MSOR08 Presentation Time: 8:35 AM

Purpose

The Association of Residents in Radiation Oncology (ARRO) annual survey aims to better understand graduating radiation oncology (RO) residents’ perceptions of their training programs and readiness to enter practice. Residents graduating from US training institutions between 2020-2023 were asked about their confidence in performing brachytherapy (BT) by the completion of their residency program.

Materials and Methods

Postgraduate year five RO residents were emailed a 50-56 question survey in May of their graduating year. Questions regarding brachytherapy asked respondents to describe their level of training and degree of comfort to practice high-dose rate (HDR) intracavitary and interstitial gynecological BT as well as HDR and low-dose rate (LDR) prostate brachytherapy after graduation. They were also asked to rate their satisfaction with various aspects of their training program. Responses were analyzed and compared. Differences between groups were analyzed using descriptive statistics and chi-square analyses. Ordinal variables were compared using the Kruskal-Wallis H test.

Results

The average response rate was 87.0% (77.8%-94.2%) and the total number of responses collected was 655. Confidence in delivering HDR interstitial and intracavitary gynecological BT rated as sufficient or adequate was 73.4% and 92.7%, respectively, while no or minimal training was 4.7% and <1%, respectively (Figure 1). Sufficient or adequate confidence in practicing HDR and LDR prostate brachytherapy was 40.9% and 43.5%, respectively, while no or minimal training was 42.1% and 29.9%, respectively. Confidence did not differ across survey years for any type of BT. Increased comfort in delivery of interstitial gynecological BT was associated with respondents’ satisfaction with treatment plan evaluation training (p<0.001), overall program training (p<0.001), clinical didactics (p<0.001), and faculty teaching (p<0.001). Intracavitary gynecological BT confidence was associated with residency size (p<0.001) and satisfaction with treatment plan evaluation training (p=0.001). Confidence in LDR prostate BT delivery was associated with satisfaction in treatment plan evaluation training (p<0.001) and residency size (p=0.001). There were no associations between HDR prostate BT comfort and program features or resident satisfaction.

Conclusions

Over three-quarters of RO residents graduating from 2020-2023 reported at least adequate training and comfort in performing gynecological BT. However, fewer than half of residents reported adequate training in prostate BT and a similar proportion reported little or no training at all during their residency, suggesting a potential training gap in prostate BT for US residents. Several factors were associated with increased confidence in these procedures; most notably the level of resident-reported satisfaction in the training of treatment plan evaluation was associated with BT confidence across gynecological BT and LDR prostate BT. It is critical that RO residency training incorporates sufficient exposure to BT such that graduates can be confident in their skills as they enter practice.