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Editorial: Dispelling Myths That May Deter Women From Pursuing Radiology and Radiation Oncology

Key findings

  • Women are substantially underrepresented in the fields of radiation and radiation oncology
  • Barriers include misconceptions that these specialties are not family-friendly, expose physicians to harmful levels of radiation, require clinicians to work in solitude, don't lend themselves to work–life integration, and similar myths
  • The American Association for Women in Radiology is running a multiyear social media campaign to counter #radmyths with #radfacts
  • A recent editorial by the group provides a combination of literature review and expert opinion to debunk the myths in detail

Since 2009, the proportion of female medical students in the U.S. has been approximately 50%. Still, the proportions of women choosing residencies in radiology and radiation oncology have stagnated at about 27% and 30%, respectively, for at least the past quarter-century.

The Medical Student Outreach Subcommittee of the American Association for Women in Radiology (AAWR) identified myths that may dissuade women—and men—from exploring these fields. Shadi A. Esfahani, MD, an instructor in the Department of Radiology at Massachusetts General Hospital, and colleagues debunk them in a multiyear series of posts on Instagram and Twitter. In an editorial in Clinical Imaging, the group provides a combination of literature review and expert opinion to discredit the myths in detail. This summary highlights several of the myths and counterarguments.

Myth: Radiology and radiation oncology are not family friendly—Thanks to a proposal led by AAWR, the American Board of Radiology in April 2021 revised its policy on family and medical leave. Residents should now receive 12 weeks of protected family and medical leave while remaining eligible for the Core/Qualifying Examinations and be able to graduate without prolonging their training.

In addition, many programs now provide a lactation room and are making efforts to create a culture of breastfeeding support.

Myth: Radiologists and radiation oncologists don't see patients—Depending on the practice setting and subspecialty, radiologists interact with patients for diagnostic ultrasounds, fluoroscopic imaging, image-guided diagnostic and therapeutic interventions, and radionuclide therapy, among other procedures. Furthermore, practice models are emerging in which radiologists deliver news directly to patients.

Radiation oncologists spend much of their day with patients at the time of cancer diagnosis, during therapy, for years in surveillance after treatment, and at the end of life.

Myth: Radiologists and radiation oncologists are unsociable and function in solitude—Diagnostic radiologists do spend most of their time interpreting images. However, in addition to patient contact in many subspecialties, radiologists work closely with technologists, medical students, other radiologists, consulting physicians across various specialties, and referring clinicians.

Radiation oncology, too, is a highly interdisciplinary profession. A radiation oncologist works as part of a team of medical physicists, dosimetrists, radiation therapists, nurses, and advanced practice providers.

Myth: Radiologists and radiation oncologists are exposed to harmful radiation levels—Changes such as stricter regulations and widespread use of personal protective equipment have substantially reduced risks to radiologists. In fact, a 2016 study published in Radiology of all U.S. physicians who graduated from 1916 to 2006 showed radiologists had lower overall death rates than psychiatrists and similar cancer death rates.

Radiation therapy uses high doses, but radiation oncologists and other personnel are shielded by stringent construction and departmental design regulations. The International Atomic Energy Agency limits occupational radiation exposure to 50 mSV, compared with 1 mSv for the general public. More stringent limits and monitoring requirements must be in place during pregnancy.

Anecdotal evidence suggests many residency programs allow flexibility in the timing of rotations in which there may be radiation exposure, so women can choose to defer those rotations until after pregnancy.

Myth: Radiology and radiation oncology don't provide much in the way of work–life integration—Practice patterns in radiology are varied and can provide flexibility. For example, a growing practice area is teleradiology, which allows some choice of work hours and opportunities to work from home. Academic institutions and private practices vary in their call schedules, options for part-time work, and scope of subspecialty involvement for radiologists.

Surveys have shown that professional satisfaction is higher for radiologists (published in Radiologyand radiation oncologists (published in Mayo Clinical Proceedingsthan for other physicians.

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