibility of blinding applications for a medical physics residency program has yet to be demonstrated in the literature. We explore the application of an automated approach with human review and intervention to blind applications during the annual medical physics residency review cycle. Methods and Materials Applications were blinded using an automated process and used for the first phase of residency review in the program. We retrospectively compared self-reported demographic and gender data with blinded and nonblinded cohorts from 2 sequential years of review from a medical physics residency program. Demographic data were analyzed comparing applicants with candidates selected to move to the next phase of the review process. Interrater agreement was also evaluated from the applicant reviewers. Results We show the feasibility of blinding applications for a medical physics residency program. We observed no more than a 3% difference between the gender selection within the first phase of application review but greater differences when examining race and ethnicity between the 2 methods. The greatest difference was shown to be between Asian and White candidates, where there are statistical differences in the scores in the rubric categories of essay and overall impression. Conclusions We suggest that each training program critically evaluate its selection criteria for potential sources of bias within the review process. We recommend further critical investigation of processes to promote equity and inclusion to ensure the methods and outcomes are aligned with the mission of the program. Finally, we recommend that the common application provide an option for blinding applications at the source so this can be an option to facilitate efforts for evaluating unconscious bias in the review process.
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Deville C. Perspectives on Diversity and Inclusion in Radiation Oncology: A Decade Later. Int J Radiat Oncol Biol Phys 2023; 116:203-206. [PMID: 37179078 DOI: 10.1016/j.ijrobp.2023.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Ponce SB, Seldon C, Yanagihara TK, Horowitz D, Yu JB, Kachnic L, Katz LM. Crazy Busy: The Blurring of Personal and Professional Boundaries as a Diversity, Equity, and Inclusion Issue. Int J Radiat Oncol Biol Phys 2023; 116:276-279. [PMID: 37179088 DOI: 10.1016/j.ijrobp.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/20/2022] [Accepted: 01/07/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Sara Beltran Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Crystal Seldon
- Department of Radiation Oncology, University of Miami/Jackson Memorial Hospital Radiation Oncology, Miami, Florida
| | - Ted K Yanagihara
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David Horowitz
- Department of Radiation Oncology, Columbia University Medical Center, New York, New York
| | - James B Yu
- Department of Radiation Oncology, Columbia University Medical Center, New York, New York
| | - Lisa Kachnic
- Department of Radiation Oncology, Columbia University Medical Center, New York, New York
| | - Leah M Katz
- Department of Radiation Oncology, Columbia University Medical Center, New York, New York.
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Abravan A, Correia D, Gasnier A, Shakhverdian S, van der Stok T, Bertholet J, Dubois LJ, Jereczek-Fossa BA, Eng MP, Spalek M, Petit SF, Franco P, Petit-Steeghs V. Qualitative Study on Diversity, Equity, and Inclusion Within Radiation Oncology in Europe. Int J Radiat Oncol Biol Phys 2023; 116:246-256. [PMID: 36792016 DOI: 10.1016/j.ijrobp.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/23/2023] [Accepted: 02/03/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Organizational culture plays a major role in prioritizing diversity, equity, and inclusion (DEI) objectives by aligning individual values of employees with organizational values. However, effective strategies to create an inclusive organizational culture, in which these values are aligned, remain unclear. The European Society for Radiotherapy and Oncology (ESTRO) launched a qualitative study, as a follow-up of the previous project on DEI that highlighted low levels of inclusion and work engagement among radiation oncology (RO) professionals in Europe. The aim of the present study was to gain an understanding of how DEI could be improved within RO departments by creating a more inclusive organizational culture. METHODS AND MATERIALS A qualitative research study was conducted by enrolling RO professionals from 4 selected European countries through an open call on the ESTRO platform. Respondents who completed an online survey and met the inclusion criteria, such as experiencing low DEI levels at work, were invited for an online semistructured interview. Interview transcripts were analyzed thematically with an abductive approach via concepts in relation to "DEI," "work engagement," "organizational culture," and "professional values." RESULTS Twenty-six eligible respondents from Great Britain, Italy, Poland, and Switzerland were interviewed. The thematic analysis identified cases in which limited engagement at work emerged when the personal values of RO professionals conflicted with dominant organizational values, hampering DEI. Three conflicts were found between the following personal versus organizational values: (1) self-development versus efficiency, (2) togetherness versus competition, and (3) people-oriented versus task-oriented cultures. CONCLUSIONS Awareness of how organizational values can conflict with professionals' values should be raised to improve inclusion and engagement in the workplace. Additionally, efforts should be focused on tackling existing power imbalances that hamper effective deliberation on organizational- versus personal-value conflicts.
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Affiliation(s)
- Azadeh Abravan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom; Department of Radiotherapy Related Research, Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Dora Correia
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland; Department of Radiation Oncology, Cantonal Hospital Aarau, Aarau, Switzerland.
| | - Anne Gasnier
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stella Shakhverdian
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tirza van der Stok
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jenny Bertholet
- European Society for Radiotherapy and Oncology (ESTRO) Young Committee, Brussels, Belgium; Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - Ludwig J Dubois
- European Society for Radiotherapy and Oncology (ESTRO) Young Committee, Brussels, Belgium; The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Barbara Alicja Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy; European Society for Radiotherapy and Oncology (ESTRO) National Societies Committee, Brussels, Belgium
| | - Matteo Pepa Eng
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Mateusz Spalek
- European Society for Radiotherapy and Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Steven F Petit
- European Society for Radiotherapy and Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Pierfrancesco Franco
- European Society for Radiotherapy and Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Violet Petit-Steeghs
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Lenards N. Diversity of medical dosimetry applicants and graduates. Med Dosim 2023; 48:225-230. [PMID: 37225598 DOI: 10.1016/j.meddos.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/30/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023]
Abstract
Diversity is a critical component in the advancement of human endeavor in science. Students who complete their education and training at diverse schools can serve patients from a wide range of ethnic backgrounds and promote cross-cultural competence. However, developing a diverse environment of professionals is a long-term effort which often takes generations to complete. Increasing awareness of underrepresented genders and/or minorities helps to establish goals for building a future of improved diversity. Specific to radiation oncology, professions such as medical physicists and radiation oncology physicians have reported underrepresented females and minorities. The problem is that there is a paucity of literature regarding diversity of medical dosimetry professionals. The professional organization does not track diversity data for those members currently working in the profession. Therefore, the purpose of this research was to present aggregate data demonstrating the diversity of medical dosimetry applicants and graduates. The methodology involved quantitative data collection from medical dosimetry program directors which answered the research question, what is the diversity of medical dosimetry applicants and graduates? In comparison to the U.S. population, there were less applicant and accepted students of Hispanic/Latino and African American ethnicities whereas the Asian population was higher. While the U.S. population data reveals 3% more females, there were 35% more female than male applicant and accepted students in this study. However, the results differ significantly from medical physics and radiation oncology physicians with only 30% female clinicians.
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Affiliation(s)
- Nishele Lenards
- Medical Dosimetry Program, The University of Wisconsin, La Crosse, WI, USA
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Beltràn Ponce S, Small CJ, Amini A, Johnstone C, Parikh JR, Rosenthal SA, Salerno KE, Schechter NR, Small W. Overcoming Burnout and Promoting Wellness in Radiation Oncology: A Report From the ACR Commission on Radiation Oncology. J Am Coll Radiol 2023; 20:487-493. [PMID: 36925094 PMCID: PMC10149602 DOI: 10.1016/j.jacr.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
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.
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Affiliation(s)
- Sara Beltràn Ponce
- Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, Wisconsin and Chair, Society for Women in Radiation Oncology
| | - Christina J Small
- Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, Wisconsin, and Events and Outreach Chair, Society for Women in Radiation Oncology
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Candice Johnstone
- Medical Director Radiation Oncology Froedtert West Bend Hospital, The Medical College of Wisconsin, Milwaukee, Wisconsin, Trustee of the American Registry of Radiologic Technologists, and President-elect, American Association of Women Radiologists
| | - Jay R Parikh
- Professor of Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Seth A Rosenthal
- Department of Radiation Oncology, Sutter Medical Group, Sacramento, California
| | - Kilian E Salerno
- Associate Research Physician, Clinical Director, Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Naomi R Schechter
- Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, Chair, American College of Radiology Practice Parameters Committee Radiation Oncology, and Chair, American Society of Radiation Oncology Patient Safety Scientific Committee
| | - William Small
- Professor and Chairman, Department of Radiation Oncology, Stritch School of Medicine, and Director, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, Illinois, Chair, American College of Radiology Radiation Oncology Commission, and Executive Committee, American Joint Commission on Cancer.
