Pilot Study Assessing Student Interest in Combined Residency Training Pathways with Radiation Oncology

Abstract

Radiation oncology (RO) is a small, highly specialized field, which most medical students have limited exposure to before having to decide what specialty to apply to for their graduate medical education (GME). This may ultimately limit the number and diversity of RO applicants. The purpose of this pilot study was to determine students' views on a combined pathway program between RO with internal medicine (IM), as well as other related medical specialties, as a potential means of overcoming some of these barriers to student interest in RO and the early decision point to solo training in RO. An electronic survey was sent to 299 United States student members of the American Society for Radiation Oncology (ASTRO) between July-August 2022. Multiple choice and Likert-type questions were used to assess students' views on the potential advantages and disadvantages of a combined IM/RO training pathway, and interest in this potential combined pathway as well as other combined pathway programs with RO and other related subspecialties. The Mann-Whitney U and Kruskal-Wallis tests were used to compare the responses of subgroups of students stratified according to their gender identity, race, or ethnicity. The Wilcoxon signed rank test was used to compare all participants' interest in different combined pathway programs compared to RO/IM. Eighty participants completed the survey (response rate 27%). Thirty-four participants (43%) were either very or extremely interested in pursuing a combined IM/RO residency (median Likert-type rating 3, IQR 2-4). The duration of a combined IM/RO training considered most preferable or ideal was five years (n = 57, 71%) or six years (n = 21, 26%). The most important potential advantages of a combined IM/RO pathway included greater flexibility in employment options (n = 51, 64%), enhanced general medical knowledge to facilitate ambitions in other career pathways (n = 46, 58%), improved patient care (n = 43, 54%), and having a pathway for combined hematologic/oncology and RO board certification (n = 46, 58%). In comparison to IM/RO, participants were significantly more interested in a combined RO and hematology/oncology program (median Likert-type rating 5, IQR 5-5, p = 0.005). Among the subgroup of 26 students who believed that it was less likely that they would be applying for RO residency, 18 (69%) believed that the availability of an IM/RO pathway would increase their interest in applying to RO (median Likert-type rating 4, IQR 3-5). Interest in IM/RO did not differ by gender, race, or ethnicity. Combined training pathways involving RO were viewed positively by most survey respondents, comprised of student members of ASTRO. Such programs may be particularly appealing to those students who are interested, but less committed to pursuing, a career in RO. Further research will help guide recommendations for the creation of these programs.