Radiation Oncology Faculty Research Articles

The impact of gender and underrepresented minority demographics on nationwide academic radiation oncology faculty promotion.

162 Background: The US is a diverse country with 13.6% of the population identifying as African-American, 19.1% as Hispanic or Latino, and 50.4% female according to the most recent US Census. Per demographic data from the American Society for Radiation Oncology (ASTRO) (the largest US organization of radiation oncologists), 28% of radiation oncologist members identify as female, 4% as African-American race, and 4% as Hispanic/Latino ethnicity; additional data has indicated the rate of URM radiation oncologists in US comprehensive cancer cents to be 5%. This data objectively indicates that females and URMs are underrepresented in the field of radiation oncology compared with the gender and racial/ethnic diversity of the US population. There is minimal data regarding promotion rates in academic radiation oncology, with virtually no data focusing on promotion rates among females and URMs. The primary objective of this study was to assess the relationships between gender and URM status in academic promotion of radiation oncology faculty. Methods: A database consisting of radiation oncologists from 51 National Cancer Institute-designated Comprehensive Cancer Centers from 2019 was accessed in September 2023 to assess academic promotion in a four-year timespan. Data regarding the gender, graduation year, institution, URM identification, and professional rank of radiation oncologists ranked as junior faculty was collected. URM was defined as African-American race and/or Hispanic ethnicity and was collected via self-described internet depictions, interviews, and facial recognition as previously described (PMID 30996695). Junior faculty status was defined as instructor/assistant professor. An online search was then conducted to identify the 2023 academic rank of previously identified faculty, focusing on promotion status from junior to senior faculty or from associate professor to full professor. Regression analysis was performed using a generalized linear mixed model to assess the impact of gender and URM status on promotion, with statistical significance defined as p < 0.05. Results: In an analysis of 554 radiation oncologists comprised of 203 women (36.7%) and 21 URMs (3.8%), 338 (61%) received promotions. Analysis revealed that neither female gender (odds ratio 1.02, 95% confidence interval, 0.68 – 1.52; p -value 0.94) nor URM status (odds ratio 0.57, 95% confidence interval 0.19 – 1.71; p -value 0.32) was significantly associated with promotion. Conclusions: These findings indicate that radiation oncologist gender and URM status may not be associated with academic promotion. However, given the small URM sample size and odds ratio of 0.57, it is possible that this study may be underpowered to adequately assess URM status on promotion. Further studies involving longer time intervals will provide much needed additional data regarding academic promotion.

Implementation and Efficacy of a Large-Scale Radiation Oncology Case-Based Peer-Review Quality Program across a Multinational Cancer Network

PurposeWith expansion of academic cancer center networks across geographically-dispersed sites, ensuring high-quality delivery of care across all network affiliates is essential. We report on the characteristics and efficacy of a radiation oncology peer-review quality assurance (QA) system implemented across a large-scale multinational cancer network. Methods and MaterialsSince 2014, weekly case-based peer-review QA meetings have been standard for network radiation oncologists with radiation oncology faculty at a major academic center. This radiotherapy (RT) QA program involves pre-treatment peer-review of cases by disease site, with disease-site subspecialized main campus faculty members. This virtual QA platform involves direct review of the proposed RT plan as well as supporting data including relevant pathology and imaging studies for each patient. Network RT plans were scored as being concordant or nonconcordant based on national guidelines, institutional recommendations, and/or expert judgment when considering individual patient-specific factors for a given case. Data from January 1, 2014 through December 31, 2019 were aggregated for analysis. ResultsBetween 2014 and 2019, across 8 network centers, a total of 16,601 RT plans underwent peer-review. The network-based peer-review case volume increased over the study period, from 958 cases in 2014 to 4,487 in 2019. A combined global nonconcordance rate of 4.5% was noted, with the highest nonconcordance rates among head-and-neck cases (11.0%). For centers that joined the network during the study period, we observed a significant decrease in the nonconcordance rate over time (3.1% average annual decrease in nonconcordance, p=0.01); among centers that joined the network prior to the study period, nonconcordance rates remained stable over time. ConclusionsThrough a standardized QA platform, network-based multinational peer-review of RT plans can be achieved. Improved concordance rates among newly-added network affiliates over time are noted, suggesting a positive impact of network membership on the quality of delivered cancer care.

Gender and the Receipt of the Association of Residents in Radiation Oncology (ARRO) Educator of the Year Award

