Ten-year trends in Canadian female medical student interest in radiation oncology: an analysis of data from the Canadian Resident Matching Service (2012-2021)

Abstract

<h3>Background</h3> Canadian medical student (MS) interest in Radiation Oncology (RO) residency training has varied over the last decade. Concerns related to post-training job availability, employment location flexibility, and extended fellowship training may have affected MS perceptions of RO, potentially deterring past applicants. With recent job market improvements, there has been increased MS interest in the specialty. However, despite recent years showing no gender differences in successfully matching to first-choice overall nonsurgical disciplines, the number of women entering RO residency remains low. This study examines 10 years of resident match data to assess trends in gender-specific interest and match characteristics in RO. <h3>Methods</h3> Publicly available Canadian Resident Matching Service (CaRMS) data from 2012 to 2021 were compiled. Gender-based analysis focused on Canadian medical graduates (CMGs) ranking RO as their first-choice discipline in the match's first iteration. No applicant gender data were available for the 1 to 8 first-year residency positions carried over to the second iteration that occurred in 7 out of 10 matches over the study period. Pearson's chi-square test was used to evaluate whether the number of female applicants differed significantly from what could be expected if RO applicant gender breakdown reflected Canadian CaRMS participant demographics. <h3>Results</h3> Numbers of applicants ranking RO as their first-choice discipline have recently increased. 2018-2021 saw 23-28 RO-preferring applicants, while 2012-2017 saw 9-18. Total applicants ranged from 24-51 per year over the study period. Numbers of female RO-preferring applicants have remained largely unchanged, with a 10-year average of 7 women per year, ranging from 2/15 (13%) in 2016 to 12/27 (44%) RO-preferring applicants in 2018. Overall, 190 CMG applicants ranked RO as their first choice over the last 10 years, comprising 73 females (38%) and 117 males (62%). During this period, 56% (17696/31618) of CMG applicants who participated in the CaRMS match were female. ​​Rates of female applicants to RO were significantly lower compared to rates of female applicants to all specialties combined (p < 0.01). <h3>Discussion</h3> While recent years have had more RO-preferring applicants overall, numbers of RO-preferring female applicants have remained low, and disproportionately less than rates of female CaRMS participants. Findings highlight the need for greater understanding of the factors influencing female medical students' career selection and CaRMS ranking decisions to develop strategies to improve female representation in RO.