Perceived Factors That Enable Resident Entry to the Specialty of Radiation Oncology

The field of radiation oncology (RO) has experienced large fluctuations in the number of applicants to residency programs. It is essential to understand the modifiable factors which influence entry. The objective of this project is to identify factors (i.e., "enablers") that motivate prospective medical students to apply to RO. A survey was developed to characterize RO enablers and barriers as perceived by current RO residents. An existing conceptual framework of why medical students choose primary care was used as the foundation of the survey and was modified for relevance towards RO. The final mixed-methods survey was administered to Canadian RO residents (2015-2019 match years) via Program Directors and the Canadian Association of Radiation Oncologists resident member database. Medical students are most likely to select a career in RO during or after a clerkship experience. Extrinsic factors strongly motivating interest in RO were (% rating as very important or extremely important on a 5-point scale) as follows: positive feedback from radiation oncologists (86%) and RO residents (66%), clinical rotations in RO (84%) and mentorship (77%). Intrinsic factors include perceived fulfillment (95.2%), commitment to patient care (85.3%), and intellectual challenge (67.7%). Qualitative data highlighted the importance of mentorship, the "hand-heart" connection, career variability/flexibility, career satisfaction/lifestyle, and personal connections with cancer/cancer care in motivating students to pursue RO. Increased preclinical exposure such as mentorship may encourage students to seek clerkship opportunities in RO. These findings inform strategies to recruit medical students to a career in RO.