Despite an increase in female physicians in recent years, a gender disparity remains in the field of radiation oncology. We hypothesized that there may be a gender disparity in the receipt of ARRO educator awards. Using a database provided by the American Society for Radiation Oncology (ASTRO), annual award recipients were identified from 2010-2022. Data on Academic Institution, Year of Award, and Repeat Awardee Status were obtained through the ASTRO database. Publicly available websites were accessed to obtain data regarding gender, years post residency graduation, percent female/male faculty, size of residency program, and program director designation. H- indices were obtained from Scopus and used as a marker of academic productivity. Basic summary statistics, stratified by gender, were calculated for award year, years since graduation, percent of male faculty, and program size. A one-sample Z-test for proportions was utilized to assess if the proportion of female ARRO award winners each year from 2010 to 2022 was significantly less than the population average, defined as the proportion of female radiation oncology faculty members in the nominating universities that year. Secondary analyses used univariable binary logistic regression to identify any global associations between gender, year since gradation, or program size. The lowest proportion of female awardees occurred in 2013 (8 [14.3%] females vs. 48 [85.7%] males) and the greatest proportion of female awardees occurred in 2022 (19 [30.6%] females vs. 43 [69.4%] males). As compared to the proportion of female faculty members in nominating programs for that respective year, there were significantly fewer female awardees in the years of 2010 (18% female awardees vs. 32% female faculty members, p = 0.02) and 2013 (14% female awardees vs. 31% female faculty members, p = 0.01). There was a statistically significant rise in female awardees over the study period (p<0.01). On logistic regression analysis, large program size (10+ residents) (odds ratio [OR]: 6.86, 95% confidence interval [CI]: 2.71-23.1, p<0.001) and medium program size (5-9 residents) (OR: 4.05, 95% CI: 1.60-13.7, p<0.001) were associated with a greater proportion of female awardees as compared to small program size (1-4 residents). There was no association between awardee gender and years since graduation. A gender disparity is present in the receipt of ARRO Educator Awards. At an institutional level, residency Chiefs, Program Directors, and Chairs should work to ensure that a diverse slate of faculty are considered annually for the ARRO Educator Award with self-assessment of awardees over time to ensure demographic representation and inclusion. Efforts should also be made to recognize biases in resident evaluations of faculty with continued education about inherent biases.

Assessment of Research Mentorship During Medical School for Future Radiation Oncology Trainees

Assessment of Research Mentorship During Medical School for Future Radiation Oncology Trainees

Financial Leadership Skills Training: Can a Hybrid Didactic/Interactive Exercise Model Fill a Gap in Graduate Medical Education?

Background With recent healthcare changes, competition for financial resources is increasing. Graduate medical education (GME) programs do not routinely prepare residents to understand the complexity of financial decisions that affect their practice. At our institution, we designed new sessions to explore personal and departmental financial education in our yearly Radiation Oncology (RO) leadership course. Methods Over the past five years, we have been piloting a longitudinal leadership course for our RO medical and physics residents, integrating a hybrid didactic/interactive exercise approach. The core RO faculty consists of the course director, the residency directors, and department leadership. The course structure includes an introduction to understanding how resource allocation is determined at the institutional level as well as a personal finance component. We recruited the RO Vice Chair, RO Department Administrator, and the MD, MBA Chair of the Vacancy Review Committee at our institution to teach these concepts over three sessions. The first was a didactic introduction to departmental finance by our Vice Chair to prepare attendees for the second interactive session, in which residents worked through a pro forma to determine the feasibility of hiring a new departmental faculty member. The final session was led by our MD, MBA colleague who taught residents how hiring decisions are made and explained what happens to the pro forma at the institutional level. The third session integrated an interactive exercise focusing on personal finance skills. Results At the end of the series, the ten resident attendees were informally surveyed regarding how effective and worthwhile the three finance sessions were. The verbal feedback regarding the curriculum was uniformly positive. All ten residents, including the physics resident, indicated that these classes were helpful and filled a gap in the current GME curriculum. Further feedback analysis noted that additional interactive exercises should be prioritized to reinforce understanding of these financial concepts. Discussion Financial education is lacking in most GME training programs. Targeted instruction for both personal and departmental financial decisions was well received in this novel course at our institution. Further studies are needed to determine effectiveness and optimal integration of financial leadership skill development in the GME setting. Future directions could be to determine the best balance of didactic instruction and interactive exercises to enhance resident understanding of these financial topics. With recent healthcare changes, competition for financial resources is increasing. Graduate medical education (GME) programs do not routinely prepare residents to understand the complexity of financial decisions that affect their practice. At our institution, we designed new sessions to explore personal and departmental financial education in our yearly Radiation Oncology (RO) leadership course. Over the past five years, we have been piloting a longitudinal leadership course for our RO medical and physics residents, integrating a hybrid didactic/interactive exercise approach. The core RO faculty consists of the course director, the residency directors, and department leadership. The course structure includes an introduction to understanding how resource allocation is determined at the institutional level as well as a personal finance component. We recruited the RO Vice Chair, RO Department Administrator, and the MD, MBA Chair of the Vacancy Review Committee at our institution to teach these concepts over three sessions. The first was a didactic introduction to departmental finance by our Vice Chair to prepare attendees for the second interactive session, in which residents worked through a pro forma to determine the feasibility of hiring a new departmental faculty member. The final session was led by our MD, MBA colleague who taught residents how hiring decisions are made and explained what happens to the pro forma at the institutional level. The third session integrated an interactive exercise focusing on personal finance skills. At the end of the series, the ten resident attendees were informally surveyed regarding how effective and worthwhile the three finance sessions were. The verbal feedback regarding the curriculum was uniformly positive. All ten residents, including the physics resident, indicated that these classes were helpful and filled a gap in the current GME curriculum. Further feedback analysis noted that additional interactive exercises should be prioritized to reinforce understanding of these financial concepts. Financial education is lacking in most GME training programs. Targeted instruction for both personal and departmental financial decisions was well received in this novel course at our institution. Further studies are needed to determine effectiveness and optimal integration of financial leadership skill development in the GME setting. Future directions could be to determine the best balance of didactic instruction and interactive exercises to enhance resident understanding of these financial topics.

Research culture in Australian and New Zealand radiation oncology: Fact or fantasy?