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Mattes MD, Gayed G, Thomas CR, Deville C. Impact of a Virtual Introduction to Radiation Oncology Presentation on Stimulating Interest in the Specialty Among Diverse Medical Students at Multiple Institutions. J Am Coll Radiol 2023; 20:243-250. [PMID: 36513260 DOI: 10.1016/j.jacr.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Many US medical students lack access to radiation oncology (RO). The authors' hypothesis was that a virtual, cross-institutional presentation introducing students to a career in RO would be valuable in exposing students to RO who are less likely to access it otherwise and would increase students' interest in a career in RO regardless of their gender, race, or ethnicity. METHODS A 1-hour, live, virtual, extracurricular presentation was offered to deans of US medical schools lacking affiliated RO departments and/or having high enrollments of students underrepresented in medicine (UIM) and also student groups composed primarily of UIM students. Presentations were given individually to each school by a single radiation oncologist. An electronic survey captured data from participating students. RESULTS One hundred ninety-seven students from 13 institutions attended presentations; 114 students responded to the survey (response rate, 58%). Ninety-two students (81%) were aware of the specialty of RO before the presentation; however, UIM students were significantly less likely to be aware of RO than all others (69% versus 87%, P = .05). Only 19 students (17%) reported previously hearing presentations from radiation oncologist (29% among second- to fourth-year students versus 9% among first-year students, P = .01). Ninety-eight students (86%) expressed more interest in pursuing a career in RO after the presentation. There was no significant difference in interest in RO for any demographic subgroups. CONCLUSIONS Virtual RO exposure was feasible to deliver to students less likely to be exposed otherwise and successfully stimulated interest in the specialty regardless of students' gender, race, or ethnicity.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Medical Student Clerkship Director at Rutgers New Jersey Medical School.
| | - George Gayed
- Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Charles R Thomas
- Chief of Radiation Oncology, Department of Radiation Oncology, Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland; Medical Director of the Johns Hopkins Proton Therapy Center; and Clinical Director of Radiation Oncology at the Johns Hopkins Kimmel Cancer Center at Sibley Memorial Hospital
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15
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Alcorn SR, Deville C. Ensuring That Health Inequities and Disparities Are Not Exacerbated in the Evolving Oligometastatic Treatment Paradigm. Int J Radiat Oncol Biol Phys 2022; 114:843-845. [DOI: 10.1016/j.ijrobp.2022.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022]
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16
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Ponce SEB, Thomas CR, Diaz DA. Social determinants of health, workforce diversity, and financial toxicity: A review of disparities in cancer care. Curr Probl Cancer 2022; 46:100893. [DOI: 10.1016/j.currproblcancer.2022.100893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
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Velazquez AI, Gilligan TD, Kiel LL, Graff J, Duma N. Microaggressions, Bias, and Equity in the Workplace: Why Does It Matter, and What Can Oncologists Do? Am Soc Clin Oncol Educ Book 2022; 42:1-12. [PMID: 35649205 DOI: 10.1200/edbk_350691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite efforts to embrace diversity, women and members of racial, ethnic, and gender minority groups continue to experience bias, inequities, microaggressions, and unwelcoming atmospheres in the workplace. Specifically, women in oncology have lower promotion rates and less financial support and mentorship, and they are less likely to hold leadership positions. These experiences are exceedingly likely at the intersection of identities, leading to decreased satisfaction, increased burnout, and a higher probability of leaving the workforce. Microaggressions have also been associated with depression, suicidal thoughts, and other health and safety issues. Greater workplace diversity and equity are associated with improved financial performance; greater productivity, satisfaction, and retention; improved health care delivery; and higher-quality research. In this article, we provide tools and steps to promote equity in the oncology workplace and achieve cultural change. We propose the use of tailored approaches and tools, such as active listening, for individuals to become microaggression upstanders; we also propose the implementation of education, evaluation, and transparent policies to promote a culture of equity and diversity in the oncology workplace.
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Affiliation(s)
- Ana I Velazquez
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | | | | | - Julie Graff
- Veterans Affairs Portland Health Care System, Portland, OR
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
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18
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Schuster JM, Saeed H, Puckett LL, Moran JM, Howell K, Thomas C, Offerman S, Suneja G, Jagsi R. Gender Equity in Radiation Oncology: Culture Change is a Marathon, not a Sprint. Adv Radiat Oncol 2022; 7:100937. [PMID: 35592465 PMCID: PMC9110895 DOI: 10.1016/j.adro.2022.100937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022] Open
Abstract
The specialty of radiation oncology's gender diversity is lagging other medical specialties. The lack of gender diversity in radiation oncology has been demonstrated at all stages of career, from medical schools to department chairs. Multiple articles have demonstrated literature-based benefits of inclusion of a diverse group of female colleagues. This editorial is intended to note areas of progress and highlight resources available to support gender equity in the field of radiation oncology.
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Mattes MD, Deville C, Vega RBM, Fung CY, Suneja G, Shumway JW, Chowdhary M, Shah C, Bates JE, Mohindra P, Siker ML, Winkfield KM, Vapiwala N, Royce TJ. Demographics of ASTRO Student Members and Potential Implications for Future U.S. Radiation Oncology Workforce Diversity. Adv Radiat Oncol 2022; 7:100834. [PMID: 34977427 PMCID: PMC8688878 DOI: 10.1016/j.adro.2021.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/06/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose The radiation oncology workforce in the United States is comparatively less diverse than the U.S. population and U.S. medical school graduates. Workforce diversity correlates with higher quality care and outcomes. The purpose of this study was to determine whether student members of the American Society for Radiation Oncology (ASTRO) are any more diverse than resident members-in-training using the recently established medical student membership category. Methods and Materials Self-reported sex, race and Hispanic ethnicity, medical school, and degree(s) earned for all medical students (n = 268) and members-in-training (n = 713) were collected from the ASTRO membership database. International members were excluded. The χ2 test was used to assess for differences between subgroups. Results Compared with members-in-training, student members were more likely to be female (40.0% vs 31.5%, P = .032), black or African American (10.7% vs 4.8%, P = .009), candidates for or holders of a DO rather than MD degree (5.2% vs 1.5%, P = .002), and from a U.S. medical school that is not affiliated with a radiation oncology residency program (30.5% vs 20.9%, P = .001). There was no significant difference in self-reported Hispanic ethnicity (7.3% vs 5.4%, P = .356). There were no indigenous members in either category assessed. Conclusions Medical student members of ASTRO are more diverse in terms of black race, female sex, and osteopathic training, though not in terms of Hispanic ethnicity or nonmultiracial indigenous background, than the members-in-training. Longitudinal engagement with these students and assessment of the factors leading to specialty retention versus attrition may increase diversity, equity, and inclusion in radiation oncology.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Raymond B Mailhot Vega
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida
| | - Claire Y Fung
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Gita Suneja
- Department of Radiation Oncology and Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - John W Shumway
- Department of Radiation Oncology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Mudit Chowdhary
- Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - James E Bates
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Pranshu Mohindra
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Malika L Siker
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karen M Winkfield
- Meharry-Vanderbilt Alliance, Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Trevor J Royce
- Department of Radiation Oncology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.,Flatiron Health, New York, New York
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Hill C, Deville C, Kiess A, Narang A, Ratnanather T, Bienstock J, Brinckerhoff L, Hodukavich A, Anderson R, Alcorn S, DeWeese T, Viswanathan A, Page BR. Establishing a Deaf and American Sign Language Inclusive Residency Program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:357-363. [PMID: 34670241 DOI: 10.1097/acm.0000000000004469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Improving diversity in residency programs has been increasingly emphasized as a means to address gender, racial, and ethnic disparities in medicine. However, limited attention has been given to the potential benefits of training physicians with differences other than gender or race and ethnicity. Americans with a disability represent about 27% of the U.S. population, whereas 1%-3% of physician trainees report having a disability. In 2013, a national survey identified only 86 physicians or trainees reporting deafness or hearing loss as a disability. To date, there are no published strategies on how to create an inclusive program for Deaf trainees. Herein, the authors report on the development of a Deaf and American Sign Language (ASL) inclusive residency program that can serve as an academic model for other programs, in any medical specialty, seeking to create an accessible training program for Deaf physicians and that can be adapted for trainees with other disabilities. In March 2017, the radiation oncology residency program at Johns Hopkins University matched an ASL-signing Deaf resident who would begin the program in July 2018. In preparation, department leadership engaged key stakeholders and leaders within the university's health system and among the department faculty, residents, and staff as well as the incoming resident to create an ASL inclusive program. A 5-step transition process for the training program was ultimately developed and implemented. The authors focused on engaging the Deaf trainee and interpreters, engaging health system and departmental leadership, contracting a training consultant and developing oral and written training materials for faculty and staff, and optimizing the workspace via accommodations. Through collaborative preparation, a Deaf and ASL-signing resident was successfully integrated into the residency program. The proposed 5-step transition process provides an effective, engaging model to encourage other institutions that are seeking to employ similar inclusivity initiatives.
