MSOR09 Presentation Time: 8:40 AM

Purpose

Brachytherapy is an essential treatment modality utilized in the management of several malignancies. However, its usage has been declining in the United States, which may be due, in part, to insufficient brachytherapy training for radiation oncology residents. The 1-year, post-residency brachytherapy fellowship has been offered to those interested in gaining additional training in brachytherapy procedures. The characteristics of individuals who choose to pursue this fellowship after graduating from US radiation oncology residency programs, however, are not well understood. In this study, we sought to better understand the characteristics and job outcomes of this cohort of individuals in order to provide further guidance to current US radiation oncology residents who are considering this fellowship.

Materials and Methods

We created a comprehensive database of individuals who completed an Accreditation Council for Graduate Medical Education (ACGME)-accredited radiation oncology residency training program in the US between 2015 and 2022 and subsequently completed a radiation oncology fellowship. We utilized information from multiple publicly available sources in building this database, including residency/fellow training program websites, hospital/institutional websites, Doximity, LinkedIn, and the National Plan and Provider Enumeration System National Provider Identifier Registry.

Results

We identified 78 individuals who completed a radiation oncology fellowship during the time period analyzed, of whom 14 (17.9%) completed brachytherapy-focused fellowships (13 individuals completed dedicated brachytherapy fellowships, and 1 brachytherapy and stereotactic body radiation therapy fellowship) at five different institutions. Nine individuals (64.3%) were men and five (35.7%) were women, and 11 individuals (78.6%) trained at the same two institutions for fellowship. Four individuals graduated from large-sized residency programs (≥4 graduates per year), 6 from medium-sized programs (1.5-4 graduates per year), and 4 from small-sized programs (≤1.5 graduates per year). 5 individuals completed residency between 2015 and 2016, 4 between 2017 and 2018, 2 between 2019 and 2020, and 3 between 2021 and 2022. We identified the post-fellowship employment positions accepted by 13 of the 14 fellows (92.9%), While all thirteen currently work as radiation oncologists, only 9 (64.3%) have brachytherapy listed as an area of focus or clinical expertise on their employment websites. 10 individuals (71.4%) practice in academic settings, while 3 (21.4%) practice in non-academic settings. 11 individuals (78.6%) have remained in the same job since graduating from fellowship, while 2 (14.3%) have changed jobs at least once. 3 individuals (23.1%) accepted their first clinical employment position at the same institution from which they graduated from fellowship.

Conclusions

In this study, we found that a substantial proportion of individuals who graduate from US radiation oncology residency programs and go on to complete brachytherapy fellowships do not list brachytherapy as an area of expertise on their current employment websites. While it is possible that at least some of these individuals continue to perform brachytherapy procedures, this finding raises concerns about the continued participation of individuals in the field of brachytherapy after the completion of fellowship. Given the importance of brachytherapy in treating patients with multiple malignancies and its declining usage in the US, efforts to retain a higher proportion of these individuals in the field should be considered. Additionally, further study of the impact of foreign medical residency graduates, who are also known to complete radiation oncology fellowships in the US, and participants in the American Brachytherapy Society's 300 in 10 program, which offers a 2-month brachytherapy elective during residency training, is needed.