Fostering a research culture is a key goal of the Royal Australian and New Zealand College of Radiologists, yet there has never been an organization-wide enquiry into the extent to which this is being realized. The purpose of this work was to address that deficit for the Radiation Oncology (RO) Faculty to serve as a baseline for future comparison. The hypothesis was that such a culture is closer to fact than fantasy. With College approval, three de-identified Excel spreadsheets detailing 25 research-related sub-categories of the Faculty's Continuing Professional Development (CPD) database were interrogated for the 2019-21 triennium, accepting that research activity in 2020-21 would be COVID-19 suppressed. The numbers obligated to self-report CPD were 482, 496 and 511, respectively. Primary endpoints were the percentages of ROs claiming at least one research-related activity overall, and in each of the sub-categories individually, by year. Secondary endpoints were the "breadth" (number of sub-categories claimed/individual) and "depth" (percentages solely claiming in one of four lower-level sub-categories), by year. ROs claimed in 23/25 sub-categories. The percentages of ROs claiming at least one research-related activity were 71%, 44%, and 62% in 2019-21, respectively. The median number of sub-categories claimed by these ROs was 2 (range 1-10) in each year. The commonest activity was journal article co-author (25%, 16% and 27%, respectively). For 2019, the most representative year, other common activities were inhouse/local meeting presentation (17%), invited lecture at state level or above (15%), manuscript peer review and research project principal investigator (14% each). The percentages of ROs solely claiming in one lower-level activity ranged between 4.4% and 5.9% per year. A culture of research is arguably more fact than fantasy in ANZ. It is likely that Faculty curriculum requirements, research funding and other promotional initiatives have contributed substantively to this.

Assessment of Differences in Academic Rank and Compensation by Gender and Race/Ethnicity Among Academic Radiation Oncologists in the United States

Advancing equity, diversity, and inclusion in the physician workforce is essential to providing high-quality and culturally responsive patient care and has been shown to improve patient outcomes. To better characterize equity in the field of radiation oncology, we sought to describe the current academic radiation oncology workforce, including any contemporary differences in compensation and rank by gender and race/ethnicity. We conducted a retrospective cohort study using data from the Society of Chairs of Academic Radiation Oncology Programs (SCAROP) 2018 Financial Survey. Multivariable logistic regression models were used to identify factors associated with associate or full professor rank. Compensation was compared by gender and race/ethnicity overall and stratified by rank and was further analyzed using multivariable linear regression models. Of the 858 academic radiation oncologists from 63 departments in the United States in the sample, 33.2% were female, 65.2% were White, 27.2% were Asian, and 7.6% were underrepresented in medicine (URiM). There were 44.0% assistant professors, 32.0% associate professors, and 22.8% full professors. Multivariable logistic regression analysis for factors associated with associate or full professor rank did not reveal statistically significant associations between gender or race/ethnicity with academic rank (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.56-1.32; P=.48 for gender; OR, 0.81; 95% CI, 0.5-1.30; P=.37 for Asian vs White; and OR, 0.69; 95% CI, 0.31-1.55; P=.37 for URiM vs White), but CIs were wide due to sample size, and point estimates were <1. Similarly, multivariable linear regression analysis modeling the log relative total compensation did not detect statistically significant differences between radiation oncologists by gender (-1.7%; 95% CI, -6.8% to 3.4%; P=.51 for female vs male) or race/ethnicity (-1.6%; 95% CI, -7.3% to 4.0%; P=.57 for Asian vs White and -3.0%; 95% CI, -12.1% to 6.0%; P=.51 for URiM vs White). The low numbers of women and faculty with URiM race/ethnicity in this radiation oncology faculty sample limits the ability to compare career trajectory and compensation by those characteristics. Given that point estimates were <1, our findings do not contradict larger multispecialty studies that suggest an ongoing need to monitor equity.

Assessment of Medical Student Research Mentorship Based on Publications in ASTRO Journals

<h3>Purpose/Objective(s)</h3> Mentored research opportunities often stimulate medical student (MS) interest in a particular field and help them to be competitive residency applicants. Many MSs pursue at least one research project during medical school. According to the Association of American Medical Colleges faculty roster there are approximately 1,800 radiation oncology (RO) faculty at US MD-granting medical schools; however, little is known about whether radiation oncologists are providing adequate research opportunities to MSs who are potentially interested in the specialty. We hypothesize that relatively few academic RO faculty mentor MSs in research, and the minority of publications in American Society for Radiation Oncology (ASTRO) journals will have MS co-authors. <h3>Materials/Methods</h3> Data for this study derived from a review of the byline and abstract of all 1,785 scientific articles (i.e., clinical, basic science, training/education) and case reports published from 2019-2021 in The International Journal of Radiation Oncology, Biology, and Physics (IJROBP), Practical Radiation Oncology (PRO), and Advances in Radiation Oncology (ARO). Review, editorial, and correspondence article types were excluded. MS authors were defined as individuals affiliated with a medical school but lacking an MD, DO, or PhD degree. The primary faculty mentor was defined as the senior (last) author. Information related to article type, methods, institution, and author position was recorded. Descriptive statistics and Chi square test were used where appropriate. <h3>Results</h3> A total of 105 of 1,785 articles (6%) included a MS author, among which 72 (69%) were clinical, 13 (11%) training/education, 12 (11%) case reports, and 8 (8%) basic science. MS authors were more common for publications in ARO (9%) than PRO (6%) or IJROBP (4%, <i>p</i> = 0.002). Thirty-eight (32%) MSs were first author, 26 (22%) second author, and 55 (46%) third author or beyond. There were 88 unique faculty mentors for these articles, with 10 mentors (11%) on 2 or more MS publications, and 57 mentors (64.7%) sharing the same institution as the MS. The median number of articles per mentor institution was 1 (interquartile range 1-2), and the mentor institutions in the upper quartile in terms of number of MS publications accounted for 53 (50.5%) of all MS publications. <h3>Conclusion</h3> Over the past 3 years, a small fraction of publications in ASTRO journals included MS authors, with mentorship disproportionately from a small number of academic faculty at select institutions. Though RO faculty may mentor MSs on projects published in other journals, efforts to more broadly encourage academic RO faculty to offer MSs research opportunities on RO-related projects may help stimulate more interest in RO, and reverse the recent trend of fewer residency applicants.