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Affiliation(s)
- Colin Hill
- C. Hill is a radiation oncology resident, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Curtiland Deville
- C. Deville Jr is associate professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ana Kiess
- A. Kiess is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amol Narang
- A. Narang is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tilak Ratnanather
- T. Ratnanather is associate research professor, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Jessica Bienstock
- J. Bienstock is associate dean of graduate medical education, Office of the Vice Dean for Education, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Loring Brinckerhoff
- L. Brinckerhoff is a disability and learning consultant, Learning Resources and Support Student Affairs, Harvard University, Boston, Massachusetts
| | - Aaron Hodukavich
- A. Hodukavich is an Americans with Disabilities Act compliance officer, Office of Institutional Equity, Johns Hopkins University, Baltimore, Maryland
| | - Roberta Anderson
- R. Anderson is director of nursing, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sara Alcorn
- S. Alcorn is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Theodore DeWeese
- T. DeWeese is vice dean for clinical affairs and president of the clinical practice association, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Akila Viswanathan
- A. Viswanathan is professor and director, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brandi R Page
- B.R. Page is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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21
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Chapman CH, Nomura K, Kothari A, Atluri' N, Saito AI. Workplace Gender Inequity Is Driven by Broader Societal Inequity: A Qualitative Study of Senior Japanese and American Radiation Oncologists. Adv Radiat Oncol 2022; 7:100879. [PMID: 35198834 PMCID: PMC8844661 DOI: 10.1016/j.adro.2021.100879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose Gender inequity in medicine harms society, and often originates in the context of broader societal discrimination. This study explores the experiences of older women in the radiation oncology specialty in Japan and the United States, with an emphasis on understanding how broader gender inequity affects career trajectory. Radiation oncology is an ideal setting to investigate cross-cultural physician gender equity issues, because few women enter the field despite fewer barriers (eg, frequent emergencies, evening/weekend hours, long procedures) that are commonly cited by women as deterrents in specialty selection. Methods and Materials Between 2012 and 2016, the authors interviewed 14 older women in radiation oncology (department chairs or full professors), with 6 from Japan and 8 from the United States. Multiple analysts identified themes to explore the impact of societal gender inequity on female radiation oncologists’ careers. Results Five themes were identified: (1) childhood gender constructs affect career aspirations, (2) persistent sexism and gender-based workplace challenges affect women's careers, (3) gender inequity in the home affects women's careers, (4) non–gender-related factors intersect to affect women's career satisfaction, and (5) attaining gender equity appears to be even more challenging in Japan compared with the United States. Conclusions Female radiation oncologists in 2 of the most technologically advanced countries report that gender discrimination across their lifespans substantially affects career success. Because gender inequality reflects societal injustice and negatively affects scientific progress and patient outcomes, future research should focus on global approaches to address professional and domestic gender constructs that impede women's career progress.
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Affiliation(s)
- Christina Hunter Chapman
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Health Care System, Ann Arbor, Michigan
| | - Kyoko Nomura
- Department of Public Health, AkitaUniversity Graduate School of Medicine, Akita City, Japan
| | | | | | - Anneyuko I. Saito
- Department of Radiation Oncology, Juntendo University, Faculty of Medicine, Bunkyo, Japan
- Corresponding author: Anneyuko I. Saito, MD, PhD
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22
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Mattes MD, Deville C. A Survey to Assess and Delineate Approaches to Medical Student Outreach to Promote Diversity at Academic Radiation Oncology Programs. Int J Radiat Oncol Biol Phys 2022; 112:1083-1089. [PMID: 35017009 DOI: 10.1016/j.ijrobp.2021.12.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/02/2021] [Accepted: 12/24/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE/OBJECTIVE(S) To assess how academic radiation oncology departments engage medical students who are either female and/or from racial and ethnic demographic groups that are underrepresented in medicine (URiM). MATERIALS/METHODS An electronic survey was sent to all 83 radiation oncology residency program directors (or if applicable medical student directors) whose department is affiliated with an on-site medical school. Questions assessed whether any faculty in the participants' department offer exposure in radiation oncology specifically to medical and premedical student groups whose members are typically female or URiM, or promote the American Society for Radiation Oncology (ASTRO) Minority Summer Fellowship (MSF) Award. Barriers to these types of involvement were also assessed. RESULTS A representative from 54/83 programs responded (response rate 65%). Faculty from 83% of departments had given a presentation to an oncology or radiation oncology medical student interest group. However, faculty from only 18% of departments had given a presentation to a Student National Medical Association chapter, 9% to a Latino Medical Student Association chapter, and 11% to an American Medical Women's Association chapter. Faculty from 15% of departments actively promote the MSF to the general student body, and 24% promote it to any minority students who express interest in radiation oncology. Faculty from 22% of departments had given a presentation to a premedical student group, 10% to an undergraduate student group focused on minority or female students, and 20% to a pipeline program for high school (or younger) female or URiM students. Lack of awareness of the existence of such programs, or not being invited, were the most common barriers to participation. CONCLUSIONS Most academic radiation oncology departments do not offer educational outreach specifically targeting women or minority students or promote the MSF. Further efforts are needed to break from the status quo and attract a more diverse workforce.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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23
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McClelland S, Huang CC, Griffith KA, Shan M, Holliday EB, Jagsi R, Zellars RC. Composition of the Current Academic Radiation Oncology Workforce in Comprehensive Cancer Centers. JCO Oncol Pract 2021; 18:e740-e747. [PMID: 34919411 DOI: 10.1200/op.21.00609] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The landscape of the profession of academic radiation oncology is constantly changing. We sought to determine the demographic makeup of the current academic radiation oncology workforce. MATERIALS AND METHODS Internet web site searches of the 51 National Cancer Institute-designated Comprehensive Cancer Centers (CCCs) were conducted in September 2019. The Scopus database was subsequently searched in December 2019 to ascertain the h-index for each radiation oncologist. Geographic location was economically stratified (New York, California, Massachusetts, Illinois, and Washington DC) as previously reported. Race and binary sex were attributed by authors using publicly available information. Univariate analysis involved the chi-square test; a multivariable model considered several factors including rank and sex. RESULTS Of 993 radiation oncologists at CCCs, 53.6% are junior faculty, 24.8% associate professors, and 21.7% full professors. The average radiation oncologist at a CCC has been a physician for 19.7 (standard deviation = 11.3) years; 4.7% (47/993) are under-represented minorities. 24.6% of men and 15.5% of women were full professors, a statistically significant difference (P = .001). Of the 51 department chairs, 11.8% are women and 5.6% are under-represented minorities. There are fewer female than male program directors in the most economically stratified locations (P = .02). The mean h-index for all faculty is 17.6 (standard deviation = 16.9), and significantly differs between junior faculty (8.21), associate professors (18.46), and full professors (40.05; P < .0001). It also differs between men (19.35) and women (14.11). On multivariable analysis, sex, academic rank, and a secondary advanced degree were independently significant correlates of h-index. CONCLUSION Among academic radiation oncologists at CCCs, under 5% are under-represented minorities, men are significantly over-represented among senior faculty, and women have significantly lower h-indices than men.
