Design and Implementation of Novel Internal Mini Fellowship Concentrations within a Radiation Oncology Residency Program.

Introduction Addressing the social determinants of health (SDOH) can improve cancer-related outcomes and is widely recognized as integral to patient care. Despite this, little is known about how medical oncology residents perceive their role in addressing SDOH. Understanding their views is important not only because SDOH impact outcomes, but also because residency training should prepare oncologists to respond to evolving societal needs. In this study, we use Figured World (FW) theory to explore how residents negotiate their role within the sociocultural world of medical oncology training. Methods We conducted semi-structured interviews with 11 medical oncology residents from the four faculties of medicine in Québec, Canada. Participants were recruited through program directors, newsletters, and snowball sampling. Interviews were audio- and video-recorded, transcribed verbatim, and thematically analyzed. FW theory helped orient our analysis toward how residents make meaning of their roles and responsibilities, how they perceive societal expectations, and how they see themselves within the context of medical oncology training. Results We identified four key themes: (a) becoming an oncologist: what does it mean and entail?, (b) dealing with SDOH in medical oncology: a distressing role, (c) exploring the roots of powerlessness when confronted with SDOH, and (d) negotiating their roles and positioning themselves relative to others in addressing SDOH. Conclusion Residents expressed a desire to engage with SDOH but felt largely unprepared to do so, pointing to gaps in training and support. These findings call for a rethinking of how oncology residency training shapes professional identity, ensuring that future oncologists are prepared to take on roles that encompass both clinical care and social accountability.

A resident satisfaction and well‐being survey was developed and administered within a Multi‐Institutional Journal Club (MIJC) including therapy medical physics residency programs within the Karmanos Cancer Institute, the University of Maryland, the University of Utah, and the University of Alabama‐Birmingham. The survey was designed as a tool for quality improvement and program evaluation within each individual program. Survey items were derived in part from existing well‐established question inventories and included 26 questions, 4 of which were derived from the Maslach Burnout Inventory (MBI) and 12 from the American Psychological Association Work and Well‐being Survey. The survey was administered anonymously via email link annually from 2022 to 2025, and 41 residents responded to the survey during this period. Mean Likert scores for positively keyed survey items (higher score is better) ranged from 4.00/5 to 4.78/5. Mean Likert scores for negatively keyed survey items (lower score is better) ranged from 1.37/5 to 2.71/5. Items were subsequently grouped into five themes: “Burnout,” “Work‐Life Balance,” “Interpersonal Relationships,” “Institutional Values,” and “Job Satisfaction.” Mean scores for these themes were universally positive and ranged from 4.55/5 for “Job Satisfaction” to 3.63/5 for “Work‐Life Balance.” For the “Interpersonal Relationships,” “Institutional Values,” and “Job Satisfaction” themes, 11 of 12 survey items had a median Likert score of 5/5. No respondent indicated a Likert score under ‘3’ for any of the items in the “Job Satisfaction” theme, making it the most consistently positive theme of the survey. Free‐text comments were categorized as “Positive,” “Neutral,” or “Negative.” Of 70 total free‐text comments, 25 (36%) were categorized as “Positive,” 39 (56%) as “Neutral” and 6 (9%) as “Negative.” Approximately 20% of respondents felt a strong sense of burnout or emotional exhaustion. However, nearly 90% felt that their program and program faculty made them feel valued and that they would recommend their residency program to trainees looking for a position. These results compare favorably with previously published data for radiation oncology residents and represent a strong positive sentiment about the characteristics of these residency programs and the residency process itself. While stress and difficulties maintaining work/life balance were clearly acknowledged, quantitative and free‐text comments indicate that the positive aspects of residency training substantially outweigh these negative aspects. The survey has provided a substantial amount of information supporting the success and best practices involved in our programs as well as some constructive negative feedback, which can allow us to further improve our respective programs and potentially serve as a model to help improve medical physics residency training throughout our profession.

