Abstract A83: Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce
Authors: Burgos Ramon , Chapman Christina H. , Hwang Wei-Ting , Both Stefan , Thomas Charles R. , Deville Curtiland 
Published: May 2015

Background/Purpose: Diversification of the oncology physician workforce has been identified as a means to address cancer disparities and serve the impending needs of newly insured patients following the Affordable Care Act, yet limited data exist regarding the current status of its diversity. The specific aim of this study was to assess the demographic diversity of the US Medical Oncology (MO) physician workforce by race, Hispanic ethnicity, and sex, with particular attention to the fellow trainee level.

Materials and Methods: Publicly available American Medical Association, American Association of Medical Colleges, Accreditation Council for Graduate Medical Education, and US Census registries were used to assess differences for 2010 amongst MO academic faculty, Hematology and Oncology fellows and Oncology fellows combined into a single category as “MO” fellows, Internal Medicine (IM) residents, and the US population, and 2008 Oncology practicing physicians – the most recent year available for this group – by using binomial tests; adjusting for multiple comparisons among different groups, differences with P&lt;0.001 were considered significant. To assess significant changes over time in percentages by different race, ethnicity, and sex for all reported academic yrs 1986 – 2011, the slope and associated 95% confidence intervals for each group were estimated using a linear regression model with yr as the independent variable.

Results: Within the MO physician workforce, females and traditionally underrepresented minorities in medicine (URM) – Blacks, Hispanics, American Indians, Alaska Natives, Native Hawaiian, and Pacific Islanders (AI/AN/NH/PI) – are underrepresented as practicing physicians (38.1% and 7.8%, respectively), faculty (22.4%, 5.7%), and fellows (45.0%, 10.9%), compared to the US population (50.8%, 30.0%), (Ps&lt;0.001). As faculty, females (22.4% vs. 38.1%, respectively), Blacks (1.8% vs. 3.5%), and AI/AN/NH/PI (0 vs. 0.2%) were underrepresented compared to practicing physicians (Ps&lt;0.001). As fellows, females (45.0%) and Hispanics (7.5%) were increased compared to both faculty and practicing physicians (Ps&lt;0.001); for Black fellows (3.1%) there were no differences compared to faculty or practicing physicians. When comparing MO fellows to IM residents, there were no differences for AI/AN/NH/PI (0.3% vs. 0.6%, P=0.137), Hispanics (7.5% vs. 8.7%, P=0.139), and females (45.0% vs. 44.7%, P=0.853); Blacks were underrepresented as fellows (3.1%) compared to IM residents (5.6%), P&lt;0.001. Over the past 26 yrs of available data, female representation as fellows has increased significantly at 1.001% per yr (95%CI: 0.867, 1.137; P&lt;0.001). Meanwhile, there has been no significant change in representation of individual URM groups over the past 17 yrs available: AI/AN/NH/PI -0.018% (95%CI: -0.132, 0.096; P=0.726), Blacks -0.063% (95%CI: -0.153, 0.028; P=0.165), Hispanics 0.063% (95%CI: -0.032, 0.158; P=0.178).

Conclusions: Females and URM are underrepresented in the MO physician workforce relative to the US population. Female representation as fellows has increased significantly over the past quarter century at 1% per annum and is increased relative to practicing physicians and academic faculty, indicating historical gains. Meanwhile, there are no significant increases in URM groups over the past 17 yrs, suggesting that racial and ethnic diversity are not increasing. Furthermore, for Blacks alone, representation as fellows is decreased compared to IM residents, suggesting a greater disparity in Blacks entering MO training. Given existing cancer disparities and an increasingly diverse society, future research and training efforts should address increasing trainee diversity.

Note: The author block has been changed and no longer matches the print Proceedings.

Citation Format: Ramon Burgos, Christina H. Chapman, Wei-Ting Hwang, Stefan Both, Charles R. Thomas, Jr., Curtiland Deville. Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A83. doi:10.1158/1538-7755.DISP13-A83