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Affiliation(s)
- Shearwood McClelland
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - Christina C Huang
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - Kent A Griffith
- Center for Cancer Biostatistics, University of Michigan, Ann Arbor, MI
| | - Mu Shan
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
| | - Emma B Holliday
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Richard C Zellars
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
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Kamran SC, Niemierko A, Deville C, Vapiwala N. Diversity Trends by Sex and Underrepresented in Medicine Status Among US Radiation and Medical Oncology Faculty Over 5 Decades. JAMA Oncol 2021; 8:221-229. [PMID: 34882189 PMCID: PMC8662536 DOI: 10.1001/jamaoncol.2021.6011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance It remains unclear how the historical exclusion of women and racial and ethnic minority groups from medical training, and therefore the oncologic subspecialties, has contributed to rates of faculty diversity among oncology departments over time. Oncologic faculty diversity is an important initiative to help improve care and address health disparities for an increasingly diverse US population with cancer. Objectives To report trends in academic faculty representation by sex and by race and ethnicity for radiation oncology (RO) and medical oncology (MO) departments and to describe comparisons with the general US population, medical students, RO and MO trainees, clinical department chairs, and faculty in other departments. Design, Setting, and Participants This cross-sectional analysis used data from the Association of American Medical Colleges to analyze trends by sex and by race and ethnicity among full-time US faculty in RO and MO departments from 1970 through 2019. Data were analyzed between October 2020 and April 2021. Main Outcomes and Measures Proportions of women and individuals from underrepresented in medicine (URM) racial and ethnic groups (Black, Hispanic, and Indigenous individuals) were calculated among RO and MO academic departments; trends were analyzed over 5 decades. These proportions were compared with cohorts already described. In addition, proportions of women and URM individuals were calculated by faculty rank among RO and MO departments. Results In 1970, there were 119 total faculty in RO (10 women [8.4%] and 2 URM [1.7%]) and 87 total faculty in MO (11 women [12.6%] and 7 URM [8.0%]). In 2019, there were 2115 total faculty in RO (615 women [29.1%] and 108 URM [5.1%]) and 819 total faculty in MO (312 women [38.1%] and 47 URM [5.7%]). Total faculty numbers increased over time in both RO and MO. Faculty representation of URM women proportionally increased by 0.1% per decade in both RO (95% CI, 0.005%-0.110%; P <. 001 for trend) and MO (95% CI, -0.03% to 0.16%; P = .06 for trend) compared with non-URM women faculty, which increased by 0.4% (95% CI, 0.25%-0.80%) per decade in RO and 0.7% (95% CI, 0.47%-0.87%) per decade in MO (P < .001 for trend for both). Faculty representation of URM men did not significantly change for RO (0.03% per decade [95% CI, -0.008% to 0.065%]; P = .09 for trend) or MO (0.003% per decade [95% CI, -0.13% to 0.14%]; P = .94 for trend). Representation of both women and URM individuals among both specialties was lower than their representation in the US population in both 2009 and 2019. Across all cohorts studied, RO faculty had the lowest URM representation in 2019 at 5.1%. At every rank in 2019, the number of total URM faculty represented among both MO and RO remained low (MO: instructor, 2 of 44 [5%]; assistant professor, 18 of 274 [7%]; associate professor, 13 of 177 [7%]; full professor, 13 of 276 [5%]; and RO: instructor, 9 of 147 [6%]; assistant professor, 57 of 927 [6%]; associate professor, 20 of 510 [4%]; full professor, 18 of 452 [4%]). Conclusions and Relevance This cross-sectional study suggests that RO and MO academic faculty have increased the representation of women over time, while URM representation has lagged. The URM trends over time need further investigation to inform strategies to improve URM representation in RO and MO.
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Affiliation(s)
- Sophia C Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Andrzej Niemierko
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Neha Vapiwala
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia
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Chapman CH, Schechter CB, Cadham CJ, Trentham-Dietz A, Gangnon RE, Jagsi R, Mandelblatt JS. Identifying Equitable Screening Mammography Strategies for Black Women in the United States Using Simulation Modeling. Ann Intern Med 2021; 174:1637-1646. [PMID: 34662151 PMCID: PMC9997651 DOI: 10.7326/m20-6506] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Screening mammography guidelines do not explicitly consider racial differences in breast cancer epidemiology, treatment, and survival. OBJECTIVE To compare tradeoffs of screening strategies in Black women versus White women under current guidelines. DESIGN An established model from the Cancer Intervention and Surveillance Modeling Network simulated screening outcomes using race-specific inputs for subtype distribution; breast density; mammography performance; age-, stage-, and subtype-specific treatment effects; and non-breast cancer mortality. SETTING United States. PARTICIPANTS A 1980 U.S. birth cohort of Black and White women. INTERVENTION Screening strategies until age 74 years with varying initiation ages and intervals. MEASUREMENTS Outcomes included benefits (life-years gained [LYG], breast cancer deaths averted, and mortality reduction), harms (mammographies, false positives, and overdiagnoses), and benefit-harm ratios (tradeoffs) by race. Efficiency (benefits per unit resource), mortality disparity reduction, and equity in tradeoffs were evaluated. Equitable strategies for Black women were defined as those with tradeoffs closest to benchmark values for screening White women biennially from ages 50 to 74 years. RESULTS Biennial screening from ages 45 to 74 years was most efficient for Black women, whereas biennial screening from ages 40 to 74 years was most equitable. Initiating screening 10 years earlier in Black versus White women reduced Black-White mortality disparities by 57% with similar LYG per mammogram for both populations. Selection of the most equitable strategy was sensitive to assumptions about disparities in real-world treatment effectiveness: The less effective treatment was for Black women, the more intensively Black women could be screened before tradeoffs fell short of those experienced by White women. LIMITATION Single model. CONCLUSION Initiating biennial screening in Black women at age 40 years reduces breast cancer mortality disparities and yields benefit-harm ratios that are similar to tradeoffs of White women screened biennially from ages 50 to 74 years. PRIMARY FUNDING SOURCE National Cancer Institute at the National Institutes of Health.
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Affiliation(s)
- Christina Hunter Chapman
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, and University of Michigan Medical School, Ann Arbor, Michigan (C.H.C.)
| | | | - Christopher J Cadham
- Georgetown University Medical Center and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (C.J.C., J.S.M.)
| | - Amy Trentham-Dietz
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin (A.T., R.E.G.)
| | - Ronald E Gangnon
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin (A.T., R.E.G.)
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan (R.J.)
| | - Jeanne S Mandelblatt
- Georgetown University Medical Center and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (C.J.C., J.S.M.)
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Kesarwala AH, Godette KD, Bradley JD. A Call to Action: Radiation Oncology Trials and Minority Enrollment. Pract Radiat Oncol 2021; 11:460-462. [PMID: 34742460 DOI: 10.1016/j.prro.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/16/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Aparna H Kesarwala
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Karen D Godette
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Jeffrey D Bradley
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia.
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Taparra K, Ebner DK, Cruz DDL, Holliday EB. The Impact of COVID-19 on Radiation Oncology Residency Applicant Away Rotations, Interviews, and Rank Lists: A Comparison Between the 2020 Match and 2021 Match. Adv Radiat Oncol 2021; 7:100842. [PMID: 34729444 PMCID: PMC8555343 DOI: 10.1016/j.adro.2021.100842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/12/2021] [Accepted: 10/20/2021] [Indexed: 11/02/2022] Open
Abstract
Purpose The COVID-19 pandemic modified the Residency Match process for fourth-year medical students. In-person away rotations were discouraged, interviews were virtual, and traditional factors used to rank programs were absent. Here, we compare survey results administered to both the 2020 and 2021 Match applicants to assess the influence of the pandemic on the radiation oncology (RO) Match process. Methods An institutional review board-approved prospective cross-sectional study was conducted. The 2020 and 2021 RO Match applicants at a large RO program were invited to participate. Descriptive summary statistics were assessed. Results The 2020 and 2021 Matches each had 76 applicants complete the survey with response rates of 54% and 57%, respectively. The 2 groups were predominantly white, cisgender male, single, and without children. Whereas 11% of 2020 applicants did not complete away rotations, 45% of 2021 applicants did not. For 2021 Match applicants, 65% of away rotations were performed virtually, whereas 51% were not for medical school credit. Of the applicants, 84% were satisfied with virtual interviews and 72% felt cost savings were worth not having in-person interviews. Whereas 49% of Match 2020 applicants spent >$5000 in interview costs, 0% of the Match 2021 applicants did so, with 45% spending <$100. Postinterview communications from programs increased during the pandemic from 36% to 42% in 2020 Match and 2021 Match, respectively. Although program culture was the most common factor influencing 2021 Match applicants program rankings, half of applicants did not gain a sense of program culture during virtual interviews. Conclusions We found 2021 Match applicants completed fewer away rotations, were satisfied with virtual interviews/reduced costs, and did not gain a sense of program culture through virtual rotations/interviews despite it being the most important ranking factor reported. This study supports further exploration of virtual away rotations and virtual interviews moving forward beyond the pandemic.