Under-represented in medicine (URM) trainees experience higher discrimination and attrition rates, increased depression and burnout. This is the first mentorship program developed for URM medical students, residents and fellows in Canada in radiation oncology to try and improve trainee well-being and inclusion.The Canadian Association of Radiation Oncology - Underrepresented in Radiation Oncology Mentorship Program (CARO-UROMP) was developed through materials adapted from the Association of Residents in Radiation Oncology's Equity and Inclusion Subcommittee. Mentees and mentors were paired based on a pre-program needs assessment. The program was administered for an 8-month duration. Pre and post-program surveys were sent to participants.Between September 2024 and April 2025, 11 mentees and 11 mentors participated. All mentees and mentors were satisfied/very satisfied (100%) with the mentorship program overall. The majority of mentees (87.5%) felt that their mentors were approachable, timely, supportive and listened to their thoughts. Most (75%) were satisfied/very satisfied with career support including jobs and networking advice. For research support, most mentees (62.5%) were satisfied/very satisfied on guidance on research/grant applications and manuscript writing. All mentors agreed/strongly agreed that they were able to improve their mentees' confidence, sense of community and inclusion within RO and that they were able to motivate their mentee to reach their objectives. All mentor/mentee pairs wanted to continue their mentorship relationship.The inaugural year of the CARO-UROMP mentorship program was successful with very high rates of satisfaction. Given the positive impact of the program, the Canada-wide program will look to expand in the future.

Burnout syndrome is an increasingly prevalent problem among young oncologists with a prevalence of up to 71% of physicians in Europe, with potential personal and professional consequences. Few studies have been conducted to evaluate the best primary prevention or interventional strategy to reduce burnout levels. The aim of our study was to determine the efficacy of a therapy. The Resilience-SEOM study was carried out by the + MIR section, which involved three training workshops organized to improve coping and communication skills in a pilot sample of medical oncology residents. On the other hand, the Group Psychotherapy (GP) program was carried out with the mentor of residents of the Oncology Department at the Vall D´Hebron University Hospital, providing a therapeutic space of 1h per month from September 2023 to June 2024. Participants in both studies completed the Maslach Burnout Inventory Human Services Survey (MBI-HSS) at the beginning and at the end of the programs. The results indicate that there was no significant difference in the average initial MBI score, although a trend toward a decrease in burnout levels was observed. The % of participants of workshops with a high level of personal achievement increased from 5 to 25%, the difference being statistically significant (p = 0.002). The results of the GP program show that the difference in the overall pre- and post-intervention scores was statistically significant (0.029). In the Resilience-SEOM study, communication skills workshops as an interventional strategy mitigated burnout levels in medical oncology residents, mainly by improving personal achievement. GP as an interventional strategy for burnout could be feasible to address the emotional impact of burnout.

Complementary therapies are increasingly integrated into the framework of integrative oncology. While numerous complementary therapies provide potential benefits, some may also carry risks, including interactions with conventional cancer treatments. The degree to which oncologists' real-world decisions regarding complementary therapies align with evidence-based guidelines remains uncertain. This study aimed to evaluate oncologists' evidence-based decisions on whether specific complementary therapies should be prohibited, permitted, or recommended for early breast cancer treatment. We conducted a cross-sectional online survey that included a randomized vignette experiment involving oncology specialists and residents from seven Southeast European countries. The primary outcome was the percentage of accurate classifications of 28 therapy-indication pairs in neoadjuvant and adjuvant settings, benchmarked against published evidence. Correctness was assessed using both a strict definition (one correct option) and an expanded definition (accepting "allow" or "recommend" when supported by evidence).A total of 136 respondents met the inclusion criteria and provided paired responses. Median accuracy was found to be 52% (95% CI 48-55) under the strict definition and 70% (95% CI 67-72) under the expanded definition, with no significant differences observed between neoadjuvant and adjuvant settings. Evidence-based therapies, such as physical exercise and cognitive behavioral therapy, were most frequently recommended, whereas most other therapies received endorsement from fewer than 25% of respondents. Overall, oncologists exhibited moderate alignment with evidence, demonstrating a tendency to permit rather than actively recommend complementary therapies, even when evidence indicated potential benefits and safety. These findings underscore the necessity for targeted educational interventions aimed at enhancing oncologists' understanding and ensuring the safe and informed integration of complementary therapies into clinical practice.

Addressing malnutrition in cancer care: Where do postgraduate oncology students stand?

