3710 - Academic and Geographic Employment Outcomes for Graduating Residents in Radiation Oncology: 2023 to 2024

Purpose/Objective(s): Employment outcomes for graduating residents in radiation oncology are of great interest to a variety of stakeholders in the field, including aspiring medical students, residents, and policymakers. In this study, we aimed to assess recent outcomes in employment trends among the graduating classes of 2023 and 2024.

Materials/Methods: We utilized publicly available data to determine the first post-graduation clinical employment position accepted by members of the 2023 and 2024 radiation oncology residency classes. The positions were classified as either academic or non-academic, with academic positions further distinguished as main site, satellite, or other academic jobs. To examine geographic trends, we identified the 2023 rural-urban continuum code (RUCC) and core-based statistical area (CBSA) for each position and residency program. Individuals who accepted a fellowship or non-clinical position after graduation, or who are not employed, were excluded from further analysis.

Results: We identified 378 RO graduates, of whom 370 (98%) first accepted clinical positions in the United States after residency. Of these individuals, a majority accepted jobs at academic sites (n = 201, 54%), of whom most (n = 125, 62%) did so at academic main sites. Additionally, 93 graduates (46%) left the state of their residency program for such a position and 91 (45%) graduates stayed at the institution from which they graduated. In contrast, 169 graduates (46%) accepted non-academic positions, and these individuals were more likely to leave the state of their residency program than those who accepted academic positions (OR = 3.5, 95% CI 2.2-5.6, p < 0.01). Lastly, the vast majority of graduates (n = 356, 96%) accepted jobs in metropolitan counties; only 14 graduates (4%) did so in non-metropolitan counties, half of whom took positions in counties adjacent to metropolitan areas. Graduates of large residency programs, (16 or more residents) all took jobs in metropolitan areas (n = 78), with most (n = 68) doing so in the largest counties (populations of 1 million or more). 3% and 11% of graduates from medium-sized (7 - 15 residents) and small-sized (6 residents or fewer) residency programs accepted positions in non-metropolitan areas, respectively. Men had higher odds of accepting non-metropolitan positions than women, though this was not statistically significant (OR = 6.0, 95% CI 0.9 - 258.9, p = 0.07).

Conclusion: Consistent with previous data, most graduates of the classes of 2023 and 2024 accepted jobs in large metropolitan areas. Roles in non-metropolitan areas were predominantly filled by male graduates who trained at small- and medium-sized residency programs. Finally, the share of graduates accepting academic positions continued to rebound after a steep drop in 2021.