Recruiting the Next Generation: A Review of Medical Student Interest and Career Decision-Making in Radiation Oncology

The rising incidence and complexity of cancer care have increased pressure on the radiation oncology (RO) workforce. Despite growing clinical demand, unfilled residency positions have raised concerns about workforce sustainability. Modeling studies predict a shortage of radiation oncologists, emphasizing the need to strengthen medical student recruitment in RO. Trainee interest in RO is influenced by both practical and personal factors. Practical components include alignment with career goals, clinical exposure, mentorship, and work-life considerations. Personal experiences, such as one's own or a family member's experience with cancer, also commonly shape interest. Bland-Meurer and Pfarrwaller frameworks contextualize how these factors interact over time to guide specialty choice. Interventions such as the Radiation Oncology Intensive Shadowing Experience and CARO Underrepresented in Radiation Oncology Mentorship Program target key motivating factors, particularly through mentorship. Recruitment challenges for radiation therapy technologists and medical physicists include training bottlenecks, retention concerns, and increasing workload pressures. Sustaining the RO workforce requires early exposure, mentorship, and targeted interventions for trainees, alongside strategies to support allied radiation professionals. Conceptual frameworks can guide development of interventions that align evolving career needs with specialty characteristics. Integrating oncology education into medical curricula and supporting recruitment and retention across the multidisciplinary RO workforce is critical for sustainable cancer care delivery.