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Affiliation(s)
- Kekoa Taparra
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California.,Transitional Year Residency Program, Gundersen Health System, La Crosse, Wisconsin
| | - Daniel K Ebner
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Denise De La Cruz
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emma B Holliday
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Wilson JM, Davies E, Tan X, Brewster W, Jones E, Weiner AA. Demographic and clinical factors associated with variations in opioid administration using conscious sedation during HDR brachytherapy for cervical cancer. Brachytherapy 2021; 20:1164-1171. [PMID: 34620572 DOI: 10.1016/j.brachy.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/09/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE/OBJECTIVES To examine patient characteristics that predispose to higher opioid administration during tandem and ovoid (T&O) high-dose rate (HDR) brachytherapy. METHODS A single-institution retrospective review was performed on patients who underwent brachytherapy for cervical cancer. Patients were included if they received at least one fraction of HDR T&O brachytherapy with analgesia administration recorded in the Medication Administration Record. Fentanyl dose was dichotomized as "low" (mean <125 μg per fraction), or "high" (mean ≥ 125 μg per fraction). Descriptive statistics and multiple logistic regression analysis were performed comparing mean opioid dose per fraction with demographic and clinical information. RESULTS From July 2014 through May 2020, 113 patients underwent 531 T&O HDR brachytherapy fractions with oral benzodiazepine and intravenous opioid fentanyl for conscious sedation. The median opioid dose per fraction was 100 μg fentanyl (range 0-250 μg). Using multiple logistic regression analysis, younger age (OR 1.071, p = 0.002) and higher BMI (OR 1.091, p = 0.019) were associated with increased opioid administration during brachytherapy. Black women received less opioid during brachytherapy when compared to White women (OR 0.296, p = 0.047). FIGO stage, ECOG score, smoking status, prior narcotic use, prior illicit drug use, parity, prior cervical procedure, Smit sleeve placement, and distance to treatment center were not associated with high opioid dose. CONCLUSION Cervical cancer patients who are younger or have higher BMI receive more narcotic analgesia during HDR brachytherapy whereas Black women received less narcotic analgesia, irrespective of age and BMI. This underscores the immediate need to address how pain is assessed and managed during brachytherapy.
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Affiliation(s)
- Jessica M Wilson
- Department of Radiation Oncology, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, North Carolina.
| | - Erik Davies
- School of Medicine of Medicine, University of North Carolina, 101 Manning Drive, Chapel Hill, North Carolina
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, North Carolina
| | - Wendy Brewster
- Department of Gynecology Oncology, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, North Carolina
| | - Ellen Jones
- Department of Radiation Oncology, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, North Carolina
| | - Ashley A Weiner
- Department of Radiation Oncology, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, North Carolina.
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Amdur RJ, Mendenhall NP, Mendenhall WM, Dagan R, Yeung AR, Okunieff PG. Increased Resident Diversity Precedes Increased Faculty Diversity: Data From a University Radiation Oncology Department. Am J Clin Oncol 2021; 44:533-535. [PMID: 34319915 DOI: 10.1097/coc.0000000000000858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Increasing the percentage of academic faculty who are female and/or an under-represented minority (URM) is a goal in radiation oncology. When studying diversity changes in our University Radiation Oncology Department, we found that increases in resident diversity preceded changes in faculty diversity in every major category. To illustrate these findings, we plotted resident versus faculty diversity each year over the 52-year history of our program. MATERIALS AND METHODS Plots were generated of the percent of residents versus faculty in our program each year between 1967 and 2020 in the following categories: female, URM, and people of color. RESULTS By 1995, substantial levels of diversity were present among both residents and faculty with approximate median annual values between 1995 and 2020 of 30% female for both residents and faculty, 15% URM for both residents and faculty, and 30% persons of color for residents and 15% for faculty. In all analyses, increase in resident diversity preceded an increase in faculty diversity and, in the great majority of years, resident diversity was greater than faculty diversity. CONCLUSION Our experience suggests that it may be easier to increase resident than faculty diversity and that increases in resident diversity may facilitate increasing faculty diversity.
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Affiliation(s)
- Robert J Amdur
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
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Jamorabo DS, Deek MP, Yom SS, Rehman H, Zietman AL, Motwani SB, Briggs WM, Kim S, Chang DT, Jabbour SK. Can Sex and Seniority Predict the Quality of a Journal Reviewer's Manuscript Critique? Int J Radiat Oncol Biol Phys 2021; 111:312-316. [PMID: 34044095 PMCID: PMC10845841 DOI: 10.1016/j.ijrobp.2021.05.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate reviewers' timeliness and review quality for the International Journal of Radiation Oncology, Biology, Physics (IJROBP) by sex and seniority. METHODS AND MATERIALS The IJROBP editorial office provided data on 3962 individuals invited to review manuscripts from 2011 through 2014. We identified 1657 reviewers who had been invited to provide a review on at least 3 occasions during the study period and compared review timeliness and scoring between male and female reviewers. We confirmed the reviewers' sex after having unblinded their names based on our personal acquaintance with them and via an Internet search on their department websites. We then did a subset analysis of 124 US-based reviewers who had returned a "major revision" decision. We used the Review Quality Instrument (RQI) to rate their reviews. We used odds ratios and t tests to look for differences in mean RQI scores and factors that might be associated with quality-in particular, Hirsch indices (h indices) and year of first certification. RESULTS Of the 1657 reviewers of interest, 1245 (75.1%) were men and 412 (24.9%) were women. We found no statistically significant differences between men and women in the time to respond to invitations. There were no statistically significant differences in timeliness or review reminders based on sex. Our subset analysis showed no difference in quality (RQI scores) based on the reviewers' sex, h index, or year of first certification. CONCLUSIONS Women and men render reviews of equal quality regardless of seniority and h index, yet women have been invited less frequently to review. This is likely because of the underrepresentation of women in radiation oncology. A more balanced academic population is needed to address this continuing disparity of women's representation in academic publishing.
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Affiliation(s)
| | - Matthew P Deek
- Department of Radiation Oncology, Johns Hopkins Medicine, Baltimore, Maryland
| | - Sue S Yom
- Department of Radiation Oncology, University of California-San Francisco, San Francisco, California
| | - Hasan Rehman
- Department of Medicine, North Shore University Hospital, Manhasset, New York
| | - Anthony L Zietman
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sabin B Motwani
- Department of Radiation Oncology, St. Joseph's University Medical Center, Paterson, New Jersey
| | - William M Briggs
- Department of Biostatistics, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York
| | - Sinae Kim
- Rutgers School of Public Health, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Daniel T Chang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
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Racial disparities in vascular surgery: An analysis of race and ethnicity among U.S. medical students, general surgery residents, vascular surgery trainees, and the vascular surgery workforce. J Vasc Surg 2021; 74:33S-46S. [PMID: 34303458 DOI: 10.1016/j.jvs.2021.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/13/2021] [Indexed: 11/21/2022]
Abstract
The ever-increasing diversity of the U.S. population has resulted in a challenge to a vascular surgery workforce that does not represent the national demographics. Educational institutions, medical organizations, and medical agencies, through initiatives and programs, have attempted to increase the number of underrepresented minorities, with, however, only modest changes during the past 30 years. Several obstacles have been identified, some of which include racism, issues of finances, lack of mentors and scholarly activities, and inequity in promotion. In the present study, we have reviewed the reported data addressing these concerns and provided guidance toward the amelioration of these issues with the hope of constructive change toward encouraging a diverse vascular surgery workforce.
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Wilson LJ, Tang TT, Moore J, Langen B, Constanzo J. Acknowledging and overcoming barriers to entry into radiation science for women. Int J Radiat Biol 2021; 98:517-521. [PMID: 34279171 DOI: 10.1080/09553002.2021.1956011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Radiation science is a unique field that brings together various disciplines to understand nature, develop new technologies, and cure diseases. Our field is a prime example of advancement through a diverse pool of competencies. Similarly, studies show that the power of diversity requires proportionate representation of sex and gender, minorities, or other groups. Nevertheless, women are still underrepresented in the radiation sciences, although disparities and underlying mechanisms were first described decades ago. This review summarizes barriers to entry and retention and suggests strategies for overcoming disparities in our field. We also highlight a concerted effort by young professionals to promote the underrepresented and underserved within the radiation science community. CONCLUSION The radiation science community should avoid losing diverse perspectives among its ranks due to sex bias or gender disparity among others. Through targeted efforts, we can cultivate change and harness the talent of researchers, practitioners, and other professionals for the benefit of scientific progress, health-care improvement, and societal advancement overall.
