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Silvestre J, Aakhus E, Weldeslase TA, DeLisser HM. A 15-Year Analysis of Supply and Demand for Hematology and Oncology Training in the United States. JCO Oncol Pract 2024; 20:717-724. [PMID: 38285966 DOI: 10.1200/op.23.00531] [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: 08/23/2023] [Revised: 10/14/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024] Open
Abstract
PURPOSE There is a paucity of research on the supply of the hematology and oncology workforce despite projected shortages in the United States Over the past 15 years of the hematology and oncology match (HOM), we hypothesized that there would be more growth in the number of training positions relative to applicants, higher match rates for US allopathic graduates relative to non-US allopathic graduates, and fewer applicants matching at their top fellowship choices. METHODS This was a national, retrospective cohort study of all applicants in the HOM (2009-2023). Match rates and applicant-to-training position ratios were calculated and compared over time with Pearson tests. RESULTS Growth in the number of annual training positions (426-708; 66% increase) exceeded growth in the number of interested applicants (706-945; 34% increase; P < .001). Annual applicant-to-training position ratios decreased from 1.7 to 1.3 (r = -0.813; P < .001). Match rates increased over the study period for both US allopathic graduates (79%-88%; r = 0.761; P = .001) and non-US allopathic graduates (45%-63%; r = 0.801; P < .001). During each year, match rates for US allopathic graduates exceeded those for non-US allopathic graduates (P < .001). From 2018 to 2023, US allopathic graduates (83%) had higher match rates than US osteopathic graduates (60%) and international medical graduates (50%; P < .001). The percentage of applicants that matched at one of their top three fellowship choices increased from 53% to 60% (r = 0.480; P = .070). Fewer available annual training positions went unfilled over the study period (3%-0.3%; r = - 0.870; P < .001). CONCLUSION Match rates have increased in the HOM but remain competitive especially for non-US allopathic graduates. Future investigation is needed to understand disparities in match outcomes by additional applicant and fellowship program characteristics. Ongoing surveillance of HOM outcomes remains critical given the projected shortages in the US hematology and oncology workforce.
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Affiliation(s)
| | - Erin Aakhus
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Horace M DeLisser
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Idossa D, Velazquez AI, Horiguchi M, Alberth J, Abuali I, Smith-Graziani D, de Lima Lopes G, Lubner S, Florez N. Mentorship Experiences Are Not All the Same: A Survey Study of Oncology Trainees and Early-Career Faculty. JCO Oncol Pract 2023; 19:808-818. [PMID: 37192431 PMCID: PMC10860955 DOI: 10.1200/op.22.00643] [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: 09/13/2022] [Revised: 02/25/2023] [Accepted: 03/08/2023] [Indexed: 05/18/2023] Open
Abstract
PURPOSE Physician workforce diversity can be a driver of institutional excellence, improving innovation and reducing health disparities. However, the current diversity of the hematology/oncology (HO) workforce does not reflect that of the US population. METHODS We conducted a cross-sectional online survey of current trainees and faculty within 5 years of completing terminal training in oncology specialties. RESULTS Of the 306 respondents, 64 (21%) were under-represented in medicine (URiM) and 161 (53%) identified as male. URiM participants were less likely to have a primary mentor (66%) than non-URiM participants (80%; P = .015). Among those who had a primary mentor, URiMs met less frequently (once every 3-6 months or less) with their mentor (19% v 7% non-URiM; P = .003). Furthermore, URiMs were more likely to report having mentors outside their own institution (47% v 40% non-URiM; P = .002) and making compromises to gain access to mentorship (36% v 23% non-URiM; P ≤ 0.001). URiMs were also less likely to apply for grants (34% v 42% non-URiM; P = .035) and awards (28% v 43% non-URiM; P = .019). In multivariable models, URiM individuals were more likely to make compromises to gain access to mentors (odds ratio [OR], 1.96; 95% CI, 1.01 to 3.82) and this remained significant for females (OR, 2.17; 95% CI, 1.26 to 3.75). CONCLUSION URiM individuals may be less likely to have effective mentorship and apply for awards and grant support. Understanding the challenges of URiM trainees can help shape training environments in academic medicine to ensure that they are grounded in diversity, inclusion, and retention.