Assessing the Impact of Diverse Approaches of Promoting Virtual Radiation Oncology Educational Content to Medical Students

Assessing the Impact of Diverse Approaches of Promoting Virtual Radiation Oncology Educational Content to Medical Students

Current Practice Patterns among Radiation Oncologists at High-Volume Pancreatic Cancer Centers Participating in the Canopy Cancer Collective Learning Health Network

<h3>Purpose/Objective(s)</h3> Radiation therapy (RT) for localized pancreatic ductal adenocarcinoma (PDAC) remains controversial, with conflicting data likely resulting in variable practice patterns. The Canopy Cancer Collective (CCC) is a learning health network of 14 institutions with high-volume multidisciplinary PDAC teams. To characterize the current state of RT for PDAC at high-volume, academic centers, radiation oncology faculty at CCC member institutions were surveyed. <h3>Materials/Methods</h3> A survey focusing on RT practice patterns for localized PDAC was distributed to 18 faculty with expertise in gastrointestinal RT at CCC sites. Survey results are descriptively reported. <h3>Results</h3> The survey was completed by 17/18 (94%) faculty. Among respondents, the number of localized PDAC patients treated per year with RT included >50 (n=5, 29%), 26-50 (n=8, 47%), 10-25 (n=3, 18%), and <10 (n=1, 6%). Two (12%) respondents reported that they routinely offer pre-operative RT for resectable PDAC. Majority of respondents (n=15, 88%) indicated that pre-operative RT is offered to certain patients with borderline resectable pancreatic cancer (BPRC), but the specific proportion of BRPC patients receiving pre-operative RT was variable across respondents (median 70%, range: 10-100%). Similarly, majority of respondents (n=16, 94%) indicated that RT is offered as definitive treatment for certain patients with locally advanced pancreatic cancer (LAPC), but the specific proportion of LAPC patients receiving RT was also variable (median 80%, range: 20-100%), as was the estimated proportion of LAPC patients who eventually undergo resection (median 25%, range 2-50%). Table 1 summarizes the distribution of preferred planning techniques and target volumes used by respondents in both the pre-operative and definitive settings. Variation was also seen in use of fiducials (n=12, 71%), preferred motion management strategy (breath-hold: n=12, 71%; gating: n=5, 29%), systematic use of adjunctive imaging beyond CT for target delineation (MRI: n=6, 35%; PET: n=3, 18%), and use of prophylactic anti-emetics (n=5, 29%) and proton pump inhibitors (n=11, 65%). <h3>Conclusion</h3> RT practice patterns for the treatment of localized PDAC remain disparate, with significant variation in institutional standards across stage of disease as well as in basic treatment parameters such as prescription dose and target volume design. A better understanding of the basis for such variation may help guide future avenues of study.

Diversity Trends by Sex and Underrepresented in Medicine Status Among US Radiation and Medical Oncology Faculty Over 5 Decades

It remains unclear how the historical exclusion of women and racial and ethnic minority groups from medical training, and therefore the oncologic subspecialties, has contributed to rates of faculty diversity among oncology departments over time. Oncologic faculty diversity is an important initiative to help improve care and address health disparities for an increasingly diverse US population with cancer. To report trends in academic faculty representation by sex and by race and ethnicity for radiation oncology (RO) and medical oncology (MO) departments and to describe comparisons with the general US population, medical students, RO and MO trainees, clinical department chairs, and faculty in other departments. This cross-sectional analysis used data from the Association of American Medical Colleges to analyze trends by sex and by race and ethnicity among full-time US faculty in RO and MO departments from 1970 through 2019. Data were analyzed between October 2020 and April 2021. Proportions of women and individuals from underrepresented in medicine (URM) racial and ethnic groups (Black, Hispanic, and Indigenous individuals) were calculated among RO and MO academic departments; trends were analyzed over 5 decades. These proportions were compared with cohorts already described. In addition, proportions of women and URM individuals were calculated by faculty rank among RO and MO departments. In 1970, there were 119 total faculty in RO (10 women [8.4%] and 2 URM [1.7%]) and 87 total faculty in MO (11 women [12.6%] and 7 URM [8.0%]). In 2019, there were 2115 total faculty in RO (615 women [29.1%] and 108 URM [5.1%]) and 819 total faculty in MO (312 women [38.1%] and 47 URM [5.7%]). Total faculty numbers increased over time in both RO and MO. Faculty representation of URM women proportionally increased by 0.1% per decade in both RO (95% CI, 0.005%-0.110%; P <. 001 for trend) and MO (95% CI, -0.03% to 0.16%; P = .06 for trend) compared with non-URM women faculty, which increased by 0.4% (95% CI, 0.25%-0.80%) per decade in RO and 0.7% (95% CI, 0.47%-0.87%) per decade in MO (P < .001 for trend for both). Faculty representation of URM men did not significantly change for RO (0.03% per decade [95% CI, -0.008% to 0.065%]; P = .09 for trend) or MO (0.003% per decade [95% CI, -0.13% to 0.14%]; P = .94 for trend). Representation of both women and URM individuals among both specialties was lower than their representation in the US population in both 2009 and 2019. Across all cohorts studied, RO faculty had the lowest URM representation in 2019 at 5.1%. At every rank in 2019, the number of total URM faculty represented among both MO and RO remained low (MO: instructor, 2 of 44 [5%]; assistant professor, 18 of 274 [7%]; associate professor, 13 of 177 [7%]; full professor, 13 of 276 [5%]; and RO: instructor, 9 of 147 [6%]; assistant professor, 57 of 927 [6%]; associate professor, 20 of 510 [4%]; full professor, 18 of 452 [4%]). This cross-sectional study suggests that RO and MO academic faculty have increased the representation of women over time, while URM representation has lagged. The URM trends over time need further investigation to inform strategies to improve URM representation in RO and MO.

