Hi everyone. My name is Kunal Sindhu and I'm an assistant professor of radiation oncology at the Icahn School of Medicine at Mount Sinai in New York City, and on behalf of my team, I'm here to present some of the results from our new paper entitled, "Academic and Geographic Employment Outcomes for Graduating Residents in Radiation Oncology: 2015 to 2022." The job market for new radiation oncology residency graduates is of key interest to a variety of important stakeholders, yet significant debate continues regarding the health of that job market and what if anything should be done to optimize it. Little however, is known about how employment outcomes particularly in the academic and geographic sense have changed over time. Thus, in this study, we sought to identify the academic and geographic employment outcomes of all radiation oncology residents who graduated between 2015 and 2022. To do this, we built a database of all radiation oncology residents who graduated from an ACGME- accredited residency program between 2015 and 2022. We then identified the first permanent job accepted by each graduating resident. We only use publicly available sources of information to build this database. We excluded individuals who accepted fellowships after graduation or did not obtain clinical positions in the United States after graduation. We subsequently identified the rural- urban continuum code (RUCC) of each job and residency program. The RUCC schema categorizes the approximately 3000 counties in the United States as either metropolitan, (approximately one third of counties) or non metropolitan or rural (approximately two thirds of counties). Metropolitan counties are assigned an RUCC code of one through three on the basis of their population, while non metropolitan counties are assigned RUCC code of four through nine on the basis of both their population and their proximity to a metropolitan area. Using this methodology, we identified 1478 radiation oncology residents who graduated from 91 residency programs between 2015 and 2022. Most of these graduates obtained an MD from a medical school in the United States and were male. After excluding 82 graduates who either took a fellowship, did not obtain a clinical position or obtain a clinical position outside of the United States after graduation. We analyzed the employment outcomes for 1396 radiation oncology graduates. A slight minority of these graduates accepted academic positions after residency. Most of these positions were located at academic main sites while fewer were at academic satellites or other academic sites and women were more likely than men to have accepted academic positions. Two hundred and eighty graduates representing 20.1% of the entire cohort or roughly 40% of all the individuals who accepted academic positions after graduation in our sample accepted academic positions at the same institution at which they completed residency. Graduates of large size residency programs were more likely to have accepted academic positions than graduates of medium size and small size programs. Here's one of the tables from our paper. The top half lists the 10 Radiation oncology residency programs that produced the greatest number of graduates who accepted academic positions and the bottom half was the 10 academic institutions which hired the most new graduates in academic positions. While there is some overlap in this table, there are important differences which can be gleaned by further analysis of the table. We also found that approximately 95% of the graduates we analyzed found employment positions in metropolitan areas; most of whom found jobs in the largest metropolitan or RUCC 1 areas. Graduates of small- sized residency programs were more likely than those of large-sized residency programs, to accept positions in nonmetropolitan or those listed as RUCC 4 through 9 areas and more graduates accepted positions per population in RUCC 1, 2, and 3 areas, as compared to those that did so in RUCC 4 through 9 areas. Here's a figure from our paper. The top half shows the proportion of radiation oncology graduates between 2015 and 2022 who accepted academic positions. As you can see there's a steady increase between 2015 and 2020 before there's a significant decline in 2021. The class of 2021 incidentally was a first whose entire job search occurred after the beginning of the COVID-19 pandemic in the United States. The class of 2022 had a partial rebound. The bottom half shows the proportion of radiation oncology graduates over this time period who accepted positions in RUCC 1, 2, 3 and 4 through 9 areas. While there is some variation on a year to year basis, the overall figures were largely stable over the time period examined. This is a second figure from our paper. The map on the left shows the distribution of employment positions accepted by the 2015 to 2022 graduates. The map in the middle shows where those individuals graduated from residency, while the map on the right shows where those individuals graduated from medical school. The three most popular core-based statistical areas in which the 2015 to 2022 graduates accepted employment positions were centered around New York, Los Angeles and Chicago. However, it is worth noting that the number of graduates who completed residency in these areas was significantly higher than the number of graduates who accepted employment positions in these areas. So in conclusion, the vast majority of radiation oncology residents, approximately 95%, accepted permanent clinical positions in the United States immediately after graduation. Most accepted clinical positions in large metropolitan areas and only about 5% accepted positions in rural areas. A slight majority accepted non-academic positions. While the radiation oncology job market was able to absorb the vast majority of these new graduates between 2015 and 2022, there's no guarantee that this equilibrium will hold in the future. Thus, additional studies aiming to further refine projections of future radiation oncology demand are critical and are needed.
