A 5-Year Analysis of the United States Radiation Oncology Job Market Using the ASTRO Career Center

Abstract

Within United States (US) radiation oncology (RO), the physician job market remains an active area of interest. Herein we provide 5-year results of prospectively-collected RO job opportunities.Full-time RO job opportunities were prospectively collected using the American Society for Radiation Oncology (ASTRO) Career Center from March 2016 to February 2021. Jobs were categorized by US Census Bureau region, metro- or micropolitan size, and job type, where academic refers to any medical center with a residency training program, network locations included. Repeat postings were excluded. A chi-squared test was used to compare regional job availability by city size and position type. The number of graduating RO residents (2017-2021) per region was also collected using National Resident Matching Program data. Expected jobs were calculated based on the number of graduates and size of each region. A chi-squared goodness of fit test was used to examine if the listed jobs per region deviated from the expected jobs based on the proportion of graduates and region size.A total of 802 unique job offerings were recorded with the following regional distribution: Northeast, 166; Midwest, 200; South, 261; West, 175. Of the total pool, 337 positions (42.0%) were academic, of which 225 (66.8%) were at the main campus. The majority of jobs were located in metropolitan areas with a population > 1M (median: 1.3M [range: 1K-18M]). A difference was seen between academic and non-academic job availability, with the highest and lowest percentage of academic jobs noted in the Northeast and Midwest, respectively (P < 0.001). Additionally, a difference was seen based on city size, with the Northeast and Midwest demonstrating the highest and lowest percentage of jobs in cities with > 1M people (P < 0.001). A total of 920 RO residents graduated during the 5-year study period. A significant difference was seen when listed jobs per region were compared to expected jobs based on the proportion of graduates and region size with a notable trainee surplus seen in the Northeast. (P < 0.001).This is the first prospective long-term quantitative analysis of the RO job market. We found significant regional imbalances of jobs by type (academic vs. non-academic) and city size (> 1M vs. ≤1M). A disproportionately small number of job opportunities compared with graduates trained in the corresponding region was seen, with the largest gap in the Northeast.