Trends in Racial and Ethnic Representation in the Oncology Trainee Workforce

Importance Professional oncology societies have invested in initiatives to enhance the racial and ethnic representation of the oncology physician workforce, particularly since 2020. Whether these initiatives have contributed to changes in the racial or ethnic representation among oncology trainees and nononcology trainees who provide cancer-related care is unclear. Objective To assess trends in the distribution of underrepresented in medicine (URiM) physician trainees over time across oncology and nononcology specialties, with a focus on trends pre- and post-2020. The URiM category included individuals who identified as American Indian or Alaskan Native; Black or African American; Hispanic, Latino, or of Spanish origin; or Native Hawaiian or Pacific Islander race or ethnicity. Design, Setting, and Participants This repeated cross-sectional study used race and ethnicity data from the Accreditation Council for Graduate Medical Education for trainees in medical, radiation, or surgical oncology; general surgery; and primary care from 2011 to 2025. Data were analyzed from April 2025 to August 2026. Main Outcomes and Measures The proportion of URiM trainees was calculated by year and specialty. Segmented logistic regression was used to estimate the odds of being URiM overall and by specialty. Overall changes in the likelihood of a trainee being URiM post-2020 (level change) and the annual trend post-2020 (slope change) were estimated. Results There were 658 891 trainee observations in the cohort, of whom 113 937 trainees (17.3%) were URiM. The percentage of trainees who were URiM was relatively stable from 2011 (5435 trainees [16.1%]) to 2020 (8192 trainees [16.4%]), then increased to 13 345 trainees (20.4%) in 2025. After 2020, there was an overall 5% increase in the likelihood of a trainee being URiM (OR, 1.05; 95% CI, 1.03-1.08), as well as a 5% annual increase (OR, 1.05; 95% CI, 1.05-1.06). Within individual specialties, significant post-2020 increases were observed in surgical oncology and general surgery. The post-2020 increase was greatest in radiation oncology (OR, 1.20; 95% CI, 1.11-1.30). There was no statistically significant change in URiM representation among medical oncology trainees over the study period. Conclusions and Relevance This cross-sectional study found that the proportion of trainees who provide cancer care identifying as URiM increased from 2011 to 2025, particularly since 2020; however, URiM representation still did not match the diversity of the general US population in 2025.