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Affiliation(s)
- Dame Idossa
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN
- Masonic Comprehensive Cancer Center, Minneapolis, MN
| | - Ana I. Velazquez
- Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Miki Horiguchi
- Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School Boston, MA
| | - Julia Alberth
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Inas Abuali
- Harvard Medical School Boston, MA
- Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA
| | | | - Gilberto de Lima Lopes
- Department of Medicine, Division of Hematology/Oncology, University of Miami, Miami, FL
- Sylvester Comprehensive Cancer Center, Miami, FL
| | - Sam Lubner
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin, Madison, WI
| | - Narjust Florez
- Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School Boston, MA
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Tsang M, Banerjee R, Quiroga D, Idossa D, Schoenbeck KL. Where the Sidewalk Ends: Parenting as a trainee during COVID-19. Cancer Invest 2023:1-14. [PMID: 37243573 DOI: 10.1080/07357907.2023.2219747] [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: 11/14/2022] [Revised: 01/20/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Physicians who are also parents have faced significant difficulties during the COVID-19 pandemic. However, most studies of the physician-parent workforce have focused on the experiences of attending physicians. In this commentary, we highlight the ways that trainee parents have uniquely experienced three major stressors during the pandemic: (1) childcare challenges, (2) scheduling difficulties, and (3) career uncertainties. We discuss potential solutions to mitigate these challenges for the future hematology/oncology workforce. As the pandemic continues, we hope that these steps can improve the ability of trainee parents to care both for their patients and their families.
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Affiliation(s)
- Mazie Tsang
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Rahul Banerjee
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA
| | - Dionisia Quiroga
- Division of Hematology/Oncology, Department of Medicine, Ohio State University
| | - Dame Idossa
- Division of Hematology, Oncology, and Transplantation Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Kelly L Schoenbeck
- Division of Hematology/Oncology, Department of Medicine, San Francisco Veteran Affairs Medical Center, San Francisco, CA
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA
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Tal AL, Bailey KA, Chou A, Offer K, Rosenblum J, Moerdler S, Askew M, Roberts S, Vagrecha A, Orsey A, Robbins G, Satwani P, Pierro J, Levine J. v-SYMPHONY career development series: A collaboration to enhance professional awareness for pediatric hematology oncology trainees. Pediatr Blood Cancer 2023; 70:e30118. [PMID: 36573297 DOI: 10.1002/pbc.30118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/01/2022] [Accepted: 11/06/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND A recent survey of pediatric hematology oncology (PHO) physicians identified that a majority believe fellows are struggling to find jobs that align with their goals. Career development for trainees has historically been home institution-specific, limiting fellows' exposures to career path possibilities. The "virtual-Symposium of Pediatric Hematology/Oncology of New York (v-SYMPHONY)" instituted a tristate Career Development Series for PHO trainees to better address their needs and increase awareness of the variety of PHO career opportunities. PROCEDURE The v-SYMPHONY Career Development Series incorporated three sessions: (a) institutional perspective, (b) individual perspectives, and (c) nuts and bolts of job search. Pre- and post-series surveys were administered to participants to measure impact. RESULTS Forty-one fellows registered for the series and completed a pre-survey. Over half (54%) were in their third or later year of fellowship. Careers with a clinical focus were the most commonly desired career path (59%). Most had received career development advice only from faculty within their institutions (90%). Post-surveys were completed by 11 PHO fellows. Overall, 100% of respondents reported benefiting from the career sessions and recommended the series should be repeated annually. Over 90% learned new information to prepare for the job search. CONCLUSIONS The v-SYMPHONY Career Development Series for PHO fellows across multiple institutions was established and was extremely well received by its participants. PHO fellows agreed that these sessions were beneficial in helping prepare them for the job search process. An annual regional Career Development Series is feasible and is strongly suggested to support PHO fellows.
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Affiliation(s)
- Adit L Tal
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kayleen A Bailey
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine, New York, New York, USA
| | - Alexander Chou
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Weill Cornell Medical Center, New York Presbyterian, New York, New York, USA
| | - Katharine Offer
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Joseph M. Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Jeremy Rosenblum
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
| | - Scott Moerdler
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Megan Askew
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Columbia University Medical Center, New York Presbyterian, New York, New York, USA
| | - Stephen Roberts
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Anshul Vagrecha
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Cohen Children's Medical Center Northwell Health, Zucker School of Medicine at Hofstra University, Long Island, New York, USA
| | - Andrea Orsey
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Gabriel Robbins
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Prakash Satwani
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Columbia University Medical Center, New York Presbyterian, New York, New York, USA
| | - Joanna Pierro
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Staten Island University Hospital Northwell Health, Zucker School of Medicine at Hofstra University, Staten Island, New York, USA
| | - Jennifer Levine
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Weill Cornell Medical Center, New York Presbyterian, New York, New York, USA
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