Recent Industry Payment Trends Across Radiation Oncology Residency Program Leadership

Summary: The landscape of industry funding to radiation oncology residency program leadership is poorly understood, and may be a useful evaluation metric for prospective applicants or accrediting bodies. This study examines recent payment trends among Charis, Program Directors (PDs), and Associate Program Directors (APDs). We expect that payments will vary by leadership role, gender, academic rank, geographic region, and years of post-residency career experience. Chairs, PDs, and APDs for each program were identified from the Association of Residents in Radiation Oncology (ARRO) Directory. Gender, academic rank, geographic region, and years of post-residency career experience for each individual were then obtained from program websites. We extracted industry payments made to leaders in 2021 and 2022 from the U.S. Centers for Medicare & Medicaid Services open payments database. Kruskal-Wallis and Mann-Whitney U tests were used to compare payment differences between groups. Multiple regression analyses was performed on log-transformed payments to identify predictive variables. Of 86 Chairs, 89 PDs, and 48 APDs identified, 24 (28%), 14 (16%), and 8 (17%) were paid, respectively. Among all Chairs, 74 (86%) were male and 12 (14%) were female. PDs consisted of 50 (56%) males and 39 (44%) females, while APDs consisted of 21 (44%) males and 27 (56%) females. Leading ranks of Chairs, PDs, and APDs paid were Professor (87.5%), Associate Professor (50%), and Assistant Professor (62.5%), respectively. Median years of post-residency career experience for Chairs, PDs, and APDs who were paid were 21, 14.5, and 9, respectively (p=0.015). Payments totaled $15,229,066 during 2021-2022, increasing +90.1% from 2021 to 2022 ($5,250,065 vs $9,979,001). Nonetheless, mean ($128,728 vs $262,605; p=0.13) and median payments ($23,930 vs $69,090; p=0.14) by year were comparable. Majority of payments were research-related (96.8%), followed by ownership (3.1%), consulting fees and food/beverage (< 1%). APDs received the highest median payment compared to PDs and Chairs ($68,377 vs $55,515 vs $38,753, respectively; p=0.57). Midwest program leadership received $6,466,541, representing the majority (42.5%) of payments across all regions. Males received more total payments than females ($11,143,458 vs $4,061,028), though mean ($216,816 vs $287,630; p=0.58) and median ($72,915 vs $7,785; p=0.13) payments were not statistically significantly different. Of Chairs paid, 21 (87.5%) were male and 3 (12.5%) were female. PDs paid had even gender distribution, with 7 (50%) males and 7 (50%) females. Of APDs paid, 6 (75%) were male and 2 (25%) were female. On multiple regression analysis, no variables were found to be statistically significant predictors of payment. Total industry payments to radiation oncology residency program leadership increased from 2021 to 2022, and varied by leadership position, academic rank, gender, geographic region, and years of post-residency career experience. More detailed analyses and further investigation of additional contributive factors are warranted to improve equity and transparency. Rojine T. Ariani (she/her/hers), MD, MS (Presenting Author) - Department of Radiation Oncology, UCLA; Luca Valle, MD (Co-Author) - University of California, Los Angeles; Michael Steinberg, MD (Co-Author) - University of California, Los Angeles; Ann Raldow, MD, MPH (Co-Author) - University of California, Los Angeles