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Importance: Women are underrepresented in medical leadership positions; however, representation of women among academic oncology leadership is unknown., Objectives: To evaluate representation of women overall and in leadership positions in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) programs and to examine the association of women leadership with overall faculty representation of women per program., Design, Setting, and Participants: In this cross-sectional study, MO, RO, and SO training program websites were queried from October 2018 through June 2019. All faculty from 265 of 273 accredited MO, RO, and SO training programs (97.1%) were included., Exposure: Gender., Main Outcomes and Measures: Observed proportions of women in leadership positions compared with the expected proportion of overall women faculty in MO, RO, and SO were assessed. Rates of representation of women across each MO, RO, and SO program's faculty based on the presence or absence of a woman in a leadership position were compared., Results: Of 6030 total faculty, only 2164 (35.9%) were women. Total representation of women among MO, RO, and SO faculty was 37.1% (1563 of 4215), 30.7% (389 of 1269), and 38.8% (212 of 546), respectively. Women composed only 21.7% (30 of 138), 11.7% (11 of 94), and 3.8% (1 of 26) of MO, RO, and SO chair positions, respectively. The observed proportion of women in chair positions was significantly lower than the expected proportion for MO, RO, and SO. In all, 47.9%, 33%, and 18.5% of MO, RO, and SO programs, respectively, had at least 1 woman in a leadership position (program director or chair). Programs with 1 or more women in a leadership position were associated with a higher mean (SD) percentage of women faculty than those without at least 1 woman leader in MO (40.7% [12.5%] vs 33.1% [11.0%]; P < .001) and RO (36.2% [13.3%] vs 23.4% [12.3%]; P < .001) but not SO (40.2% [15.4%] vs 31.4% [16.9%]; P = .29)., Conclusions and Relevance: Gender disparity exists in academic MO, RO, and SO faculty, which is magnified at the chair level. Programs in MO and RO with a woman physician in a leadership position were associated with a higher percentage of women faculty, but this was not true for SO. These data will serve as a benchmark to monitor progress toward a more balanced workforce.

Academic promotion patterns were studied in the facilities of four US medical colleges. The average number of years for promotion to each professional rank in each college was consistently greater for women than for men. While the data themselves do not prove discrimination, they are consistent with the underuse of female physicians in medical academia, with the lack of improvement in their statistical representation over the past 15 years, and with the picture of women in higher education in general. This topic should receive more attention, and more complete data on the relative qualifications of male and female medical faculty should be obtained.

The supply and specialty distribution of physicians in Belgium, West Germany, the Netherlands, and the United Kingdom were compared with those in the United States. The numbers of physicians per 10,000 population in 1980 was 24 (Belgium), 22.9 (West Germany), 19.1 (United States), 19.0 (the Netherlands), and 16.2 (United Kingdom). Projections for 1990 were 34 (Belgium), 32.6 (West Germany), 24.3 (United States), and 17.1 (United Kingdom). The United States and the United Kingdom produce about half as many physicians per population but have a much higher proportion (26%) of foreign physicians. The United States has a much higher ratio of specialists to generalists. Official recognition of physician oversupply exists in Belgium, which is restricting specialty training, and the Netherlands, which is reducing both medical school intake and specialty training, but not yet in West Germany. The European experience suggests that the United States' most pressing health manpower problem is an oversupply of specialists.

During the past several years, the American Medical Association's Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect physicians, their practices, and the provision of medical care in the future. In the course of its environmental analysis studies, the Council has recognized that each medical specialty is uniquely subject to anticipated changes in the environment of medicine. As part of an ongoing series of analyses prepared by the Council, this report focuses on environmental trends that are likely to influence the practice of general surgery. The report outlines the current state of general surgery, the forces for change in the environment, and the implications regarding these changes. The Council concludes that there are certain challenges and many positive indicators for the future of general surgery.