Formal Research Mentorship of Medical Students in Radiation Oncology: A 15-Year Experience

<h3>Purpose/Objective(s)</h3> At our institution, students receive formal research mentorship by radiation oncology faculty mentors through structured research programs, such as the Medical Student Summer Research Program (MSSRP) and radiation oncology research elective, as well as in extracurricular research time. In this analysis, we report the research productivity of students who engaged in formal radiation oncology mentorship over the past 15 years. <h3>Materials/Methods</h3> We compiled a database of all publications, consisting of abstracts (including oral and poster presentations) and manuscripts, co-authored by 58 students from 2005 to 2020. We searched radiation oncology faculty curriculum vitae as well as PubMed to identify publications with student authors. The means, medians, ranges, and interquartile ranges (IQR) of co-authorships and first authorships were calculated for the overall cohort and compared for male versus female students as well as students who matched into radiation oncology and those who matched into other fields. <h3>Results</h3> Among all 58 students, 106 unique abstracts and 70 unique manuscripts were identified. Of the 58 students, 54 (93.1%) published at least one abstract or manuscript. The mean number of abstract co-authorships per student was 3.07 (median 2, range 0-25, IQR 0-4), and the mean number of manuscript co-authorships per student was 2.22 (median 1, range 0-18, IQR 1-3). There were no significant differences in research output between male and female students. However, the students who matched into radiation oncology published more co-author manuscripts (mean 3.67, median 3, IQR 1-5) than those who matched into other fields (mean 1.63, median 1, IQR 1-2), <i>P</i> = 0.014. They also published more first-author manuscripts (mean 1.62, median 2, IQR 0-3) than those who matched into other fields (mean 0.53, median 0, IQR 0-1), <i>P</i> = 0.006. Among the 51 students who have graduated, the top three specialties that students matched into were radiation oncology with 21 (41.2%) students, internal medicine with 9 (17.6%) students, and radiology with 6 (11.8%) students. <h3>Conclusion</h3> In this 15-year analysis, students mentored by radiation oncology faculty are successful with high research productivity. The results of this analysis lay the groundwork for further implementation of formal medical student research mentorship programs, which will in turn allow for more research on the benefits of mentorship. Further research is warranted to assess whether skills gained from student-directed research translate into residency and beyond.

Radiation Oncology Virtual Education Rotation 2.0 for Residents: Preliminary Results

<h3>Purpose/Objective(s)</h3> Radiation Oncology Virtual Education Rotation (ROVER) is a virtual education platform developed to support radiation oncology education for medical students during COVID19 when away and in-person rotations were suspended. Due to the positive reception of ROVER, we created ROVER2.0 tailored to radiation oncology residents. <h3>Materials/Methods</h3> ROVER2.0 comprises monthly case-based discussions on various topics with radiation oncology faculty from across the country and is tailored to radiation oncology residents. Sessions are 1 hour in duration and hosted over Zoom. Sessions were advertised on social media (Twitter) and on ARRO, ACRO, and ADROP mailing lists. Pre- and post-session surveys were used to explore resident perspectives on virtual education and assess the utility of virtual education as a modern learning platform. <h3>Results</h3> Five ROVER2.0 sessions have been held, led by 17 faculty from 16 institutions (3-4 faculty per session) with a total of 868 registrants (R), 445 attendees (A), and 152 post-survey respondents (P): gastrointestinal (R = 186, A = 103, P = 50), genitourinary (R = 159, A = 83, P = 29), central nervous system (R = 140, A = 58, P = 19), pediatrics (R = 177, A = 94, P = 27), and head and neck (R = 206, A = 107, P = 27). 43.5% of registrants were female, 6.1% were PGY-1, 37.3% were PGY-2/3, and 45% were PGY-4-5. Of all registrants, 82% signed up for ROVER2.0 for the "opportunity to hear from a diverse expert panel." At baseline, 73.5% reported that their home programs conducted mock oral exams and programs were reported to have a median of 5 hours/week of dedicated didactics. A third or fewer reported that COVID-19 negatively impacted residency didactics (22.8%), faculty engagement in teaching (30.8%), or access to faculty (33.9%). 24.2%, 37.3%, and 38.5% of respondents felt that virtual platforms are superior, equal, or inferior to in-person learning, respectively. 98.0% considered the sessions very valuable or valuable and that it was very easy or easy (94.1%) to learn through the virtual format. 83.6% strongly agreed or agreed that they felt more confident treating the disease site cancer as a result of the session. 84.2% reported that they had no difficulty attending sessions due to clinical responsibilities. <h3>Conclusion</h3> ROVER2.0 case-based sessions can augment radiation oncology residency didactics by providing exposure to different practices across the country as an adjunct to in-person learning. Most respondents felt that COVID-19 did not negatively impact educational quality, and a rapid transition to virtual platforms likely served as an important buffer. ROVER2.0 was met with enthusiasm and considered an effective teaching tool by radiation oncology resident participants. This virtual and open-access resource can facilitate accessible and equitable education to those negatively impacted by in-person learning restrictions and allow broader dissemination of information about radiation oncology.

