Should I stay, or should I go? Factors associated with intent to leave academic oncology.

Ana I. Velazquez Manana University of California San Francisco, San Francisco, CA info_outline Ana I. Velazquez Manana, Bismarck Odei, Narjust Florez, Sankalp Pandya, Valerie M Dandar, Dame Idossa, Bridget P. Keenan, Katherine Van Loon, Fumiko Chino

Authors Ana I. Velazquez Manana University of California San Francisco, San Francisco, CA info_outline Ana I. Velazquez Manana, Bismarck Odei, Narjust Florez, Sankalp Pandya, Valerie M Dandar, Dame Idossa, Bridget P. Keenan, Katherine Van Loon, Fumiko Chino Organizations University of California San Francisco, San Francisco, CA, University of Utah, Salt Lake City, UT, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, Memorial Sloan Kettering Cancer Center, New York, NY, Association of American Medical Colleges, Alexandria, VA, University of Minnesota, Minneapolis, MN, University of California, San Francisco, San Francisco, CA Abstract Disclosures Research Funding No funding received None. Background: Physicians who are female and/or belong to racial/ethnic groups underrepresented in medicine (UIM) face disparities in salary, promotion, and leadership opportunities in academic oncology. Also, growing rates of burnout, increasing burden of documentation/administrative tasks, and lack of adequate supportive staff represent threats to workforce retention, particularly for female and racial minority subgroups. We evaluated the prevalence and factors associated with likelihood of leaving their specific academic institution in a national sample. Methods: We obtained national faculty data from the AAMC’s StandPoint Faculty Engagement Survey, conducted between 2017-2020 with 25 U.S. medical schools. Chi-squared and Fisher’s exact tests were used to determine differences in likelihood of leaving their institution within 1-2 years by sex and UIM status. Multivariate analyses (MVA) examined the associations between likelihood of leaving their institution and self-reported sex, year born, sexual orientation, UIM race/ethnicity, degree, academic rank, and administrative role. Results: We identified 724 oncology faculty at academic institutions (overall response rate 64%). Slightly less than half of oncologists self-identified as female (42%, n = 303) and only 7% (n = 47) as UIM. When asked about the likelihood of leaving their current institution, 22% (n = 152/687) of oncologists reported being at least somewhat likely to leave within the next 1-2 years. Notably, 26% of female oncologists reported they were likely to leave, compared to 19% of males (p = 0.022); no differences were observed by UIM status (p = 0.714). MVA identified sex as associated with likelihood of leaving; females had 78% higher odds of leaving their institution within 1-2 years (aOR 1.78; 95% CI, 1.13–2.79). Among those likely to leave, 46% (n = 72/157) reported intent to leave academic medicine completely; rates were similar across sex and UIM groups (p = 0.746). When evaluating workplace experience, most oncologists (86%, n = 621) felt respected in their workplace. Among those reporting feelings of disrespect in the workplace, 16% of female oncology faculty felt disrespected due to their gender (n = 47), compared to 0% of male oncologists. A small number of faculty reported disrespect due to age (n = 26), race/ethnicity (n = 11), sexual orientation (n = 2), marital status (n = 10), or religion (n = 7). Females endorsed greater feelings of disrespect in all categories other than religion. Conclusions: Female oncologists are almost twice as likely to state they are likely to leave their academic institutions within 1-2 years; this aligns with published data on attrition of female faculty in academic medicine. Our findings confirm the persistence of these trends in the modern era and stress the urgency of improving workplace experience, culture, and supports in order to preserve and enhance the diversity of faculty in academic oncology.