Diversity of the oncology physician workforce: Projections from 2020 to 2060.

273Background: Racial and ethnic groups underrepresented in medicine (URiM) comprise 31% of the US population but 8% of oncologists. Although there have been initiatives to increase diversity of the oncology workforce, recent challenges have raised concerns over the degree to which the oncology workforce will be reflective of the broader population in the coming years. This has implications for patient access to concordant physicians and quality of cancer care. This modeling study projects the racial and ethnic diversity of the cancer physician workforce through 2060 under three distinct scenarios. Methods: We used data from the American Medical Association (physician specialty and age) linked to data from the Association of American Medical Colleges (physician self-reported race and ethnicity). We classified cancer oncology specialties as Medical, Radiation, and Surgical Oncology, General Surgery, and Palliative Care. URiM was defined as American Indian/Alaska Native (AIAN), Black, Hispanic, or Native Hawaiian/Pacific Islander (NHPI). We determined the URiM distribution of the oncology workforce in 2020 and created stock and flow models to project changes by decade from 2030 to 2060, factoring in inflows from graduating trainees and expanded training slots, and outflows due to retirement. We modeled three scenarios with varying trends in the growth rate of URiM trainees: Baseline (URiM distribution remains the same as 2020 levels); Trajectory (distribution changes each decade at the same rate of change observed from 2010-2020); and Doubling (URiM growth occurs at twice the rate of non-URiM). Results: In 2020, there were 66, 450 practicing cancer care physicians. Of these, 11.3% identified as URiM (9.7% of medical oncologists, 8.8% of radiation oncologists, 8.3% of surgical oncologists, 12.3% of general surgeons, 11.5% of palliative care physicians). The trend sample from 2010-2020 of physicians within 5 years of training completion showed a +1.2% increase in URiM representation (11.7%–12.9%), +1.2% in Hispanic (6.2%–7.4%), and +0.05% in Black (4.95%–5.00%). In the baseline scenario (no change in the % URiM trainees), in 2060, an estimated 12.5% of the workforce would be URiM, compared to 43.2% of the US population (Table). Continuing 2010-2020 trends would raise URiM representation to 16.5% in 2060. Doubling URiM growth would reach 19.1%. Achieving census parity would require increasing URiM trainee representation by 8% per decade. Conclusions: Achieving oncology physician workforce alignment with U.S. demographics by 2060 will require deliberate, systemic action—not just incremental change.[Table