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Affiliation(s)
- Lydia J Wilson
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tien T Tang
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Jade Moore
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Britta Langen
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Julie Constanzo
- Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
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Chukwueke UN, Vera E, Acquaye A, Hervey-Jumper SL, Odia Y, Klesse LJ, Dunbar E, Sharma A, Fonkem E, Thomas AA, Werbowetski-Ogilvie TE, Camelo-Piragua S, Gatson NTN, de la Fuente MI, Armstrong TS, Porter AB, Jackson S. SNO 2020 diversity survey: defining demographics, racial biases, career success metrics and a path forward for the field of neuro-oncology. Neuro Oncol 2021; 23:1845-1858. [PMID: 34302487 DOI: 10.1093/neuonc/noab172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neuro-oncology has grown tremendously since 2010, marked by increasing society membership, specialized clinical expertise, and new journals. Yet, modest improvement in racial/ethnic diversity amongst clinical trial participants, researchers and clinicians led us to conduct a survey to identify opportunities to enhance diversity and inclusiveness amongst neuro-oncology professionals. METHODS In summer 2020, the Women and Diversity Committee of the Society for Neuro-Oncology (SNO) distributed an anonymous online survey to members and affiliates including European Association of Neuro-Oncology (EANO), Asian Society for Neuro-Oncology (ASNO), Society for Neuro-Oncology Latin America (SNOLA) and Society for Neuro-Oncology Sub-Saharan Africa (SNOSSA). The survey captured personal and professional characteristics, biases, effective mentorship qualities, career service metrics and suggested field/society changes. Results were analyzed by geography, profession, age, racial/ethnic and sexual identity. Standard descriptive statistics characterized the study population. RESULTS The 386 respondents were predominantly female (58%) with a median age range of 40-49 years (31%), White (65%), and SNO members (97%). Most worked in North America (77%) in a research profession (67%). A majority of White respondents reported never experiencing biases (64%), while the majority of non-White respondents reported unconscious biases/microaggressions, followed by a lack of/limited mentorship. Qualitative assessments showcased that personal/professional success metrics were linked to needed improvements in diversity and inclusion efforts within the neuro-oncology field. CONCLUSIONS The prevalence of racial/ethnic biases and poor mentorship rates amongst underrepresented groups in neuro-oncology is high and potentially linked to the limited diverse representation amongst members and affiliates. These findings warrant a swift implementation of equity and inclusion practices within the neuro-oncology field.
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Affiliation(s)
- Ugonma N Chukwueke
- Division of Neuro-Oncology, Dana-Farber Cancer Institute, Department of Neurology, Harvard Medical School
| | | | | | - Shawn L Hervey-Jumper
- Neurological Surgery, University of California San Francisco and Weill Institute for Neurosciences.,Neuro-Oncology, Miami Cancer Institute (MCI) at Baptist Health South Florida (BHSF)
| | - Yazmin Odia
- Neuro-Oncology, Miami Cancer Institute (MCI) at Baptist Health South Florida (BHSF)
| | - Laura J Klesse
- Department of Pediatrics, University of Texas Southwestern Medical Center
| | - Erin Dunbar
- Brain Tumor Center, Piedmont Atlanta Hospital
| | - Akanksha Sharma
- Department of Translational Neurosciences and Neurotherapeutics, Pacific Neuroscience Institute at John Wayne Cancer Institute
| | | | - Alissa A Thomas
- Neurological Sciences, University of Vermont Larner College of Medicine
| | | | | | | | - Macarena I de la Fuente
- Neuro-Oncology Division, Department of Neurology/Sylvester Comprehensive Cancer Center, University of Miami
| | | | - Alyx B Porter
- Department of Neurology, Mayo Clinic Cancer Center, Phoenix, Arizona
| | - Sadhana Jackson
- Surgical Neurology Branch, NINDS, and Pediatric Oncology Branch, NCI, NIH
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Abstract
OBJECTIVE. The purpose of our study was to review key social justice and competitive advantage arguments for diversity in interventional radiology (IR) to substantiate the need for a more inclusive workforce. CONCLUSION. As a specialty based on innovation and flexibility of thought, IR is well positioned to be a driver of diversity and inclusion in medicine. The status quo is far from ideal. Social justice and business advantage arguments provide us with the imperative for change.
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Odei B, Kahn J, Holliday EB, Diaz DA, Bello-Pardo E, Odei J, Bae J, Arnett A, Raval R, Mitchell D. Where Are the Women in Radiation Oncology? A Cross-Sectional Multi-Specialty Comparative Analysis. Adv Radiat Oncol 2021; 6:100735. [PMID: 34278054 PMCID: PMC8267431 DOI: 10.1016/j.adro.2021.100735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose We aimed to evaluate the growth of women within the general radiation oncology (RO) workforce in comparison to the growth among other medical specialties. We also sought to create a predictive model for gender diversity to guide future recruitment efforts. Methods and Materials We identified 16 medical specialties, including RO, for analyses. We used data from the Association of American Colleges and assessed female representation at 4 time points (2006, 2011, 2016, and 2020). Additionally, we determined characteristics of medical specialties that were predictive of increased gender diversity. We performed univariate statistical analysis with linear regression to evaluate factors predictive of greater gender diversity among the medical specialties in our cohort. Results The proportion of women within the represented specialties increased over time. Obstetrics/gynecology (14,750 [2006], 23,921 [2020]; 18.7% absolute growth) and dermatology (3568 [2006], 6329 [2020]; 15.1% absolute growth) experienced the highest absolute growth in female representation between 2006 and 2020. When assessing changes between various time points in RO, the absolute change in female physicians increased by 1.5% between 2006 and 2011, by 2.2% between 2011 and 2016, and by only 0.4% between 2016 and 2020, which was the lowest growth pattern relative to the other 15 specialties. Factors predictive of gender diversity among specialties were lower average step 1 scores (P = .0056), fewer years of training (P = .0078), fewer work hours (P = .046), the availability of a standard third year clerkship for a given specialty (P = .0061), and a high baseline number of female physicians within a specialty (P = .0078). Research activities (P = .099) and interest among matriculating medical students (P = .28) were not statistically significant. Conclusions The percentage of women in RO lags behind other medical specialties and has been notably low in the last few years. Interventions that incorporate novel initiatives proposed within this study may accelerate current recruitment milestones.
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Affiliation(s)
- Bismarck Odei
- Ohio State University, Department of Radiation Oncology, Columbus, Ohio
| | - Jenna Kahn
- Oregon Health and Science University, Department of Radiation Oncology, Portland, Oregon
| | - Emma Brey Holliday
- MD Anderson Cancer Center, Department of Radiation Oncology, Houston, Texas
| | | | | | - James Odei
- Ohio State University College of Public Health, Columbus, Ohio
| | - Junu Bae
- Ohio State University, School of Medicine, Columbus, Ohio
| | - Andrea Arnett
- Ohio State University, Department of Radiation Oncology, Columbus, Ohio
| | - Raju Raval
- Ohio State University, Department of Radiation Oncology, Columbus, Ohio
| | - Darrion Mitchell
- Ohio State University, Department of Radiation Oncology, Columbus, Ohio
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Taparra K, Ebner DK, De La Cruz D, Holliday EB. Away Rotations, Interviews, and Rank Lists: Radiation Oncology Residency Applicant Perspectives on the 2020 Match Process. Adv Radiat Oncol 2021; 6:100696. [PMID: 34113741 PMCID: PMC8170351 DOI: 10.1016/j.adro.2021.100696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 11/04/2022] Open
Abstract
Purpose Using 2020 match applicants, the purpose of this study was to identify baseline applicant perspectives on the match process surveying (1) away rotations, (2) interview/postinterview communications, and (3) factors influencing applicant rank order lists. Methods and Materials Applicants in the 2020 match cycle at a large radiation oncology (RO) residency program received a questionnaire covering demographics and the match process: away rotations, interview/postinterview communications, and ranking. Univariable and multivariable logistic regression analyses were used to identify factors associated with completing fewer away rotations. Results Of 141 surveys sent, 76 were completed, for a response rate of 54%. Most applicants were White, male, and matched into RO. One in 3 applicants did not have a home RO program. Most applicants completed 2 RO rotations (ie, a home rotation and an additional away rotation; range, 0-4 total rotations); RO rotations influenced the applicant rank order lists and the ultimate match result for 94% and 79% of applicants, respectively. Forty-seven percent of applicants reported being asked inappropriate questions during the interview (eg, parental or marital status). Applicants did not perceive a consistent message regarding postinterview communications from program directors. Most applicants were contacted postinterview. Interviews cost most applicants more than $5000. Thirty-seven percent of respondents reported submitting a letter of interest after the interview, hoping to improve their rank. When applying to programs, general reputation and location were the most common influential factors mentioned. When ranking programs, informal conversations with residents and program culture observations were the most common influential factors mentioned. Based on multivariable analysis, applicants who completed fewer RO rotations (including away rotations) had greater odds of matching to their home program (odds ratio [OR], 12.05; 95% CI, 1.27-206.69), lower odds of program location influencing where to apply (OR, 0.04; 95% CI, 0.003-0.37), and lower odds of the program's general reputation affecting their rank list (OR, 0.04; 95% CI, 0.001-0.47). Conclusions The results suggest that medical students perceive away rotations as an important influencer of their match process. Although applicants and program directors both participate in postinterview communications, interactions with residents influence rank order lists. These data may serve as an up-to-date baseline to evaluate the influence of the COVID-19 pandemic on the RO match process.
