Gender Differences in Educational Activity Time Allocation Among Radiation Oncology Residency Programs in the United States

Summary: Radiation oncology differs from most residency specialties, utilizing an apprenticeship model where residents work directly with attending physicians rather than being supervised by senior residents. This training involves mastering diverse clinical skills, such as clinic preparation, patient communication, toxicity evaluation, CT simulation, contouring, treatment plan evaluation, and brachytherapy. Concurrently, residents must acquire fundamental oncologic knowledge, including anatomy, cancer staging, radiation biology, physics, dose constraints, and clinical trial data. Despite these demands, there is no standardized approach to balancing skills and knowledge acquisition. Prior research suggests gender-based differences in task distribution among physicians, with female providers spending more time on patient consultations and electronic health record charting compared to male colleagues. Based on this, we hypothesize that radiation oncology residents identifying as male or female allocate their time differently across educational tasks. This study employs a sequential explanatory mixed-methods approach. Beginning in January 2025, a survey informed by informal interviews will be administered, followed by in-depth qualitative interviews. After identifying approximately 750 radiation oncology residents (PGY2–PGY5) from ACGME-accredited programs during the 2024–2025 academic year, a 10% random sample will be selected and recruited using publicly available e-mail addresses. The survey will gather information on demographics, involvement in educational tasks, the time spent on these activities, and levels of confidence in related areas. To boost participation, strategies such as personalized emails, reminders, and gift card incentives will be utilized. Residents who complete the survey will be invited to participate in qualitative interviews to further elaborate on their survey responses. These interviews will be recorded, transcribed, and analyzed until thematic saturation is achieved. Descriptive statistics and univariate analyses will be used to summarize demographic data and survey findings, while Kruskal-Wallis, Wilcoxon rank-sum, and Spearman correlation tests will assess relationships between participant and program characteristics and survey outcomes. Integration of quantitative and qualitative data will provide a comprehensive interpretation of the findings. To guide the creation of the survey, informal interviews were conducted to examine residents' educational experiences and the time allocated to various tasks. These discussions highlighted several potential factors contributing to differences in training experiences, including the availability of specific opportunities within programs and individual attitudes or priorities regarding tasks. The insights gained are being used to shape the survey questions. The study is currently in progress, and our findings will be shared at the conference. We anticipate that our findings will provide information regarding learning differences between female and male residents in radiation oncology, which can be used to further inform Entrustable Professional Activities for radiation oncology training. Stephanie O. Dudzinski (she/her/hers), MD, PhD (Presenting Author) - MD Anderson Cancer Center; Elaine Cha (she/her/hers), MD (Co-Author) - The University of Texas MD Anderson Cancer Center; Jillian Gunther, MD PhD (Co-Author) - The University of Texas MD Anderson Cancer Center