Domestic Job Shortage or Job Maldistribution? A Geographic Analysis of the Current Radiation Oncology Job Market

Abstract

Purpose To examine whether permanent radiation oncologist (RO) employment opportunities vary based on geography. Methods and Materials A database of full-time RO jobs was created by use of American Society for Radiation Oncology (ASTRO) Career Center website posts between March 28, 2016, and March 31, 2017. Jobs were first classified by region based on US Census Bureau data. Jobs were further categorized as academic or nonacademic depending on the employer. The prevalence of job openings per 10 million population was calculated to account for regional population differences. The χ2 test was implemented to compare position type across regions. The number and locations of graduating RO during our study period was calculated using National Resident Matching Program data. The χ2 goodness-of-fit test was then used to compare a set of observed proportions of jobs with a corresponding set of hypothesized proportions of jobs based on the proportions of graduates per region. Results A total of 211 unique jobs were recorded. The highest and lowest percentages of jobs were seen in the South (31.8%) and Northeast (18.5%), respectively. Of the total jobs, 82 (38.9%) were academic; the South had the highest percentage of overall academic jobs (35.4%), while the West had the lowest (14.6%). Regionally, the Northeast had the highest percentage of academic jobs (56.4%), while the West had the lowest (26.7%). A statistically significant difference was noted between regional academic and nonacademic job availability (P=.021). After we accounted for unit population, the Midwest had the highest number of total jobs per 10 million (9.0) while the South had the lowest (5.9). A significant difference was also observed in the proportion of RO graduates versus actual jobs per region (P=.003), with a surplus of trainees seen in the Northeast. Conclusions This study presents a quantitative analysis of the RO job market. We found a disproportionately small number of opportunities compared with graduates trained in the Northeast, as well as a significant regional imbalance of academic versus nonacademic jobs. Long-term monitoring is required to confirm these results.

Regional Influence of Radiation Oncology Residency Training on Job Securement over Two Time Periods

“…The analysis reported here within supports this conclusion as only 50% of residents trained in the Northeast were employed there, which is significantly lower than the rate of trainees in the South (66%) and West (70%) who stayed in their respective regions for employment. Chowdhary et al also demonstrated that the Midwest had more jobs available than the number of graduating residents, with roughly two trainees for every three jobs (proportion of total jobs to graduates, 1.54) [13]. This study's findings suggest that Midwest-trained graduates are just as likely to take these jobs as graduates from other regions.…”

“…A point of contention is whether residents' dissatisfaction with the current job landscape is due to an oversupply of ROs, a maldistribution of ROs, or a combination of both. Chowdhary et al [13] shed light on this topic. The authors demonstrated that the Northeast trains far more residents than jobs available in that region with roughly five trainees for every four jobs (proportion of total jobs to graduates, 0.78).…”

Top Concerns of Radiation Oncology Trainees in 2019: Job Market, Board Examinations, and Residency Expansion

“…3 Interestingly, a majority of jobs were either located in the Midwest (n Z 51, 23.7%) or South (n Z 60, 27.4%), reflecting a potential mismatch in positions sought (ie, West Coast) versus those that are currently offered. 3 Figure 3 gives the geographic distribution of all posted positions by job type in 2018, including an additional 38 part-time jobs, locums, or instructor positions, for a total of 257 unique postings. Accurate information regarding the distribution of available jobs is important to graduating residents and medical students considering RO.…”

Regional Differences in the Treatment of Localized Prostate Cancer: An Analysis of Surgery and Radiation Utilization in the United States

“…Significant regional imbalances of academic versus nonacademic radiation oncology jobs, regional job availability, and a surplus of radiation oncology trainees may exist in the Northeast. 20 There are also more National Cancer Institute–designated cancer centers in the Northeast and South Atlantic regions than other regions in the United States. One study found that the further patients live from a radiation center, the less likely they are to choose radiation for their prostate cancer treatment.…”

“…The reasons for this are likely similar to those previously described for RT, namely the increased proportion of academic centers in the Northeast. 20 …”