A Resident Quality Improvement Incentive Program in Radiation Oncology: 15-Year Experience at a Single Institution

Radiation oncology (RO) resident participation in quality improvement (QI) is mandated in the United States by the Accreditation Council for Graduate Medical Education; however, the degree of involvement and methods of implementation are not specified. This study evaluated a resident-driven QI incentive program at a single institution over a 15-year period.

Residents in an RO program were encouraged to develop, implement, and evaluate an annual QI project. At the completion of the academic year, residents were eligible for a financial incentive if the predetermined QI goal was met. The primary outcome in this study was program sustainability, defined as the number of years with resident participation divided by the total number of program years. Project success was defined as meeting the predetermined annual QI goal. Scholarly impact was measured by the number of scholarly works (manuscripts, abstracts, or posters) that resulted from resident-led QI projects. Project sustainability was also assessed, defined as continued efforts in the 3 years following the QI project. All data were obtained from a retrospective review of projects and related presentations.

From 2010 to 2025, RO residents led 14 QI projects as part of a QI incentive program. Program sustainability was 93%. Project success was 93%. Over the 15-year period, 12 of 14 (86%) projects led to scholarly works. Project sustainability was 100%.

This study showed that a resident-led QI program was sustainable, academically productive, and effective in meeting resident QI goals. Because this was a single-institution study, future work is needed to determine feasibility for other programs.