International Journal of Radiation Oncology*Biology*Physics
The ProfessionFactors that Determine Academic Versus Private Practice Career Interest in Radiation Oncology Residents in the United States: Results of a Nationwide Survey
Introduction
Radiation oncology has become an increasingly competitive field for medical school graduates in the United States. Annual data from the 2011 National Residency Matching Program indicate that of 163 US seniors who applied to radiation oncology as their only choice of residency, 23 (14%) were not able to match, a rate that is exceeded only by dermatology, orthopedic surgery, plastic surgery, and general surgery (1). As programs continue to be faced with the ever-increasing quality of applicants, many evaluate candidates on the basis of their academic potential as evidenced by research publications, presentations at scientific meetings, and grant funding, factors that are assumed to play an important role in determining the applicant's career path. Programs typically include several months of research elective time to support and encourage academic interest, and overall, radiation oncology residents have been successful in publishing first author publications (2). In fact, resident research productivity has been shown to correlate with elective time allowed during residency (3), suggesting that elective time is an effective way to encourage academic-bound trainees. However, a resident's decision to pursue an academic versus private practice career path is multifactorial, affected by factors both intrinsic and extrinsic to the residency training experience (4).
A study by Wilson et al in 2005 surveyed graduating senior residents of the 2004 graduating class to determine what factors influenced the particular career path they had chosen immediately upon graduation (5). The results suggested that academic pursuits during residency played an important role in choosing an academic career. Nevertheless, several issues remain unclear: (1) Among these residents, what is their degree of academic interest upon entering residency? (2) How does an interest in academic medicine change over time during residency? and (3) What types of academic activities during residency most correlate with academic interest? The answers to these questions could be important for training programs to better recognize trainees with a genuine academic career interest and how to foster and develop that interest during residency.
The purpose of this study was to determine the factors that influence academic versus nonacademic career interest in all radiation oncology residents in the United States.
Section snippets
Methods and Materials
Under institutional review board approval, a 20-question online survey was devised and delivered using commercial software (Qualtrics, Provo, UT). Because no comprehensive mailing list of current radiation oncology residents is maintained, the survey link was sent to the residency program directors and program coordinators at all listed US residency training programs in the online directory of the American Medical Association website (6). Directors and coordinators were then asked to forward
Respondent characteristics
Currently, there are 87 Accreditation Council for Graduate Medical Education (ACGME)-accredited radiation oncology programs with active residents, and residents from 64 programs (74%) responded to this survey. Three hundred thirty-one residents and graduates responded, of whom 259 are current residents at the time of completing the survey. Of the 681 radiation oncology residents currently in postgraduate year (PGY) 2 through 5, the estimated response rate among residents was 38%. In total, 264
Discussion
The decision to enter a career in academia depends on many factors and has been studied previously. A review of the literature by Borges et al (4) highlighted the importance of: (1) individual values; (2) financial considerations (salary and school debt); (3) gender; (4) role models; (5) and research activities. Given the high level of competition now for radiation oncology residency, the common perception is that programs strongly prefer applicants who want to pursue academics and have a track
Acknowledgments
We thank Jessica Kirwan for editing this manuscript and Christopher Morris for providing statistical support for this study.
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Conflicts of interest: none.