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Affiliation(s)
- Kekoa Taparra
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.,Transitional Year Residency Program, Gundersen Health System, La Crosse, Wisconsin
| | - Daniel K Ebner
- Alpert Medical School of Brown University, Providence, Rhode Island.,Department of Medicine, University of California Irvine Medical Center, Irvine, California
| | - Denise De La Cruz
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emma B Holliday
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Amdur RJ, Mendenhall NP, Mendenhall WM, Dagan R, Yeung AR, Okunieff PG. Journey to Diversity in a University Radiation Oncology Residency Program: The Role of Leadership and Target Goals. Am J Clin Oncol 2021; 44:45-48. [PMID: 33284238 DOI: 10.1097/coc.0000000000000779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Increasing diversity in radiation oncology with respect to sex, under-represented minorities (URMs), and people of color is a major objective of our profession. The purpose of this project is to plot diversity percentages in our residency program over the past 52 years and explain major causes for change when identified. MATERIALS AND METHODS Plots of the percent of residents in our program each year between 1967 and 2020 in the following categories: White male, female, URM, and people of color. RESULTS Between 1967 and 1992 diversity percentage in our program changed little with ∼90% of residents representing White males. Between 1992 and 1995, overall diversity increased by 40 percentage points, a change maintained from 1995 to 2020. Approximate annual percentages over the past 25 years were: female, 35%; URM, 10%; and people of color, 25%.The main reason for increased diversity starting in 1992 was new leadership seeking to promote diversity. Tools that helped promote diversity were measuring our diversity profile and setting target goals. CONCLUSIONS Our experience provides a model to measure diversity and track performance over time in residency programs, departments, or practice groups. The priority to place on diversity, and specific performance goals, vary by group. For those seeking to increase diversity, our experience shows it is possible to achieve substantial diversity in all categories, but change requires leadership making diversity a priority.
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Affiliation(s)
- Robert J Amdur
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
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McClelland S, Huang CC, Jagsi R, Zellars RC. The gender of radiation oncologists treating breast and genitourinary cancers at US comprehensive cancer centers. Postgrad Med J 2021; 97:138-139. [PMID: 33468541 DOI: 10.1136/postgradmedj-2020-139104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Shearwood McClelland
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christina C Huang
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Richard C Zellars
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Salama JK, Floyd SR, Willett CG, Kirsch DG. Fostering Radiation Oncology Physician Scientist Trainees Within a Diverse Workforce: The Radiation Oncology Research Scholar Track. Int J Radiat Oncol Biol Phys 2021; 110:288-291. [PMID: 33412263 DOI: 10.1016/j.ijrobp.2020.12.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
There is a need to foster future generations of radiation oncology physician scientists, but the number of radiation oncologists with sufficient education, training, and funding to make transformative discoveries is relatively small. A large number of MD/PhD graduates have entered he field of radiation oncology over the past 2 decades, but this has not led to a significant cohort of externally funded physician scientists. Because radiation oncologists leading independent research labs have the potential to make transformative discoveries that advance our field and positively affect patients with cancer, we created the Duke Radiation Oncology Research Scholar (RORS) Program. In crafting this program, we sought to eliminate barriers preventing radiation oncology trainees from becoming independent physician scientists. The RORS program integrates the existing American Board of Radiology Holman Pathway with a 2-year post-graduate medical education instructor position with 80% research effort at the same institution. We use a separate match for RORS and traditional residency pathways, which we hope will increase the diversity of our residency program. Since the inception of the RORS program, we have matched 2 trainees into our program. We encourage other radiation oncology residency programs at peer institutions to consider this training pathway as a means to foster the development of independent physician scientists and a diverse workforce in radiation oncology.
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Affiliation(s)
- Joseph K Salama
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
| | - Scott R Floyd
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina
| | - Christopher G Willett
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - David G Kirsch
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina
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40
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Mailhot Vega RB. Broadening the Tent with Intentional Spaces. Int J Radiat Oncol Biol Phys 2020; 108:1118-1119. [PMID: 33069344 PMCID: PMC7561299 DOI: 10.1016/j.ijrobp.2020.05.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Raymond B Mailhot Vega
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida
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41
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Vengaloor Thomas T, Perekattu Kuruvilla T, Holliday E, Bhanat E, Parr A, Albert AA, Page B, Schuster J, Chapman C, Vijayakumar S. Cross-Sectional Gender Analysis of US Radiation Oncology Residency Programs in 2019: More Than a Pipeline Issue? Adv Radiat Oncol 2020; 5:1099-1103. [PMID: 33305070 PMCID: PMC7718546 DOI: 10.1016/j.adro.2020.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/18/2020] [Accepted: 07/06/2020] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The purpose of this study is to assess the current status of gender disparities in academic radiation oncology departments in the United States and the associated factors. METHODS AND MATERIALS The data were collected from publicly available resources, including websites of individual radiation oncology programs, the Fellowship and Residency Electronic Interactive Database, the Accreditation Council for Graduate Medical Education, and the Association of American Medical Colleges. We collected data on the gender information of residents in each year (postgraduate years 2-5) and of the faculty (attendings, program director, and chair) during the academic year 2018 to 2019. Spearman's rho test, Pearson's chi-squared test, and Fisher exact tests were used for evaluating the correlation among variables using SPSS version 24. RESULTS Women constituted 30.8% of radiation oncology residents in the United States in 2019. Eight programs (12.5%) did not have any female residents in their programs, whereas 6 programs (9%) had women constituting more than half of their resident class. The fraction of female medical students applying to radiation oncology over the last 7 years varied between 27% and 33%. Female attending physicians accounted for 30.5% of all the attending physicians in the academic programs. In the leadership positions of the department, the gender gap was wider where only 19 (20%) and 11 (12%) of programs had female program director or chair, respectively. There was a positive correlation between the number of attending physicians and the number of female residents in programs (P = .01). CONCLUSIONS A significant gender disparity continues to exist among the residents and physicians in the academic radiation oncology departments in the US. This disparity is pronounced in the leadership positions. The results of this study could be used as a benchmark to evaluate the progress that has been made by the efforts to improve gender disparities in radiation oncology.
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Affiliation(s)
| | | | - Emma Holliday
- University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eldrin Bhanat
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Amy Parr
- University of Mississippi Medical Center, Jackson, Mississippi
| | | | - Brandi Page
- Johns Hopkins University, Baltimore, Maryland
| | - Jessica Schuster
- University of Wisconsin School of Medicine and Public Health, Madison, Wsconsin
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42
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Affiliation(s)
- Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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43
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Perni S, Saraf A, Milligan M, Oladeru OT, Franco I, Elmore SNC. A Paradigm Shift in Radiation Oncology Training. Adv Radiat Oncol 2020; 6:100599. [PMID: 33732957 PMCID: PMC7940784 DOI: 10.1016/j.adro.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/24/2020] [Accepted: 10/13/2020] [Indexed: 11/21/2022] Open
Abstract
The coronavirus disease 2019 pandemic has been intertwined with the movement for racial justice in the United States and has highlighted and risks aggravating educational and workforce disparities within radiation oncology. We discuss wide-ranging changes within radiation oncology training that are essential to developing and maintaining diversity, including utilization of competency-based educational models that allow for streamlining of training and examinations; responsiveness to the needs of residents and medical students of different gender, racial/ethnic, and socioeconomic groups; and technological integration to increase educational efficiency and decrease barriers.
