By Raymond Mailhot Vega, MD, MPH
In mid-December, a colleague emailed me a link to an ROhub discussion on the creation of a society for Hispanics in radiation oncology. This prospect excited me. Representation matters. As a Latino becoming a radiation oncologist, I did not see myself in the workforce. Becoming what I did not see presented unique challenges and, at times, a feeling of isolation since I struggled to find others who had shared my experiences. A silver lining is charting your own territory, but being on your own, it can be hard to know if you’re making progress heading towards your destination. How do you explain to an attending whose feedback post-consult is, “Wow, you speak Spanish so well” that while meant as a compliment, so do 15% of Americans and such an observation does not provide a meaningful critique of my patient knowledge or my memorization of the inclusion criteria of PORTEC-2. Now as an attending and full member of ASTRO, I am eager to extend a hand to the next generation as they navigate their careers.
Recently, ASTRO has been working to create different ROhub communities to provide virtual spaces for communities of radiation oncologists to gather, addressing an important need. A space for communities of radiation oncologists to gather is manifold in its benefits. Latinx physicians are drastically underrepresented in radiation oncology at only 2% of the rad-onc workforce overall,1 despite the fact that 15% of Americans identify as Hispanic. Established in education is the credo “you can’t be what you can’t see,” and medical training and employment is no different. A virtual affinity space allows for mentorship of trainees and junior faculty seeking career advice. A dedicated space also provides mental health support. Physician burnout continues to gain more visibility, and the extra stress and invisible labor that more commonly burden diverse faculty are well-documented.2 A defined space for Latinx doctors facilitates the creation of a community in which we can share our common experiences, interests, stories and struggles.
Some may feel that purposely creating communities around race or ethnicity could increase divisions between people. Divisions already exist, and the “I don’t see race” perspective from the 1990s blinds ourselves and hinders our ability to dismantle the extraordinary barriers developed over hundreds of years of systemic racism that affects both patients and doctors. A dedicated community can provide a safe space to generate ideas from lived experience and foster leaders to represent that community among the larger membership. The COVID-19 pandemic has thrust in the spotlight the disparities that communities of color have faced, and a forum representing those affected can create opportunities that successfully address such inequities in health care and oncology.
To address the need for connection among physicians, physicists and trainees, ASTRO is launching various ROhub communities. These forums will create a virtual space in which ASTRO’s underrepresented and diverse members can congregate and network along with all members who wish to participate. I am excited for ASTRO’s debut and kick-off of these ROhub communities — intentional spaces for radiation oncologists to unite and grow from shared experiences. Particularly as we face social changes with our Annual Meeting moving to a virtual experience, planned socializing and networking must adapt. The timing for this initiative could not be more appropriate. Opportunity is not a zero-sum game: we don’t have to lose power or influence when others gain it. Increased diversity will push our research forward, bring new ideas to the forefront and result in higher-quality care for all patients.
ASTRO’s initiative will provide a broader tent for all of us. I encourage you to speak out for increased equity in representation of your brown and Black radiation oncology colleagues, for bridging the health-care disparities that patients of color face, for making our system more accessible for the disabled, for improving gender parity among our workforce and for creating a safe space for those who identify as LGBT+. Our time is now.
Since the submission of this blog post, ASTRO is pleased to announce the launch of the Gender Equity Community on the ROhub, a space for members to discuss gender gaps, offer mentorship and seek or provide helpful resources. The community was created for those personally encountering gender-related concerns and for those who wish to support and promote gender equity within their workplace. Work is underway to launch additional communities in the coming months.
Raymond Mailhot Vega, MD, MPH, is a gay, Latino assistant professor at the University of Florida, where he directs the hematology radiotherapy program in addition to treating pediatric patients and patients with breast cancer. He is a recipient of a Global Oncology-Young Investigator Award to conduct educational interventions for pediatric radiotherapy treatment in Mexico to reduce disparate outcomes.
1. Fung CY, Chen E, Vapiwala N, et al. The American Society for Radiation Oncology 2017 Radiation Oncologist Workforce Study. Int J Radiat Oncol Biol Phys. 2019; 103: 547-56.
2. Matthew PA. What is Faculty Diversity Worth to a University? The Atlantic. 2016 November 23, 2016;Sect. https://www.theatlantic.com/education/archive/2016/11/what-is-faculty-diversity-worth-to-a-university/508334/. Accessed on May 11, 2020.