Dr Karen Winkfield Discusses Importance of Workforce Diversity in Oncology

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Representation of minority populations in the oncology workforce is important to educate physicians on the meaning of being culturally appropriate, and to provide culturally appropriate care.


Representation of minority populations in the oncology workforce is important to educate physicians on the meaning of being culturally appropriate, and to provide culturally appropriate care, said Karen Winkfield, MD, PhD, incoming executive director, Meharry-Vanderbilt Alliance.


AJMC®: You’ve written about the particular need to diversify the workforce in radiation oncology. Why is the need for better minority representation so important here, and what have been the barriers to attracting minority physicians to this specialty?

Radiation oncology tends to be a very technical subspecialty. We deal with physics; I'm board certified in physics and radiation biology, and that can be discouraging to some. Although, I must say that the science that's required in order for me, for instance, to do a good job is science that we learn in the context of the work we're doing.

So, it has been a challenge for individuals who may think about oncology as a subspecialty, to think about radiation in particular, because of the fact that they think it's technical and they have to have all of this background in science. And so, that's 1 of the challenges.

The other challenge is that oftentimes people may not get any exposure. So, there may not be exposure to oncology, in general. If you look at medical schools that have very diverse populations, those medical schools tend to not have oncology specialties associated with them. So, students who might be primed—they could have been oncologists, but they may not have had that exposure. And so if you don't have exposures to oncology as a career, and you don't have exposure to radiation as a career, then you're not going to be in a position necessarily, to know what to do, how to do it, and to get the expertise that you need in order to make yourself a more viable candidate.

Cancer is the number 2 killer in the United States, it will probably surpass cardiovascular disease as the number 1 killer in the United States. And so again, our workforce, our oncology workforce needs to be representative of the communities that we are hoping to serve. It's really important to make sure that not only is the workforce diverse, because we want to make sure that patients feel comfortable, but we know that you're not going to be able to have every Black person, every Black patient see a Black doctor, but there's importance in terms of having representation in the field, so that colleagues can understand what it means to be culturally appropriate, and to provide culturally appropriate care.

AJMC®: ASCO just announced a new position statement on disparities in cancer outcomes, which discusses the workforce issues. What elements of this new statement do you feel are the most important?

So, the ASCO statement was really important. I think, for me, the most important thing that I got out of that is community engagement. I am a community engagement expert as well. I believe that you have to listen to the communities that you're hoping to serve so you know how best to serve them. And so that was one of the most important factors—the fact they talked about community engagement and understanding the communities that you hope to serve; but as you may know, I've been working with ASCO on their workforce diversity plan for years.

We created the strategic plan for workforce diversity, and now I'm leading their task force that really is helping to implement the plan. And we've already made wonderful strides. As you see, our current president is an African American woman. So, not only are we thinking about racial and ethnic diversity, but also gender diversity, because we know that women have traditionally also not been in leadership positions.

So, ASCO is putting its money where its mouth is, if you will, by making sure that the institution, the organization itself, is really highly representative of the populations that we're hoping to serve, both in terms of gender, but also race and ethnicity. So, we are working hard at ASCO and I feel like that statement is, once again, just another overview, but still highlighting some of the important things that can be done. Community engagement and also working more towards having diversity within the oncology workforce.