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While the proportion of women represented in radiation oncology and medical oncology academic departments has increased over the last 5 decades, that growth in diversity has not extended to Black, Hispanic, and indigenous people considered to be underrepresented in medicine (URM), according to a cross-sectional study.

Faculty representation of non-URM women increased by 0.4% per decade in radiation oncology, and by 0.7% per decade in medical oncology. Representation of URM women also proportionally increased over this time -- but only by 0.1% per decade in both fields, reported Sophia C. Kamran, MD, of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues.

Even with these increases, the proportion of women faculty members remains significantly lower than the proportion of women in the U.S. population as a whole, they noted in .

The representation of URM men in oncology academic departments has not significantly changed for either radiation oncology (0.03% per decade) or medical oncology (0.003% per decade).

"Overall, our results indicate that, despite marginal improvements, more progress is needed to recruit and retain a diverse workforce in both radiation oncology and medical oncology, as the current academic workforce still does not reflect the diversity of the general U.S. cancer population nor of the medical school population, particularly regarding URM status," Kamran and colleagues wrote.

The authors used data acquired from the Association of American Medical Colleges' full-time faculty roster from 1970 to 2019 for radiation and medical oncology departments, finding that total faculty numbers substantially increased in both disciplines.

In 1970, there were 119 total faculty members in radiation oncology, 8.4% of whom were women and 1.7% of whom were URM individuals, and 87 total faculty members in medical oncology, 12.6% of whom were women and 8% of whom were URM individuals.

By 2019, there were 2,115 total faculty members in radiation oncology (29.1% women and 5.1% URM individuals) and 819 total faculty members in medical oncology (38.1% women and 5.7% URM individuals).

Despite the increasing numbers of women and URM individuals in both departments, the proportions were much lower than their representation in the U.S. population in 2019, Kamran and colleagues pointed out.

When looking at how women and URM individuals fared by rank within academic departments, the authors observed that there were significant proportional increases in women at the full, associate, and assistant professor levels in both radiation oncology and medical oncology.

However, the vast majority of these academic ranks were still held by men: in 2019, men accounted for 79% and 72% of full professorships in the radiation oncology and medical oncology departments, respectively.

The number of URM faculty members represented at every rank among both departments remained low in 2019:

• Assistant professor, 18 of 274 in medical oncology and 57 of 927 in radiation oncology
• Associate professor, 13 of 177 and 20 of 510, respectively
• Full professor, 13 of 276 and 18 of 452, respectively

While the proportion of women applying to (52%), matriculating at (52%), and graduating from (48%) medical schools in 2019 was similar to their representation in the U.S .population (51%), this was not the case for URM individuals. While they made up 31% of the U.S. population, they accounted for 18% of medical school applicants, 17% of matriculants, and just 11% of graduates.

In a , Frederick Lansigan, MD, and Charles R. Thomas Jr., MD, both of the Geisel School of Medicine at Dartmouth University in Hanover, New Hampshire, called the gap between URM medical school matriculants and graduates "concerning."

"Although medical schools need to do better at supporting and retaining URM students, can we honestly expect this to significantly improve in the short run?" they wrote.

They noted that attainment of a bachelor's degree is lower among Black, Hispanic, and indigenous individuals, and that Black students are more likely than their white counterparts to switch out of STEM (science, technology, engineering, and mathematics) majors, which is the traditional pathway into medicine.

"For every individual URM student who enters the pipeline, support at all levels of training pathways and gateways is needed to achieve equity compared with their peer groups," they wrote.

In the case of oncology, the community must "agree that intentionally increasing the number of URM physicians in the U.S. workforce is necessary to better address health care inequities," they added.

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