The Declining Residency Applicant Pool: A Multi-Institutional Medical Student Survey to Identify Precipitating Factors

Purpose To better understand and identify concerns that may be responsible for the declining radiation oncology residency applicant pool. Methods and materials All RO residency programs affiliated with a US medical school were asked to participate in the study survey. An optional and anonymous survey consisting of twelve questions was emailed to all graduating medical students in 2020 at the twelve allopathic medical schools that agreed to survey administration. Survey responses were collected from March to May 2020. Results The study consisted of 265 survey responses out of 1766 distributed to eligible medical students, resulting in a response rate of 15.0%. The majority of students reported no exposure to RO (60.8%) and never considered it as a career option (63.8%). Neutral perceptions of the field were more common (54.3%) than positive (39.6%) and negative (6.0%). The top factors attracting medical students to RO were perceptions of high salary, favorable lifestyle and workload, and technological focus. The top negative factors were the field’s interplay with physics, competitive USMLE board scores for matched applicants, and the focus placed on research during medical school. In the subgroup of students who were interested in RO but ultimately applied to another specialty, the job market was the most salient concern. Conclusions Finding a place for RO in medical school curricula remains to be a challenge with most surveyed students reporting no exposure during their education. Concern over the job market was the primary deterrent for medical students interested in pursuing RO. For disinterested students who had not considered RO as a career option, the required physics knowledge was the main deterrent.