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Purpose: The geographic distribution of practicing radiation oncologists is of concern for multiple stakeholders within the field. Employment outcomes of graduating residents can affect that distribution, and they are of major concern to current residents. Data investigating employment outcomes of recent graduates are sparse. We aimed to analyze the employment outcomes of the radiation oncology residency class of 2019.Methods and Materials: Using publicly available information, we identified the employment of 179 of 183 graduating residents in the class of 2019. For each, the place of employment, residency program, and medical school were geocoded using Google Maps. We used the rural-urban continuum code (RUCC) published by the United States Department of Agriculture to determine the rurality of each location and compared employment outcomes by RUCC and program size.Results: Two thirds of graduates (66%) took a position in a county within a metropolitan area with a population greater than 1,000,000 people; only 3.4% took a position in a county outside of a metropolitan area. Graduates of smaller programs (≤6 residents) and those in smaller metropolitan areas were more likely to take positions in smaller metropolitan areas or nonmetropolitan areas. The geographic distance between location of employment and residency program did not significantly vary by program size or size of metropolitan area where a residency program was located.Conclusions: Among the class of 2019, a small proportion took positions in nonmetropolitan areas. Smaller programs and those in smaller metropolitan areas may be more likely to produce graduates that practice in similar settings, but those graduates might not do so locally. We advocate for a centralized, prospective data collection of employment outcomes for graduating residents to refine these analyses and to reduce employment prospect information asymmetry for trainees. [ABSTRACT FROM AUTHOR]

Purpose: Data regarding the amount and use of nonclinical time (NCT) in radiation oncology residency programs are scarce. We surveyed every U.S. radiation oncology residency program to obtain benchmark data to inform decisions about optimal program structure.Methods and Materials: An anonymous, web-based survey was distributed to postgraduate year 5 residents at Accreditation Council for Graduate Medical Education-accredited radiation oncology training programs. The survey included 33 yes/no, Likert-scale, and free-response questions. Program data were analyzed for all programs, including those considered "top 10" per Doximity and those "not top 10." Likert-scale responses were dichotomized as "not as satisfied" (1, 2, 3) or "very satisfied" (4, 5).Results: One hundred twenty-six residents (69%) completed the survey. Program-specific data were obtained for 100% of programs (n = 82). Almost all training programs (98%) provide residents with protected NCT. Including programs with no NCT, the median NCT is 10 months in all programs. The median NCT is 12 months in "top 10" programs and 9 months in "not top 10" programs (P < .01). Most programs (68%) reported >6 months of NCT. The proportion of residents wanting more NCT decreased as the amount of NCT increased (73%, 52%, and 19% for 4-6, 7-9, and 10-12 months, respectively; P < .01). The proportion of residents who were very satisfied with NCT flexibility increased with more NCT (64%, 79%, and 94% for 4-6, 7-9, and 10-12 months, respectively; P < .01), as did the proportion of residents who were very satisfied with accomplishments during NCT (35%, 53%, and 72% for 4-6, 7-9, and 10-12 months, respectively; P < .01). When asked whether residents would theoretically give up some NCT to shorten residency, the proportion of residents willing to shorten their residencies decreased as the amount of NCT increased (65%, 47%, and 33% for 4-6, 7-9, and 10-12 months respectively; P = .04).Conclusions: Programs should maintain an emphasis on NCT and implement measures to ensure meaningful resident experiences. [ABSTRACT FROM AUTHOR]