Understanding Equity, Diversity, and Inclusion Within Canadian Radiation Oncology Training Programs: Experiences of Residents and Fellows

Background: This study characterizes the current representation of sociodemographic groups within Canadian radiation oncology training programs and trainees’ lived experiences. Methods: A 59-item ethics approved bilingual survey assessed: sociodemographics, training perceptions, mentorship, discrimination/harassment experienced and open-ended questions. Electronic surveys were distributed to all Canadian radiation oncology residents/fellows. Descriptive statistics summarized survey responses. Categorical groups were compared using Chi-squared/Fisher’s exact tests. Thematic analysis was performed on open-ended responses. Results: Between July-December 2023, 98 of 177 (56%) trainees participated: 70% were residents, 52% identified as male, 62% as a racialized minority, and 10% as a sexual minority. Most respondents reported training program satisfaction (83%) and a respectful workplace culture (69%); however, discrimination during training was reported by 38%. Less than half (45%) felt comfortable reporting discrimination/harassment within their workplace. Women were more likely to feel under-represented in training (46% vs. 13%, p=0.001) and perceived more discrimination events (64% vs. 19%, p<0.001). Three themes emerged: importance of offering EDI education, ensuring pathways for reporting learner mistreatment, and creating appropriately diverse selection committees. Conclusions: Although most Canadian radiation oncology trainees reported satisfaction and a respectful culture, key differences between groups were observed. Targeted strategies and stronger institutional policies to improve representation and reduce rates of discrimination/harassment are needed.