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Loewen SK, Ruan Y, Wu CHD, Arifin A, Kim M, Bashir B, Halperin R, McKenzie M, Archambault J, Thompson R, Ringash J, Brundage M, Brenner D, Stuckless T. Supply and Demand for Radiation Oncologists in Canada: Workforce Planning Projections From 2020 to 2040. Int J Radiat Oncol Biol Phys 2024; 119:756-770. [PMID: 37562734 DOI: 10.1016/j.ijrobp.2023.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/05/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The number of Canadians diagnosed with cancer, and subsequent demand for radiation therapy, are expected to increase over time. This study aimed to update our needs-based workforce planning model to ensure appropriate staffing levels in the future. METHODS AND MATERIALS The supply of radiation oncologists, by age group, sex, and full-time equivalent status, was projected from 2020 to 2040 using a recursive-aging, input-output model developed with seeding parameters derived from national sources. The demand for radiation oncologists until 2040 was estimated using referral patterns for radiation therapy and consultation workload metrics applied to projected annual cancer incident cases to calculate required full-time equivalent positions. Baseline model parameters were also applied to the 2005-2019 workforce and incident case data to evaluate preprojection supply and demand trends. RESULTS Preprojection trends for 2005 to 2019 revealed accelerated staffing growth that transitioned from a workforce shortage to a surplus state in 2014 followed by substantial growth slowdown in 2016. The model predicts a transient surplus of radiation oncologists until 2026 followed by a projected deficit in subsequent years. Sensitivity analyses using the plausible range for each parameter continued to favor an undersupply, suggesting a trainee shortage unable to meet workforce expansion needs. Considering possible future declining trends in radiotherapy utilization and workload, calculations to inform corrective efforts in resident numbers resulted in 25 entry positions per year, up from 21 per year currently. Geographic distribution of trainees, relative to workforce and cancer incidence distributions, could be improved with more residency positions in Canadian regions outside Ontario. CONCLUSIONS Demand for radiation therapy and radiation oncologists in Canada are expected to grow more quickly than future expansion in staffing levels. Our workforce planning model provides evidence for more trainee requirements to inform stakeholders of possible corrective actions to training programs and recruitment. Further research is needed to explore additional strategies to expand capacity and high-quality delivery of radiation therapy to meet the foreseeable increase in Canadian patients with cancer.
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Affiliation(s)
- Shaun K Loewen
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Che Hsuan David Wu
- Division of Radiation Oncology, BC Cancer, Victoria, British Columbia, Canada
| | - Andrew Arifin
- Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - Michael Kim
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bashir Bashir
- Division of Radiation Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada
| | - Ross Halperin
- Division of Radiation Oncology, BC Cancer, Kelowna, British Columbia, Canada
| | - Michael McKenzie
- Division of Radiation Oncology, BC Cancer, Vancouver, British Columbia, Canada
| | - Jean Archambault
- Department of Radiation Oncology, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec City, Quebec, Canada
| | - Robert Thompson
- Department of Radiation Oncology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael Brundage
- Department of Radiation Oncology, Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
| | - Darren Brenner
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Teri Stuckless
- Department of Radiation Oncology, Cancer Care Program of Eastern Health, St. John's, Newfoundland, Canada
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Kwok JK, Samson N, Doll CM, Barbera L, Loewen SK. Representation of Women in Canadian Radiation Oncology Trainees and Radiation Oncologists: Progress or Regress? Adv Radiat Oncol 2022; 7:101023. [PMID: 36164478 PMCID: PMC9507987 DOI: 10.1016/j.adro.2022.101023] [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: 03/03/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Methods and Materials Results Conclusions
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Affiliation(s)
- Jaime K. Kwok
- Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Corresponding author: Jaime K. Kwok, MD
| | - Nina Samson
- Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Corinne M. Doll
- Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lisa Barbera
- Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shaun K. Loewen
- Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Wu CHD, Malik N, Kim M, Stuckless T, Halperin R, Archambault J, Thompson R, Ringash J, Brundage M, Loewen SK. Employment Outcomes for Canadian Radiation Oncology Graduates: 2020 Assessment and Longitudinal Trends. Adv Radiat Oncol 2022; 7:100915. [PMID: 35372718 PMCID: PMC8971833 DOI: 10.1016/j.adro.2022.100915] [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: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose Canadian radiation oncology (RO) trainees have experienced employment challenges after residency training. The present study was conducted to evaluate current employment trends and perform comparisons to prior reported assessments. Methods and Materials A survey was administered to all 13 Canadian RO program directors requesting the employment status and location of their graduates during the past 3 years, and their perceptions on graduates’ employment challenges. Visa trainees were excluded. Findings were compared with surveys performed in 2014, 2016, and 2018. Results The response rate from RO program directors was 100%. There were 77 graduates identified who completed their residency training between 2017 and 2020. All had known employment status and location. Two (17%) 2020 graduates, 16 (84%) 2019 graduates, 17 (81%) 2018 graduates, and 24 (100%) 2017 graduates had staff employment. Of the 59 graduates with staff positions, 86% were in Canada. Some graduates (28%) obtained staff or locum employment in a province other than their training program. The proportion of graduates obtaining staff positions 1 year after residency increased to 84% from 46%-48% in prior assessments. Most program directors (62%) did not perceive any difficulties with their graduates finding staff employment or trainees transferring to training programs in other disciplines owing to perceived workforce challenges. Conclusions Compared with 3 prior employment outcome assessments, this study observed a higher proportion of graduates with staff positions in Canada, fewer total graduates, fewer graduates seeking staff employment or in fellowship positions, and a trend for fewer graduates seeking employment or fellowships abroad. These findings support the view that the Canadian RO job market continues to improve. Although employment challenges for newly certified, Canadian-trained radiation oncologists still exist, national corrective measures to regulate resident intake in 2011 appear to have had a positive effect on the employment outcomes of recent Canadian RO graduates.
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Affiliation(s)
- Che Hsuan David Wu
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Nauman Malik
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael Kim
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Teri Stuckless
- Department of Radiation Oncology, Cancer Care Program of Eastern Health, St. John's, Newfoundland and Labrador, Canada
| | - Ross Halperin
- Division of Radiation Oncology, BC Cancer, Kelowna, British Columbia, Canada
| | - Jean Archambault
- Department of Radiation Oncology, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Robert Thompson
- Department of Radiation Oncology, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael Brundage
- Department of Radiation Oncology, Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
| | - Shaun K. Loewen
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Corresponding author: Shaun K. Loewen, PhD, MD
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