Diversity and Experiences of Radiation Oncologists in Canada: A Survey of Gender Identity, Sexual Orientation, Disability, Race, Ethnicity, Religion and Workplace Discrimination

Background: This study’s objective was to be the first to explore the ethnicity/cultural origins, gender identity, ability/disability, sexual orientation, socioeconomic background and harassment/discrimination experiences of Canadian radiation oncologists (ROs). Methods: Following a literature review and input from content experts, an eth-ics-approved survey was developed in English and French and electronically distributed to all ROs in Canada (n=598). Descriptive statistics summarized responses. Comparisons between groups were performed using Chi-square tests and content analysis was per-formed on open-ended responses. Results: The survey response rate was 48% (298/598). Most respondents were male (62%), 35-44 years old (39%) and heterosexual (90%). 41% identified as belonging to a racialized group, which is higher than the overall Canadian population (27%), but Black, Indigenous and South Asian ROs were underrepresented (2% vs 4%, < 1% vs 5% and 1% compared to 4% respectively). A significant subset analysis showed that only 20% (21/105) of racialized ROs were women whereas Caucasian women comprised 49% (74/150) of Caucasian respondents (p < 0.001). While 75% of re-spondents reported job satisfaction, 42% reported experiencing workplace discrimina-tion/harassment within the past 5 years; most commonly this was perpetrated by fellow faculty (32%; 58/183) or patients or their family members (32%; 58/183). Respondents felt that gender, race/ethnicity, and age were the three top reasons for discrimina-tion/harassment with double the amount of racialized ROs reporting harassment com-pared to White ROs (p < 0.001). Nearly half (45%; 114/252) did not understand how to report, or felt uncomfortable reporting, workplace discrimination/harassment. Conclu-sions: This study highlights high harassment and discrimination rates amongst Canadian ROs, especially amongst racialized women, which may affect career satisfaction and attrition rates. Compared to census data, Black, Indigenous and South Asian ROs were underrepresented, and amongst racialized ROs, racialized women were significantly underrepresented. These findings underscore the need for targeted diversity initiatives, improved mentorship programs, and stronger institutional policies to address harass-ment and foster an inclusive work environment.