Filling a Void: The Creation of the ARRO Equity and Inclusion Subcommittee

The killings of George Floyd, Breonna Taylor, and Ahmaud Arbery have again magnified the lethality of institutional anti-Black racism. Medicine is not exempt. Black physicians have been systematically and disproportionately excluded from radiation oncology (RO).¹ Physicians from backgrounds under-represented in medicine (UIM) are also subject to the deleterious effects of structural racism.² Although the number of RO residents doubled from 1974 to 2016, the number of Black residents decreased from 5.9% to 3.2% over the same period. Diversity is essential for innovation, creativity and improved patient care.³ Moreover, the full and equitable inclusion of UIM physicians in RO and all fields is a moral imperative.

The Association of Residents in Radiation Oncology (ARRO) was founded in 1982 to advocate for all RO residents. Membership in ARRO has been correlated with increased membership in the American Society for Radiation Oncology (ASTRO), as it enables trainees to connect beyond their own programs.⁴ The ARRO Equity and Inclusion Subcommittee (EISC) was formed to create a space for support and mentorship for excluded trainees within RO. Eschewing old models pressuring UIM physicians to spearhead initiatives, we welcome all trainees with a desire to create meaningful change.

The ARRO EISC’s goals are threefold: 1) to create a shared space for UIM trainees to mitigate isolation in training from being “the rarest of the rare;” 2) to elevate UIM voices on issues of diversity, equity, inclusion, and social justice within RO; and 3) to assess and report workforce trends to generate impactful solutions. Building upon the success of our first journal club, which drew over 130 attendees, we intend in future events to center equity using intersectional frameworks that include race, class, gender identity, sexual orientation, and ability. We intend to build on previous work, including the LEADS recommendations to reduce anti-Black racism in RO.⁵ Our next step is to survey attitudes and practices related to diversity, equity, and inclusion among program directors and residents. We are committed to the long-term work of making our shared world of RO more anti-racist, equitable, and inclusive for all. We invite anyone interested in these efforts to join us.

References

1. Deville C, Jr., Cruickshank I, Jr., Chapman CH, et al. I can’t breathe: the continued, disproportionate exclusion of black physicians in the United States radiation oncology workforce. Int J Radiat Oncol Biol Phys. 2020;S0360-3016(20)31413-31419.
2. Doll KM, Thomas CR, Jr. Structural solutions for the rarest of the rare - underrepresented-minority faculty in medical subspecialties. N Engl J Med. 2020;383(3):283-285.
3. Hofstra B, Kulkarni VV, Munoz-Najar Galvez S, He B, Jurafsky D, McFarland DA. The diversity-innovation paradox in science. Proc Natl Acad Sci. 2020;117(17):9284-9291.
4. Flynn D. Personal Letter to ASTRO Board of Directors Regarding the ARRO-ASTRO relationship. 2003.
5. Jones RD, Chapman CH, Holliday EB, et al. Qualitative assessment of academic radiation oncology department chairs’ insights on diversity, equity, and inclusion: progress, challenges, and future aspirations. Int J Radiat Oncol Biol Phys. 2018;101(1):30-45.