How Serious are we Regarding Resident Education and Wellness in Radiation Oncology Residency Programs?

Abstract

Residency is the time for education and training during which a medical student transforms into a capable physician to take care of the patients. Resident wellness and prevention of burnout has become an important objective of ACGME in recent years. Despite the efforts from ACGME to make sure the basic standards are met across the training programs, significant variations exist in educational and wellness resources among residency programs. The purpose of this research is to evaluate the educational and wellness resources for residents among Radiation Oncology residency programs across the United States. A list of accredited programs for the academic year 2018-2019 was collected using the ACGME website (www.acgme.org). Individual residency program websites were used as the main source of the data whereas Fellowship Residency Electronic Interactive Data Access System (FREIDA) website (www.freida.ama-assn.org) aided to complement the missing data. Information from all the 94 Radiation Oncology residency programs which are currently ACGME accredited, was up to date as of April 30th, 2019. Excel 2013 was used for analysis. Educational resources Only 53 radiation oncology residency programs reported the duration of protected education time per week on their websites. The median protected education time was 8 hours/week (range: 2 hours to 13 hours) including all the conferences the residents were supposed to attend. Seventy-five (80%) programs have reported the duration of dedicated research time on their websites. At least six months were allowed in 48 (51%) programs, whereas 27 (29%) programs have reported the dedicated research time is negotiable. Outstandingly, 20 (21.28%) programs allow one year of dedicated research time, and the median dedicated research time was nine months. Elective rotations outside the primary department or the primary training institutions help the residents improve their clinical skills and perspectives. From our study, only 13 (14%) residency programs reported to allow residents to rotate in other departments of the same institution. Fifty-nine (63%) of programs allow away rotations at other institutions (external electives). An international rotation was permitted only in 19 (20%) programs. Wellness resources Resident burnout and wellness are areas where ACGME and individual residency programs focus to improve the training for the residents. We evaluated the availability of wellness resources as presented in the radiation oncology program websites and found that there are a lot of variations across the programs. Fatigue management training was available in 50 (53%) programs. Twenty-four (26%) programs routinely organize resident retreat yearly. Thirty-nine (42%) programs reported that they have resident mentoring programs. Financial wellness is an important part of resident wellness and we evaluated the resident salary information across the programs. The salary information was obtainable for 63 institutions, and residents are reasonably well-compensated (range: 51000$ to 78,000 yearly) compared to the median family income in the United States. Moonlighting was allowed only in 28 (30%) of programs. Our study found that significant variations exist among radiation oncology residency programs in the United States with regards to educational and wellness resources for residents. This study reports the current status of these resources and significant improvements can be made from this baseline.