Women’s participation in the medical profession increased steadily after the enactment in 1972 of Title IX, which proscribed discrimination by educational institutions, including medical schools’ decisions for admissions, hiring and promotions. Before either physician author of this post entered medical school themselves, women constituted over 40% of the medical student body. However, even today, women comprise under a third of all radiation oncologists. They remain in an even smaller minority in positions of influence and authority in the field, ranging from professional society board members and honorees to institutional deans and department chairs.
At the national level, organizations such as the Association of American Medical Colleges have long been engaged in generating and disseminating evidence regarding the status of women in medicine. The National Academies explicitly included medicine in its Committee for Women in Science and Medicine in 2007, soon after publishing a landmark report on gender bias. This allowed subsequent efforts, including reports on the sexual harassment of women, promising practices to promote equity, and the impact of COVID-19 on the scientific workforce to specifically include recommendations relevant to women in medicine. These efforts generated observations that those who challenge the status quo, such as those entering a field from which they had historically been excluded, are often targets of hostility and harassment. Gender bias can be so pervasive that a name change at the top of a CV is enough to have a meaningful impact on whether a candidate receives a job interview or is hired. Moreover, gendered expectations of society lead to differences in family care responsibilities that can challenge women’s full participation in the professions, something that has been both highlighted and amplified by the COVID-19 pandemic. These types of challenges ultimately act to the detriment of all, given the demonstrated value that diverse perspectives bring to any endeavor, especially one as important as the improvement of human health.
Although efforts at the level of the profession as a whole have had great impact, needs still exist for work at the level of individual specialties. In radiation oncology, women’s participation among physicians reached approximately 30% over three decades ago and then essentially flattened. This pattern, which differs from what is observed in medical oncology and many other fields, requires focused attention. For as long as we can remember, the American Association for Women Radiologists (AAWR) has generated tremendous interest in its annual luncheon bringing women together at the ASTRO Annual Meeting. The AAWR celebrated its 40th anniversary during the pandemic and its impact in facilitating both the understanding and mitigation of challenges disproportionately encountered by women in both diagnostic radiology and radiation oncology cannot be overstated.
In more recent years, led primarily by newer members of the profession, a stronger desire for groups specifically focused on women in radiation oncology has emerged. This led to the founding of the Society for Women in Radiation Oncology and the Radiation Oncology Women Physicians Facebook group. At the same time, broader efforts within ASTRO to develop a robust committee focused on equity, diversity and inclusion led to the Committee on Health Equity, Diversity and Inclusion (CHEDI) and ultimately the more recent establishment of the Council for Health Equity, Diversity and Inclusion (HEDI Council). An ad hoc ASTRO task force that was first formed in 2020 and focused on gender equity was recently retired. In its place, a new Women in Radiation Oncology Affinity Group was formally created in the summer of 2022 as a component of the HEDI Council.
As the chair, co-chair and ASTRO staff liaison of this Affinity Group, we write this post to share its structure and goals with the broader community of radiation oncologists. We are excited that this task force is particularly well situated to advance equity with an intersectional lens, as one of six standing units within the HEDI Council. The membership currently includes a diverse group of 24 members, including physicians and physicists, ASTRO Gold Medalists and trainees. We have created three working groups that will focus on 1) gender bias and harassment, 2) family caregiving, and 3) mentorship, sponsorship and leadership development. These groups will focus on developing education, research, policy and other initiatives in their areas of focus.
In this way, we seek to collaborate with, and build on, the tremendous foundation of existing groups, including those mentioned above, to create a unified forum within the primary professional society of our field to pursue research and initiatives that will promote equity for women in radiation oncology. We invite all interested members of the field to bring their ideas to our working groups and engage with us to pursue our mission. Please feel free to email us and join the Gender Equity community on the ROhub to start a conversation.
