Fifteen-Year Trends in Canadian Female Medical Student Interest in Radiation Oncology

Abstract

<h3>Purpose/Objective(s)</h3> The proportion of female radiation oncology residents in Canada remains disproportionately low. The objective of this study was to examine 15 years of resident match data to assess trends in gender-specific medical student interest and match characteristics in radiation oncology (RO). <h3>Materials/Methods</h3> Public Canadian Residency Matching Service (CaRMS) data between 2007-21 were compiled. Gender-based analysis focused on Canadian medical graduates (CMGs) ranking RO as their first-choice discipline in the first iteration of the match. Gender data were not available for applicants and match characteristics for second iteration outcomes. Pearson's chi-square test was used to compare 15-year average female medical student interest in RO versus all training programs. Paired t-test was used to compare total, female, and male applicant numbers over five-year increments (2007-11; 2012-16; 2017-21). Statistical analysis was performed using statistical software. <h3>Results</h3> Total applicants to RO programs ranged between 24-51 per year over the study period. The mean number of applicants ranking RO as their first-choice discipline significantly decreased from 24 (range: 20-27) in 2007-11 to 16 (12-18) in 2012-16 (p<0.01), with an increase to 22 (9-28) in 2017-21 (p<0.05). The 15-year average of female RO applicants was 9 per year, ranging from 2/9 (22%) in 2017 to 12/18 (67%) applicants in 2015. Female applicant numbers were lower in 2012-16 (mean 7; 4-12) compared to 2007-11 (mean 14; 11-16; p<0.01). Female applicant numbers in 2017-21 (mean 7; 2-10) were comparable to 2012-16 (p=0.46), but remained lower than 2007-11 (p<0.01). Male applicant numbers were similar (p=0.12) in 2007-11 (mean 10; 9-12) and 2012-16 (mean 8; 5-11), but increased in 2017-21 (mean= 15; 7-20) compared to 2007-11 (p=0.03) and 2012-16 (p=0.01). Overall, 308 CMG applicants ranked RO as their first choice over the past 15 years; 141 females (46%) and 167 males (54%). Over the same period, 56% (24472/43667) of CMG applicants who participated in the CaRMS match were female. Female CMG application rates to RO were significantly lower compared to application rates to all specialties combined (p<0.01). <h3>Conclusion</h3> Despite increasing male applicant numbers, the number of RO-preferring female medical students remains disproportionately low. Female medical student interest in RO over the last ten years has also fallen significantly from 2007-11 levels. These findings highlight the need for early exposure of female medical students and improved mentorship efforts. A deeper understanding of factors influencing female medical students' career selection and CaRMS ranking decisions is required to improve female representation in RO. These data have led to a special interest group proposal for women in RO, now being considered by the Canadian Association of Radiation Oncology.