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Affiliation(s)
- Subha Perni
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Anurag Saraf
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Michael Milligan
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Oluwadamilola T Oladeru
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Idalid Franco
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Shekinah N C Elmore
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
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44
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Kamran SC, Yerramilli D, Vapiwala N. No Talent Left Behind: A Silver Lining for Diversity in Radiation Oncology in the Post-Coronavirus Disease 2019 (COVID-19) Era. Int J Radiat Oncol Biol Phys 2020; 108:472-474. [PMID: 32890536 PMCID: PMC7462790 DOI: 10.1016/j.ijrobp.2020.05.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Sophia C Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Divya Yerramilli
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Neha Vapiwala
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
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45
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Siker ML, Deville C, Suneja G, Winkfield K. Lessons From COVID-19: Addressing Health Equity in Cancer Care. Int J Radiat Oncol Biol Phys 2020; 108:475-478. [PMID: 32890537 PMCID: PMC7462894 DOI: 10.1016/j.ijrobp.2020.06.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Malika L Siker
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah, Salt Lake City, Utah
| | - Karen Winkfield
- Department of Radiation Oncology, Wake Forest Baptist Health, Winston-Salem, North Carolina
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Franco I, Oladeru OT, Saraf A, Liu KX, Milligan M, Zietman A, Nguyen PL, Hirsch AE, Jimenez RB. Improving Diversity and Inclusion in the Post-Coronavirus Disease 2019 Era Through a Radiation Oncology Intensive Shadowing Experience (RISE). Adv Radiat Oncol 2020; 6:100566. [PMID: 32984656 PMCID: PMC7505821 DOI: 10.1016/j.adro.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose In response to the coronavirus disease 2019 pandemic, current Association of American Medical Colleges guidelines discourage away rotations, posing significant challenges for attracting students to radiation oncology (RO). This is particularly concerning for medical students underrepresented in medicine (UIM) due to the potential of widening existing disparities in applicant and workforce composition. To proactively address this, we created a Radiation Oncology Intensive Shadowing Experience (RISE) to expose UIM students to the field of RO. Methods and Materials Key stakeholders within the residency program, including both UIM faculty and residents with experience in health disparities and medical education, designed a 1-week virtual RISE intended for fourth year UIM students recruited through established national organizations serving UIM medical students. A 1-week disease-specific curriculum was developed using 4 components: (1) foundational exposure to RO, (2) didactic teaching, (3) mentorship opportunities, and (4) a capstone experience. Mentorship was continuously weaved through the experience by attendings, peer resident mentors, and a UIM resident panel to optimize exposure. Results RISE was successfully initiated at 2 academic medical centers with 12 UIM students enrolled through August. Anonymized pre- and postclerkship surveys were developed for students, residents, and faculty involved in RISE to evaluate participants’ satisfaction, resident and attending time burden, and perceptions of program effectiveness. Conclusions We created a unique virtual RO shadowing experience for UIM students to address a critical gap in exposure to RO, heightened by the corona virus disease 2019 pandemic, with the goal of improving diversity, equity, and inclusion in our field.
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Affiliation(s)
- Idalid Franco
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Oluwadamilola T Oladeru
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Anurag Saraf
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Kevin X Liu
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Michael Milligan
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Anthony Zietman
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Paul L Nguyen
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham & Women's Hospital, Boston, Massachusetts
| | - Ariel E Hirsch
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Rachel B Jimenez
- Harvard Radiation Oncology Program, Boston, Massachusetts.,Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
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Virtual Radiation Oncology Clerkship During the COVID-19 Pandemic and Beyond. Int J Radiat Oncol Biol Phys 2020; 108:444-451. [PMID: 32890529 PMCID: PMC7462792 DOI: 10.1016/j.ijrobp.2020.06.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/21/2020] [Indexed: 12/09/2022]
Abstract
Purpose We evaluated the impact of a virtual radiation oncology clerkship. Methods and Materials We developed a 2-week virtual radiation oncology clerkship that launched on April 27, 2020. Clerkship components included a virtual clinic with radiation oncology faculty and residents, didactic lectures, student talks, and supplemental sessions such as tumor boards and chart rounds. Medical students completed pre- and post-clerkship self-assessments. Faculty and resident participants also completed surveys on their experience with virtual lectures and clinics. Pre- and post-clerkship results were compared using a 2-sided paired t test. An analysis of variance model was used to analyze the clerkship components. Results Twenty-six medical students, including 4 visiting students, enrolled over 2 clerkship periods (4 weeks). All students completed the pre- and post-clerkship self-assessments and agreed that the clerkship improved their understanding of radiation oncology. Compared with 3 (11.5%) students who agreed that they understood the daily responsibilities of a radiation oncologist before the clerkship, 22 (84.6%) students agreed and 3 (11.5%) strongly agreed that they understood the daily responsibilities of a radiation oncologist after the clerkship (P < .0001). Although 15 students (57.7%) reported an increased interest in radiation oncology because of the clerkship, the mean level of interest in radiation oncology as a career remained the same, with pre- and post-clerkship scores of 3.0 (±0.9) and 3.0 (±1.1) on a 5-point scale, respectively (P = .7). Students found virtual clinic and didactic lectures to be the most valuable components of the clerkship. Most respondents agreed (30.8%) or strongly agreed (65.4%) to recommend the clerkship to their classmates. Conclusions Our virtual clerkship was effective in increasing medical student interest in and knowledge about radiation oncology. These data will help optimize a new paradigm of virtual radiation oncology education for medical students during COVID-19 and beyond.
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White MJ, Wyse RJ, Ware AD, Deville C. Current and Historical Trends in Diversity by Race, Ethnicity, and Sex Within the US Pathology Physician Workforce. Am J Clin Pathol 2020; 154:450-458. [PMID: 32785661 DOI: 10.1093/ajcp/aqaa139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study assessed historical and current gender, racial, and ethnic diversity trends within US pathology graduate medical education (GME) and the pathologist workforce. METHODS Data from online, publicly available sources were assessed for significant differences in racial, ethnic, and sex distribution in pathology trainees, as well as pathologists in practice or on faculty, separately compared with the US population and then each other using binomial tests. RESULTS Since 1995, female pathology resident representation has been increasing at a rate of 0.45% per year (95% confidence interval [CI], 0.29-0.61; P < .01), with pathology now having significantly more females (49.8%) compared to the total GME pool (45.4%; P < .0001). In contrast, there was no significant trend in the rate of change per year in black or American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander (AI/AN/NH/PI) resident representation (P = .04 and .02). Since 1995, underrepresented minority (URM) faculty representation has increased by 0.03% per year (95% CI, 0.024-0.036; P < .01), with 7.6% URM faculty in 2018 (5.2% Hispanic, 2.2% black, 0.2% AI/AN/NH/PI). CONCLUSIONS This assessment of pathology trainee and physician workforce diversity highlights significant improvements in achieving trainee gender parity. However, there are persistent disparities in URM representation, with significant underrepresentation of URM pathologists compared with residents.
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Affiliation(s)
- Marissa J White
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rhea J Wyse
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
- Michigan State University College of Human Medicine Grand Rapids Campus, Grand Rapids
| | - Alisha D Ware
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Curtiland Deville
- Department Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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More than learning technical skills: The importance of mentorship and coaching during a brachytherapy fellowship. Brachytherapy 2020; 19:758-761. [PMID: 32798179 DOI: 10.1016/j.brachy.2020.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/02/2020] [Accepted: 07/07/2020] [Indexed: 11/24/2022]
Abstract
Brachytherapy exposure during residency varies between residency training programs. As a result, many graduating radiation oncology residents do not feel competent or confident in performing brachytherapy procedures. A brachytherapy fellowship encompasses hands-on procedural skills in addition to clinical decision-making, radiotherapy treatment planning, as well as post-treatment care. During this time, a fellow develops interpersonal relationships with their faculty supervisors in the form of mentorship, sponsorship, and coaching in addition to clinical teaching. The objective of this article is to review these important relationships focusing on brachytherapy fellowship training as an example.
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50
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Odei B, Das P, Pinnix C, Raval R, Holliday EB. Potential Implications of the New USMLE Step 1 Pass/Fail Format for Diversity Within Radiation Oncology. Adv Radiat Oncol 2020; 6:100524. [PMID: 33490722 PMCID: PMC7807134 DOI: 10.1016/j.adro.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Bismarck Odei
- Department of Radiation Oncology, James Cancer Center and Solove Research Institute at Ohio State University, Columbus, Ohio
- Corresponding author: Bismarck Odei, MD
| | - Prajnan Das
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chelsea Pinnix
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Raju Raval
- Department of Radiation Oncology, James Cancer Center and Solove Research Institute at Ohio State University, Columbus, Ohio
| | - Emma B. Holliday
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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