Longitudinal Outcomes of Medical Student Research Mentorship: a 15-Year Analysis of the Radiation Oncology Mentorship Initiative.

At our institution, students can be mentored by radiation oncology faculty through structured research programs, such as the Medical Student Summer Research Program (MSSRP). The purpose of this study is to report the research productivity of students who engaged in radiation oncology research mentorship, whether through the MSSRP or other avenues of research mentorship. We compiled a database of abstracts and manuscripts co-authored by 58 students who conducted research with radiation oncology faculty from 2005 to 2020. The means, medians, ranges, and interquartile ranges (IQR) of co-authorships and first authorships were calculated for the overall cohort and compared for MSSRP and non-MSSRP students, who matched into radiation oncology and those who did not, and male versus female students. Among all 58 students, 106 abstracts and 70 manuscripts were identified. Of those students, 54 (93.1%) published at least one abstract or manuscript. The mean number of abstract co-authorships per student was 3.07 (median 2, range 0-25, IQR 0-4), and the mean number of manuscript co-authorships per student was 2.22 (median 1, range 0-18, IQR 1-3). There were no significant differences in research output between MSSRP and non-MSSRP students or male and female students. However, the students who matched into radiation oncology published more co-author (3.67 vs. 1.63, p = 0.01) and first-author (1.62 vs. 0.53, p = 0.006) manuscripts than those who did not. Further research is warranted to assess whether skills gained from student-directed research translate into residency and beyond.

U.S. radiation oncology and medical oncology department faculty diversity trends by sex and underrepresented in medicine status over five decades.

11010 Background: Academic faculty are critical in training future generations of oncologists to care for our increasingly diverse cancer patient population. It is unclear if the growing imperative to address disparities in racial/ethnic and gender representation in the medical field has resulted in corresponding progress in the composition of academic radiation and medical oncology (RO, MO) departments. Herein we report trends in faculty diversity, overall and by academic rank, among US radiation and medical oncologists over the past 5 decades. Methods: Data were acquired from the Association of American Medical Colleges (AAMC) Faculty Roster between 1970-2019 for academic RO and MO departments to determine sex and race/ethnicity trends over five decades. Underrepresented in Medicine (URM) was defined as individuals identifying as Black, Hispanic, and Native American. Linear regression models were used to estimate slopes and associated p-values. Results: Total faculty complements grew over time in both RO and MO departments. The number of URM female faculty increased by 0.85/year in RO and 0.79/year in MO (P-trend&lt;0.001), compared to non-URM female faculty, which increased by 11.3/year in RO and 7.9 in MO (P-trend&lt;0.001). URM male faculty increased by 1.4/year in RO and 1.1/year in MO (P-trend&lt;0.001), compared to non-URM male faculty, which increased by 25.5/year for RO and 12.2/year for MO (P-trend&lt;0.001). Males represented the majority of URM and non-URM faculty for both RO and MO. The proportion of females grew more than the proportion of URM faculty over the study period for both RO and MO. There were also significant differences in diversity by faculty rank. Although MO outperformed RO in terms of the proportion of female faculty members with more advanced rank, female faculty members had a lower academic rank than their male counterparts in both specialties. At every rank, there was a low number of URM faculty represented among both MO and RO (Table). Conclusions: Gender and racial/ethnic diversity of academic RO and MO faculty has increased over time but has not kept pace with the diversity of the US population served, particularly with respect to URM status. The proportion of female faculty in both specialties demonstrates more promising growth, and may inform measures to achieve similar progress in recruiting and retaining URM faculty in both MO and RO.[Table: see text]

Radiation Oncology Medical Student Formal Research Mentorship: Update on the Medical Student Summer Research Program

