Supply and Demand for Radiation Oncologists in Canada: Workforce Planning Projections From 2020 to 2040

Shaun K Loewen; Yibing Ruan; Che Hsuan David Wu; Andrew Arifin; Michael Kim; Bashir Bashir; Ross Halperin; Michael McKenzie; Jean Archambault; Robert Thompson; Jolie Ringash; Michael Brundage; Darren Brenner; Teri Stuckless

doi:10.1016/j.ijrobp.2023.07.026

Supply and Demand for Radiation Oncologists in Canada: Workforce Planning Projections From 2020 to 2040

Int J Radiat Oncol Biol Phys. 2023 Aug 9:S0360-3016(23)07684-8. doi: 10.1016/j.ijrobp.2023.07.026. Online ahead of print.

Authors

Affiliations

¹ Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada. Electronic address: shaun.loewen@albertahealthservices.ca.
² Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.
³ Division of Radiation Oncology, BC Cancer, Victoria, British Columbia, Canada.
⁴ Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
⁵ Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada.
⁶ Division of Radiation Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada.
⁷ Division of Radiation Oncology, BC Cancer, Kelowna, British Columbia, Canada.
⁸ Division of Radiation Oncology, BC Cancer, Vancouver, British Columbia, Canada.
⁹ Department of Radiation Oncology, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec City, Quebec, Canada.
¹⁰ Department of Radiation Oncology, Saint John Regional Hospital, Saint John, New Brunswick, Canada.
¹¹ Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
¹² Department of Radiation Oncology, Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada.
¹³ Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁴ Department of Radiation Oncology, Cancer Care Program of Eastern Health, St. John's, Newfoundland, Canada.

PMID: 37562734
DOI: 10.1016/j.ijrobp.2023.07.026

Abstract

Purpose: The number of Canadians diagnosed with cancer, and subsequent demand for radiation therapy, are expected to increase over time. This study aimed to update our needs-based workforce planning model to ensure appropriate staffing levels in the future.

Methods and materials: The supply of radiation oncologists, by age group, sex, and full-time equivalent status, was projected from 2020 to 2040 using a recursive-aging, input-output model developed with seeding parameters derived from national sources. The demand for radiation oncologists until 2040 was estimated using referral patterns for radiation therapy and consultation workload metrics applied to projected annual cancer incident cases to calculate required full-time equivalent positions. Baseline model parameters were also applied to the 2005-2019 workforce and incident case data to evaluate preprojection supply and demand trends.

Results: Preprojection trends for 2005 to 2019 revealed accelerated staffing growth that transitioned from a workforce shortage to a surplus state in 2014 followed by substantial growth slowdown in 2016. The model predicts a transient surplus of radiation oncologists until 2026 followed by a projected deficit in subsequent years. Sensitivity analyses using the plausible range for each parameter continued to favor an undersupply, suggesting a trainee shortage unable to meet workforce expansion needs. Considering possible future declining trends in radiotherapy utilization and workload, calculations to inform corrective efforts in resident numbers resulted in 25 entry positions per year, up from 21 per year currently. Geographic distribution of trainees, relative to workforce and cancer incidence distributions, could be improved with more residency positions in Canadian regions outside Ontario.

Conclusions: Demand for radiation therapy and radiation oncologists in Canada are expected to grow more quickly than future expansion in staffing levels. Our workforce planning model provides evidence for more trainee requirements to inform stakeholders of possible corrective actions to training programs and recruitment. Further research is needed to explore additional strategies to expand capacity and high-quality delivery of radiation therapy to meet the foreseeable increase in Canadian patients with cancer.