This study aimed to investigate the publication rate of radiation oncology specialization theses in Türkiye and to identify the factors influencing this rate. This retrospective study examined radiation oncology specialization theses completed between 2003 and 2023 in Türkiye. The data were obtained from the Council of Higher Education Thesis Center, an official national database that archives all postgraduate and specialty theses completed in the country. Publication status was determined by searching the student's name, surname, and thesis title in PubMed, Google Scholar, Web of Science, and ULAKBİM TR Index. Journal indexing categories were defined as follows: SCI-E (Science Citation Index Expanded, indicating international journals indexed in Web of Science Core Collection), ESCI (Emerging Sources Citation Index, representing emerging international journals), and TR Index (Türkiye's National Academic Index for peer-reviewed journals). Among the 277 theses included,52.3%were published. The mean time to publication was4.79 ± 3.70years. Of the 145 published theses,58.6%were published in SCI-E indexed journals,24.1%in the TR Index,12.4%in ESCI, and4.8%in other peer-reviewed journals. Theses authored by residents who pursued academic careers had a significantly higher publication rate. To our knowledge, this is the first study to examine the publication rate of radiation oncology theses. Our findings indicate that the publication rate in this field is comparatively higher than in other specialties, underscoring the contribution of radiation oncology residents to the scientific literature. These findings highlight the need to strengthen research training and mentorship during residency to support publication productivity.

To evaluate the effectiveness of an interprofessional sequential simulation (ISS) teaching mode in improving theoretical knowledge, practical skills, interdisciplinary collaboration, and anxiety management among radiation oncology residents (RORs) and radiation therapists during standardized training in China.A prospective randomized controlled study enrolled 70 RORs and radiation therapists (35 control vs. 35 simulation group). The control group received traditional clinical training, while the simulation group underwent ISS training, integrating role-play, standardized patient interactions, and collaborative radiotherapy planning. Outcomes were assessed via theoretical/practical examinations (0-100 points), interdisciplinary competency scales (ICA and TBP), anxiety levels (GAD-7), and satisfaction surveys.The simulation group demonstrated superior post-training theoretical scores (90.97 ± 4.53 vs. 86.54 ± 3.99,p< 0.0001) and practical performance (91.71 ± 4.61 vs. 87.83 ± 3.50,p= 0.0007) compared to the control group. Interdisciplinary collaboration scores (ICA: 43.83 ± 2.96 vs. 40.31 ± 3.38; TBP: 10.49 ± 2.03 vs. 7.94 ± 1.81,p< 0.001) and patient satisfaction (90% vs. 75%,p= 0.026) were significantly higher in the simulation group. Anxiety levels decreased markedly post-intervention for residents (GAD-7: 4.83 ± 1.32 to 4.23 ± 1.37,p= 0.056) and patients (moderate to mild,p< 0.05).The ISS model enhances RORs and radiation therapists' clinical competency, fosters interdisciplinary teamwork, and reduces anxiety, offering a robust framework for improving radiation oncology training in resource-limited settings. Future studies should explore long-term behavioral impacts and scalability.

Resident Versus Teaching Faculty Perceptions of Radiation Treatment Plan Education: A National Survey

Examining Recent Employment Outcomes for Graduating Radiation Oncologists Across and Within the Metropolitan/Nonmetropolitan Continuum: 2015-2022.

BackgroundRadiation oncology residents report a lack of understanding and confidence in assessing radiotherapy plan quality. A contributing factor is the environment in which plan review is taught during residency, that is, routine clinical practice, which does not provide ample time for self‐guided practice in a low‐stakes setting. Expertise in plan review requires diverse case presentation and many examples, which are often not achievable in smaller programs and for less common cancer types. As plan quality affects patient outcomes, it is important to address these pitfalls in the education of residents on plan review.PurposeTo address the identified pitfalls of clinic‐based training, we have developed techniques to create realistic dose distributions that appear suboptimal in a controllable way. These plans can provide many more case examples in the training curriculum and present a low‐stakes technique for safe and effective education of radiation oncology residents.MethodsHigh‐quality dose distributions were first generated with a pre‐trained deep learning model (trained using only high‐quality plans). The dose distributions were then altered directly to create three classes of suboptimal dose distributions: (1) decreased organ‐at‐risk sparing, (2) decreased target conformality, and (3) hotspots in the target. Experienced clinicians then reviewed a subset of these suboptimal dose distributions to assess realism.ResultsWe successfully decreased the quality of radiotherapy dose distributions. The decreased organ‐at‐risk sparing, decreased target conformality, and increased target hotspots were statistically significant (p < 0.05) when assessed by dose‐volume histogram metrics for all parameters evaluated, and the magnitude of dose change was controllable. The resulting dose distributions were overall scored by experienced clinicians as realistic.ConclusionIn this study, we developed techniques to generate realistic but suboptimal dose distributions. The techniques operate directly on existing dose distributions without the need for a treatment planning system and produce dose distributions that appear realistic to experienced clinicians.

