Fertility Concerns, Family Planning, and Career Decisions Among Female Oncologists

A national survey of more than 1,000 female oncologists explores their difficult career choices amidst attempts to build families, their concerns about fertility, and their issues with discrimination during pregnancy and/or maternity leave. Dr. Fumiko Chino, Dr. Anna Lee, and Dr. Erin Gillespie discuss the survey’s findings and share their own insights and experiences as female oncologists.

TRANSCRIPT

Dr. Fumiko Chino: Hello, I am Dr. Fumiko Chino, a radiation oncologist and health equity researcher at Memorial Sloan Kettering Cancer Center and the guest host of the ASCO Daily News podcast today.

In today's episode, we'll explore gender equity within the oncology workforce. Our discussion is centered on a newly published article in JAMA Network Open.

This national survey of over 1,000 female oncologists found that 95% considered their career when planning a family, and about one-third faced fertility concerns when trying to become pregnant. Additional findings include that one-third faced discrimination during pregnancy and/or maternity leaves.

Joining me for this discussion are study team members Dr. Anna Lee, an assistant professor in radiation oncology at the University of Texas, MD Anderson Cancer Center, and Dr. Erin Gillespie, an associate professor in radiation oncology at the University of Washington and a member of the Hutchinson's Institute for Cancer Outcomes Research.

Our full disclosures are available in the transcript for this episode, and disclosures relating to all episodes of the ASCO Daily News podcast are available on our transcripts at asco.org\podcasts.

We have all agreed to go by our first names today. Anna and Erin, it's great to have you on the podcast today.

Dr. Anna Lee: Thank you, excited to be here.

Dr. Erin Gillespie: Yeah, thanks so much, Fumiko.

Dr. Fumiko Chino: Well, I'm hoping to just dive right in to talk about this study, which I was proud to be on the authorship team with both of you. I just want to give a little bit of setup about how this study started, which was essentially within our own group of junior female faculty.

We have semi-regular meetings, and this idea for the study actually came up at a picnic for some young female faculty members. That then led to a small survey that I did on a Facebook group of young female oncologists and then, ultimately, to the national survey. So, Anna, do you mind telling me just a little bit about your research background and why this topic is important to you?

Dr. Anna Lee: Yeah. So, when I was a resident along with my co-resident Virginia Osborn, we helped co-found a group called the Society for Women in Radiation Oncology, or SWRO. We were able to bring a group of women in our field who were interested in looking at the experiences of female radiation oncologists, both starting at the residency, the training level, but also into practice. And we had generated an initial survey looking at women's experience, and they found that even though the majority, almost 95% of women, felt like radiation oncology was a family-friendly field, only about half of the group actually felt that it was after their lived experiences. So, this kind of led me to being interested in participating in the development of this study.

And personally, I have been going through the fertility journey myself. My partner and I got married last year and, you know, you think that for so long you put an effort into something and get a result and just how I did in academics or in terms of my career aspirations, you think that it'd be very straightforward, but it's been more of a challenge than I expected, and we are going through the whole workup process and considering our options. So this is a study that is of personal interest to me.

Dr. Fumiko Chino: Thank you so much for sharing that. And Erin, do you mind just sharing a little bit about your background and why this topic is important for you?

Dr. Erin Gillespie: My research really focuses on access to high-quality, patient-centered care. I'm from Anchorage, Alaska, so this idea of variation in quality and differences in care people receive has been central. And one thing that I've noticed over time is that the physician workforce has such an important—and physicians, in general, in oncology—have really big impacts on the care that patients receive.

And in radiation oncology, we've seen for many decades now that we have only about 30% of our workforce is women. And to Anna's point, why is that? And I think this study sort of gets at some of the challenges that women may be foreseeing in entering an oncology career.

For me personally, I started my first faculty position in my mid-30s. And it being a small field, I've...