2826 - Career Pathways in Global Radiation Oncology: Training Gaps, JobMarket Realities, and Workforce Implications

Purpose/Objective(s): Global radiation oncology (GRO) is a growing area of academic and humanitarian engagement; however, structured career pathways remain poorly defined. We conducted a national survey to characterize training exposure, job market integration at contract signing, and sustainability factors to inform workforce policy and professional society action.

Materials/Methods: An electronic survey was distributed to radiation oncology faculty engaged in global oncology. Domains included residency exposure and mentorship, formal global health training, job search experiences, protected effort, institutional support, and career reflections. Descriptive statistics were performed.

Results: Twenty-four respondents completed the survey. Most were senior faculty (Professor: 9/24; Associate Professor: 5/24; Assistant Professor: 7/24), with 11/24 reporting >15 years in practice.

Support during residency was limited: 15/24 (63%) reported no formal global health curriculum or protected time, and 15/24 (63%) lacked a dedicated global health mentor, and 79.2% reported no formal global health training

Integration into the job market was largely unstructured. Eight respondents (33%) did not include global health in their initial job search. Six (25%) reported that their global oncology role developed after hiring, and 5 (21%) accepted positions without formal support. Only a small minority negotiated protected global health time or resources at contract signing (~13%). Currently, 13/24 (54%) dedicate <10% FTE to GRO, 9/24 (38%) dedicate 10–25%, and only 2/24 (8%) report >25% effort. 66.7% reported their global health work is self funded/volunteer work, and only 4% reported grant funding for their global health efforts.

Despite structural limitations, 21/24 (88%) anticipate maintaining or increasing engagement over the next 5–10 years. Qualitative reflections emphasized passion-driven work sustained by individual initiative rather than institutional infrastructure, with key barriers including unstable funding, limited protected time, and unclear promotion pathways.

Conclusion:

Global radiation oncology careers in the U.S. remain largely self-constructed and insufficiently integrated into formal training or hiring structures. As global cancer burden rises, reliance on senior faculty operating with <10% protected effort represents a fragile workforce model.