Workforce Trends Among Canadian Medical Oncologists and Medical Oncology Trainees over Two Decades

Background: Understanding oncology health human resources across Canada is critical to the delivery of quality cancer care. Little has been published about the medical oncology (MO) workforce and trainees; this study sought to characterize trends in the MO workforce and explore the relationship between medical oncologists and cancer incidence as a surrogate demand marker. Materials and Methods: Publicly available databases from the Canadian Medical Association, the Canadian Institute of Health Information, and the Canadian Post MD Education Registry were utilized to estimate the number, demographics, and regional distribution of practicing MOs and MO trainees between 1994 and 2020. Cancer incidence by province was obtained from Statistics Canada. To estimate changes in demand for, and supply of, medical oncology services over time, annual cancer incidence to MO provider ratios were calculated. Results: Between 1994 and 2020, annual cancer incidence nationally rose from 120,255 to 225,800 cases, while the number of MOs increased by 298%. Incident cancer case to medical oncologist (MO) ratio dropped from 749:1 to 352:1 in the same time. However, the MO workforce is aging; in 2020, 40% of providers were ≥50 years old versus 24% in 1994. Trends in Canadian MO trainees mirror MO trends. Ontario has the largest proportion of the country's MOs (34% in 2020) and MO trainees (49%). Conclusions: Although the Canadian MO workforce has grown, more MO providers are nearing retirement age, which may influence future workforce trends. Ongoing monitoring of human resources in oncology is essential to ensure future demands for services are met.