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Racial and Ethnic Diversity of the Oncology Workforce: Projections From 2020 to 2060
William L Roberts1, Pamela R Soulos2, Jeph Herrin3
1National Clinician Scholars Program, New Haven, CT.
Purpose:
Racial and ethnic underrepresentation in medicine (URiM) threatens the capacity of the cancer physician workforce to provide accessible, culturally competent care. We projected racial and ethnic diversity of the workforce through 2060 under three scenarios.
Methods:
We assessed workforce composition using data from the American Medical Association (physician specialty and age) and Association of American Medical Colleges (race/ethnicity) in 2020. We defined URiM as American Indian/Alaska Native; Black or African American; Hispanic, Latino, or of Spanish origin; or Native-Hawaiian/Pacific-Islander. We used stock-and-flow models based on 2020 data to project the racial and ethnic distribution of the workforce by decade from 2030 to 2060 across three scenarios: baseline (URiM distribution remains at 2020 levels); trajectory (growth of URiM% physicians continues at current rates); and doubling (URiM growth is twice the rate of non-URiM growth). We calculated representation ratios (RR) by dividing workforce share by population share for each race group. Finally, we estimated growth in URiM physicians required for the workforce to reach parity with the 2060 US population.
Results:
In 2020, there were 66,450 cancer physicians (11.3% URiM overall, radiation oncology 8.2%, medical oncology 9.9%, surgical oncology 10.2%, palliative care 11.8%, general surgery 13.6%) compared with 31% of the US population. Under baseline conditions, 12.5% of the workforce would be URiM in 2060, compared with 43.2% of the US population (RR, 0.29). Continuing 2010-2020 trends would raise 2060 URiM representation to 16.5% (RR, 0.38). Doubling URiM growth relative to non-URiM would raise 2060 URiM representation to 19.1% (RR, 0.44). Achieving parity would require increasing URiM physicians entering the workforce by 9.5% per decade.
Conclusion:
Across various scenarios of physician recruitment, URiM representation in the cancer physician workforce will remain below half the US population share by 2060.
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