TRANSFORM-O: A new training program in translational research offered by the French Society of Cancer (SFC) and the French National College of Oncology Teachers (CNEC)

American Brachytherapy Society Education Committee Technical Report: A Resident's Guide to Evaluation of Prostate Low-Dose-Rate Brachytherapy Treatment Plans.

Background: Empiric antibiotic therapy choices and de-escalation practices for the management of febrile neutropenia (FN) can vary. Facility-specific antimicrobial guidelines have an important role in influencing prescription practices for FN and is a foundation of antimicrobial stewardship activities. Methods: This pre-post quality improvement study at the University of Maryland Medical Center (UMMC) Greenebaum Comprehensive Cancer Center evaluated the impact of the implementation of updated institutional FN guidelines. The changes primarily included: 1) removal of meropenem as first-line agent for patients receiving levofloxacin prophylaxis without other risk factors (e.g. history of resistant organism) and 2) de-escalation protocol for low-risk patients (e.g. afebrile, hemodynamically stable). Education of oncology attendings, residents and pharmacists were carried out. We included patients receiving antipseudomonal antibiotics for FN or sepsis as indicated by prescriber (~70% concordance with antimicrobial stewardship review). Sepsis was included because of high rates of observed misclassification for patients with FN. Stem cell transplant patients were excluded. Pre-intervention (04/2021 – 12/2022) and post-intervention (01/2023 – 09/2024) groups were compared for total anti-pseudomonal antibiotic and meropenem-specific days of therapy (DOT) per 1000 days present (DP) and count of unique antibiotic order per 1000 DP. In addition, a sample of antibiotics reviewed by the UMMC antimicrobial stewardship team was assessed for guideline compliance. Means were calculated across quarters for each period and Willcoxon rank sum was used for comparisons (p Results: A total of 3,311 antibiotics were ordered for FN (79%) or sepsis (21%) during the study period. Longitudinal trends and antibiotic type distribution are illustrated in Figures 1 and 2, respectively. DOT per 1000 DP for all antipseudomonal antibiotics was 213 in the pre-intervention group compared to 191 in the post-intervention group (p=0.06). Meropenem DOT per 1000 DP decreased from 105 in the pre-intervention group to 87 in the post-intervention group (p=0.004). Unique antibiotic order per 1000 DP of all antipseudomonal antibiotics remained constant (62 vs. 56, p=0.1), while unique antibiotic order per 1000 DP for meropenem decreased (16 vs. 8, p =0.01). Of the 317 antibiotics reviewed, 130/169 (77%) were guideline compliant in the pre-intervention group and 113/148 (76%) in the post-intervention group. Conclusion: Changes in FN guidelines at the UMMC cancer center led to decreased meropenem use with a nonsignificant decline in all antipseudomonal antibiotics. Additional work is needed to identify barriers to guideline adherence.

Trends in Program Satisfaction and Perceived Confidence Levels Among United States Radiation Oncology Residents: A 5-Year Aggregate Analysis of the 2020-2024 Association of Residents in Radiation Oncology Graduating Resident Survey.

2803MO High-fidelity simulation reduces stress and enhances communication skills in oncology residents: Results from the ACACIAS 2 study

2191P Global gaps in bereavement education and associated emotional morbidity among oncology residents: Findings from a 21 country cross-sectional survey

Results of the 2020-2023 Association of Residents in Radiation Oncology Graduating Resident Survey: Job Search Experience and Satisfaction.

The Shift to Online: Availability and Content of Digital Platforms for Canadian Radiation Oncology Residency Programs