The Medical Student Summer Research Program (MSSRP) at our institution provides the opportunity for medical students to conduct 7-10 weeks of supported research between their first and second years in medical school. Interested students submit a research proposal in collaboration with a faculty mentor. The program includes sessions on responsible conduct of research, critical thinking, and presentation skills. Herein we report research output based on total publications and presentations from students who have participated in the MSSRP with a radiation oncology faculty mentor, as well as their future career choice. Since 2005, radiation oncology faculty have mentored 16 medical students on a variety of projects in the MSSRP. Data were collected on the total number of unique publications (manuscript or abstract) authored by these 16 students, number of publications with a student as the first author versus co-author, and for the 10 students who have graduated, what their residency choice was. Among the 16 students, 37 unique abstracts and 22 unique manuscripts have been presented or published, which represents a mean of 2.31 abstracts per student and 1.38 manuscripts per student, respectively. Of the 37 abstracts, 18 (48.6%) had a student as the first author, while out of the 22 manuscripts, 7 (31.8%) had a student as the first author. Furthermore, 27 abstracts had one student author, while 10 abstracts had two student authors. Sixteen manuscripts had one student author, while 6 had two student authors. None of the abstracts or manuscripts had three or more student authors. For abstracts, the distribution of co-authorships is as follows: 18 first authors, 9 second, 5 third, 5 fourth, 9 fifth, and 1 sixth. For manuscripts, the distribution of co-authorships is as follows: 7 first authors, 3 second, 10 third, 3 fourth, 2 fifth, 1 sixth, and 2 seventh. A total of 6 abstracts were selected for oral presentation at national conferences. Among the ten students who have graduated, 3 (30%) chose to pursue careers in radiation oncology, and the remaining students include 2 current medical oncology fellows, 2 internal medicine residents, 1 radiology resident, 1 dermatology resident, and 1 attending neurologist. Radiation oncology research mentorship via the MSSRP, a formal, funded summer program, has allowed for successful student research. Participation in the MSSRP is beneficial in promoting research skills that lead to future publications in the form of abstracts, oral presentations, and manuscripts. Radiation oncology faculty mentorship is productive for students entering both radiation oncology and non-radiation oncology residencies.

I Can’t Breathe: The Continued Disproportionate Exclusion of Black Physicians in the United States Radiation Oncology Workforce

PurposeBlack physicians remain disproportionately underrepresented in certain medical specialties, yet comprehensive assessments in radiation oncology (RO) are lacking. Our purpose was to report current and historical representation trends for Black physicians in the US RO workforce.Methods and MaterialsPublic registries were used to assess significant differences in 2016 representation for US vs RO Black academic full-time faculty, residents, and applicants. Historical changes from 1970 to 2016 were reported descriptively. Linear regression was used to assess significant changes for Black residents and faculty from 1995 to 2016.ResultsIn 2016, Black people represented 3.2% vs 1.5% (P < .001), 5.6% vs 3.2% (P = .005), and 6.5% vs 5.4% (P = .352) of US vs RO faculty, residents, and applicants, respectively. Although RO residents nearly doubled from 374 (1974) to 720 (2016), Black residents peaked at 31 in 1984 (5.9%; 31 of 522) and fell to 23 (3.2%; 23 of 720) in 2016 across 91 accredited programs; Black US graduate medical education trainees nearly doubled over the same period: 3506 (1984) to 6905 (2016). From 1995 to 2016, Black US resident representation significantly increased by 0.03%/y, but decreased significantly in RO by –0.20%/y before 2006 and did not change significantly thereafter. Over the same period, Black US faculty representation significantly increased by 0.02%/y, whereas Black RO faculty significantly increased by 0.07%/y before 2006, then decreased significantly by –0.16%/y thereafter. The number of Black RO faculty peaked at 37 in 2006 (3.1%; 37 of 1203) and was 27 (1.5%; 27 of 1769) in 2016, despite the nearly 1.5-fold increase in the number of both RO faculty and Black US faculty overall (4169 in 2006 and 6047 in 2016) during that period.ConclusionsBlack physicians remain disproportionately underrepresented in RO despite an increasing available pipeline in the US physician workforce. Deliberate efforts to understand barriers to specialty training and inclusion, along with evidence-based targeted interventions to overcome them, are needed to ensure diversification of the RO physician workforce.

Assessment of the Medical Schools From Which Radiation Oncology Residents Graduate and Implications for Diversifying the Workforce

To identify factors predictive of a medical school graduating a high volume of future radiation oncology (RO) residents to better understand potential pathways to effectively recruit women and underrepresented minority (URM) students into RO. Demographics for US allopathic medical schools and affiliated RO departments were collected from web resources and correlated with the percentage of graduates from each school currently enrolled in RO residency in 2019, and the probability of at least 1 female or URM student from each school pursuing RO. The median percentage of students per medical school who pursued RO residency was 0.37% (interquartile range, 0.16%-0.66%). A total of 79.7% of schools graduated at least 1 RO resident, whereas 51.7% graduated at least 1 female RO resident and 14.0% graduated at least 1 URM RO resident. The 30 schools graduating the highest percentage of RO residents accounted for 52.1% of current RO residents, only 4 of which were in the top quartile for URM enrollment. Medical students were significantly more likely to pursue RO when there was an affiliated RO department (0.42% vs 0.18%, P < .001) or RO residency program (0.51% vs 0.18%, P < .001), more total RO faculty (rs = 0.521, P < .001), female RO faculty (rs = 0.481, P < .001), and URM RO faculty (rs = 0.197, P < .001). The probability of at least 1 female student pursuing RO was also correlated with the number of female faculty in the affiliated RO department (rpb = 0.348, P = .001), and a similar correlation was observed between URM students and URM faculty (rpb = 0.312, P = .011). Most RO residents graduate from medical schools with larger affiliated RO departments but fewer URM students. To promote greater RO diversity, outreach should be considered among schools with greater URM enrollment but fewer affiliated radiation oncologists, and among female and URM students in schools that graduate many RO residents.

