An Analysis of US Radiation Oncology Resident Educational Activity Distribution and Task Efficiency Across Years of Training and Institution

Summary: Radiation oncology residency differs from most specialties in that residents typically have limited clinical experience in the field before starting their training. This leads to a steep learning curve for PGY2 residents, who must quickly adapt to a wide range of novel tasks. Early in training, residents may spend considerable time preparing for clinic or contouring for complex disease sites — over the course of the next 4 years, they are then expected to streamline their workflow to ‘run the service’ as PGY5 residents. However, published guidelines on resident task prioritization and the manner in which responsibilities should evolve throughout training are limited; therefore, assessment of one's own proficiency and efficiency is challenging. Variability in training experiences across institutions further complicates this assessment, as some programs offer unique opportunities in advanced technologies (e.g., proton therapy or adaptive radiation planning) and/or place varying emphasis on formal didactic instruction. Thus, we hypothesize that the radiation oncology educational experience will vary by year and institution. This is a mixed methods study with a sequential explanatory design. Starting in January 2025, a survey (developed through informal interviews) will be followed by formal qualitative interviews. A 10% random sample of the approximately 750 US radiation oncology residents (PGY2-PGY5s at ACGME-accredited programs for the 2024-2025 academic year) will be recruited via email solicitation. Email addresses will be collected from publicly available sources. The survey will include questions on demographics, participation in educational tasks, time spent on tasks, and confidence in these areas. Strategies to increase response rates will include personalized correspondence, reminder emails, and gift card incentives. After survey completion, respondents will be invited to participate in qualitative interviews to expand on survey responses. Interviews will be recorded, transcribed, and analyzed until thematic saturation is reached. Descriptive and univariate analyses will summarize demographics and survey responses. As appropriate, Kruskal-Wallis, Wilcoxon rank-sum, and Spearman correlation tests will evaluate associations between participant/program characteristics and survey responses. Quantitative and qualitative data will be integrated to enhance significance. Informal interviews were conducted to inform survey development, with questions exploring resident educational experiences and the time spent on various tasks. Discussions revealed multiple potential reasons for differences in training experiences, ranging from availability of the experience at a program to individual attitudes/prioritization of tasks. Survey questions are being developed accordingly. The study is ongoing, and results will be presented at the conference. Findings may provide greater insight regarding the current educational experience of radiation oncology residents in the US, highlighting potential strategies for success as well as areas for improvement. Elaine Cha (she/her/hers), MD (Presenting Author) - The University of Texas MD Anderson Cancer Center; Stephanie O. Dudzinski (she/her/hers), MD, PhD (Co-Author) - MD Anderson Cancer Center; Jillian Gunther, MD PhD (Co-Author) - The University of Texas MD Anderson Cancer Center