RO Corner: On Diversity, Equity and Inclusion

With the official observances of Black History Month in February and Women’s History Month in March, this article is dedicated to some thoughts on diversity, equity and inclusion (DEI). In recent years, topics related to DEI have been brought to attention on the national level, generating much interest, discussion and activism. Some such movements include LGBTQ+ rights, #MeToo movement, Black Lives Matter, Missing and Murdered Indigenous Women (MMIW), Indigenous Rights, and many others. Anti-Asian hate crimes have also increased during the COVID-19 pandemic.

Many individuals, groups and organizations in radiation oncology (i.e., ACR, ACRO, ASTRO) are interested in advancing DEI, which has led to various discussions at recent annual meetings. The ACR, which has a Commission for Women and Diversity, recently held a webinar on DEI^1,2. ASTRO offers the Committee on Health Equity, Diversity and Inclusion⁴. In addition to committees within professional organizations, many opportunities to be involved in DEI exist at the local level.

Insightful articles on DEI topics, such as racial justice and gender equity, were recently published in our field of radiation oncology (see resources below). In addition, publications dedicated to understanding and combating racism include NEJM’s Race and Medicine collection.

For those who are new to this topic, having conversations about DEI may feel challenging or uncomfortable. These discussions are not easy, and they are not always risk-free, but coming at them with an open mind and willingness to listen and learn can lead to valuable insights and promote collective progress.

Recognizing and deconstructing systemic forms of disempowerment used by certain groups over others is critical in creating a workforce in which members can feel physically and psychologically safe, which allows them to be better positioned to thrive, be successful and have their talents and skills be realized. Such action is also necessary to creating a more culturally sensitive workforce that can better understand and care for patients of diverse backgrounds and needs.

Although we have made progress in DEI, much work still remains as injustice continues to exist in our society and in medicine. I personally am constantly learning and unlearning! Despite our shortcomings, I am hopeful that we can work together towards a better future for all.

I encourage you to learn about DEI and consider implementing changes in radiation oncology with the help of many excellent books, websites and other resources, including the ones provided below:

1. ACR Radiation Oncology Diversity Equity and Inclusion Webinar. https://www.youtube.com/watch?v=ZrKk-0cd7TI&ab_channel=RadiologyACR 
2. ACR Commission for Women and Diversity. https://www.acr.org/Member-Resources/Commissions-Committees/Women-Diversity 
3. Chapman, et al. “Why Racial Justice Matters in Radiation Oncology,” Advances in Radiation Oncology, Sept. 1, 2020, pp. 783–790. https://www.advancesradonc.org/article/S2452-1094(20)30162-7/fulltext
4. Deville, et al. “Updates from ASTRO's Committee on Health Equity, Diversity and Inclusion (CHEDI),” ASTRO Blog, July 24, 2018. https://www.astro.org/Blog/July-2018/Updates-from-ASTRO-s-Committee-on-Health-Equity,-D
5. Holliday, et al. “Achieving Gender Equity in the Radiation Oncology Physician Workforce,” Advances in Radiation Oncology, Oct. 1, 2018, pp. 478–483. https://www.advancesradonc.org/article/S2452-1094(18)30179-9/fulltext
6. Howell, et al. “New Gender Equity Community opens in the ROhub,” ASTRO Blog, Dec. 15, 2020. https://www.astro.org/Blog/December-2020/New-Gender-Equity-Community-opens-in-the-ROhub
7. Lightfoote, et al. “Improving Diversity, Inclusion, and Representation in Radiology and Radiation Oncology Part 1: Why These Matter,” Journal of the American College of Radiology, July 2014, pp. 673–680. https://www.jacr.org/article/S1546-1440(14)00125-2/fulltext
8. Lightfoote, et al. “Improving Diversity, Inclusion, and Representation in Radiology and Radiation Oncology Part 2: Challenges and Recommendations,” August 2014, pp. 764–770. https://www.jacr.org/article/S1546-1440(14)00126-4/fulltext
9. Mansfield, Carl M. African American Radiation Oncologists. Chapter 10, pp. 263–275. https://www.arrs.org/publications/HRS/oncology/RCI_O_c10.pdf
10. McClelland III, et al. “Improving the Clinical Treatment of Vulnerable Populations in Radiation Oncology,” Advances in Radiation Oncology, Aug. 6, 2020, pp. 1093–1098. https://www.advancesradonc.org/article/S2452-1094(20)30209-8/abstract
11. Siker, et al. “Lessons from COVID-19: Addressing Health Equity in Cancer Care,” International Journal of Radiation Oncology, Biology, Physics, Oct. 2020, pp. 475–478. https://www.redjournal.org/article/S0360-3016(20)31329-8/fulltext
12. Society for Women in Radiation Oncology https://www.societywomenradiationoncology.com/
13. Suneja, et al. “Pathways for Recruiting and Retaining Women and Underrepresented Minority Clinicians and Physician Scientists Into the Radiation Oncology Workforce: A Summary of the 2019 ASTRO/NCI Diversity Symposium Session at the ASTRO Annual Meeting,” Advances in Radiation Oncology, May 20, 2020, pp. 798–803. https://www.advancesradonc.org/article/S2452-1094(20)30133-0/fulltext
14. Washington, et al. “Representation Trends of Underrepresented Minority Physicians in the US Radiation Oncology (RO) Workforce,” International Journal of Radiation Oncology, Biology, Physics, Sept. 2019, Oral Scientific Session. https://www.redjournal.org/article/S0360-3016(19)31348-3/fulltext