Abstract B26: Analysis and comparison of survival and functional outcomes in oropharyngeal squamous cell carcinoma patients within City of Hope Cancer Center sites

Abstract Introduction: Oropharyngeal squamous cell (OPSCC) is a subset of head and neck cancers and is known to be associated with human papillomavirus (HPV). We designed a retrospective analysis to determine differences in survival and functional outcomes of OPSCC patients treated at City of Hope (COH) Cancer Center’s main campus versus selected satellite sites with COH-associated faculty and facilities. Methods and Materials: A retrospective analysis was done on patients diagnosed with OPSCC and treated with concurrent chemoradiation therapy from May 2009 to February 2017 at COH main campus or satellite sites. Eligible patients (N=94) had available demographic data, treatment data, survival and functional outcomes, and recent follow-up at a COH site. Results: 50 patients underwent treatment at the COH main campus and 44 at its satellite sites. Majority of patients were Caucasian (38 patients at main campus, 32 patients at satellite sites), male (40 at main campus, 39 at satellite sites), diagnosed with stage IV locally advanced OPSCC by AJCC 7th edition (43 vs. 32 patients), and p16 positive (42 vs. 30 patients). There was an equal smoking history distribution within our cohort (50% never smokers, 50% former/current smokers at both sites). A small subset of patients at both sites underwent surgical resection prior to concurrent chemoradiation (N=23, 25%). Chemotherapy agents chosen for treatment included cisplatin, carboplatin, cetuximab, and platinum/paclitaxel. Cisplatin was highly favored at the main campus (N=39, 78%); cisplatin (N=21, 48%) and cetuximab (N=21, 48%) use was equally distributed at the satellite sites. Of the 60 cisplatin-treated patients, 58 (98%) received the recommended total minimum dose of 200 mg/m2. Majority of patients completed their prescribed cumulative radiation therapy dose (50-70 Gray) (49 [98%] at main campus, 43 [98%] at satellite sites) and had a complete response to treatment (35 [70%] at main campus, 37 [84%] at satellite sites). There were few hospitalizations during the course of treatment (6 at the main campus, 4 at the satellite sites). 12 patients (24%) at the main campus and 19 patients (43%) at the satellite sites underwent feeding tube placement. A trend toward significant difference in feeding tube dependency at 6 months was observed between the main campus (N=2) and satellite sites (N=11) (17% vs. 58%, p=0.08). No significant difference in the 2-year recurrence rate was observed between the main campus (N=5) and the satellite sites (N=7) (10% vs. 16%, p&amp;gt;0.05). Conclusion: Our retrospective analysis highlights comparable recurrence rates between a major tertiary cancer center and selected satellite sites with dedicated radiation and medical oncology faculty and facilities. Discrepancies in the feeding tube dependency rates could be potentially overcome by integration of supportive services between satellites and main campus. This study also highlights the importance of telehealth services in major institutions. Citation Format: Rebecca R. Pharaon, Ellie Maghami, Arya Amini, Atish Mohanty, Nayana Vora, Sue Chang, Thomas Gernon, Robert Kang, Lalit Vora, Samuel Chung, Sagus Sampath, Erminia Massarelli. Analysis and comparison of survival and functional outcomes in oropharyngeal squamous cell carcinoma patients within City of Hope Cancer Center sites [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B26.

Abstract A075: Gender diversity in academic oncology programs

Abstract Purpose: This study sought to examine gender diversity among academic faculty of medical oncology, hematology/oncology, and radiation oncology residency programs in the United States (U.S.), Canada, and Spain. Methods: Data from the Association of American Medical College (AAMC) were used to examine faculty composition of medical oncology, hematology/oncology, and radiation oncology departments in U.S. institutions for the years 1977 and 2017. For international data, public webpages listing post-graduate training programs in medical oncology and radiation oncology were examined and the genders of department heads were recorded. Results: In the U.S., in 1977, women made up 8%, 9%, and 7% of the total workforce among hematology/oncology, medical oncology, and radiation oncology faculty positions, respectively, compared to 44%, 40%, and 27%, respectively, in 2017. Regarding departmental leadership, in the U.S., 9% (8/89) of radiation oncology department chairs were women. In Canada, for radiation oncology, 11 department heads were men, 1 was a woman, and 1 department could not be determined (8-15% women). For medical oncology, 10 department heads were men, 3 women, and 2 were unknown (20-33% women). In Spain, 12 radiation oncology heads were women, 28 men, and 8 were unknown (25-42% women); for medical oncology, 14 department heads were women, 52 were men, and 11 were unknown (25-42% women). Conclusions: Women have historically increased in representation in the U.S. oncology workforce; however, they remain under-represented relative to the overall U.S. population. Women were also under-represented at the level of chair in the U.S., Canada, and Spain. Further research and efforts are needed to enlist and advance women in oncologic fields both nationally and internationally and understand barriers to training, practice, and advancement. Citation Format: Crystal S. Seldon, Awad A. Ahmed, Ricardo Llorente, Stella K. Yoo, Emma B. Holliday, Charles R. Thomas, Reshma Jagsi, Curtiland Deville Jr. Gender diversity in academic oncology programs [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A075.