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In France, radiation oncology remains predominantly male, as women represented 44% of radiation oncologists. Many studies have highlighted gender disparities in medicine. Disparities in salaries, publications, and representation in key positions have been reported. Some studies have looked also at the impact of discrimination related to ethnic origin or sexual orientation. However, this kind of study has not been conducted in France yet. The main objective of our study was to assess the current situation, study the factors that may influence disparities, and to propose solutions for improvement.

An anonymous online questionnaire, inspired by the one used in 2021by the ESMO W4O group, was disseminated to all the residents and radiation oncologists in France between March and June 2022. It included questions related to professional experience, gender, socio-ethnicity, sexual orientation, personal life, as well as a section dedicated to academic research.

Among the 999 radiation oncology practitioners and 168 residents in France, 225 questionnaires were collected (19.2%). Among the responders, 135 (60%) were women and 90 were men (40%). The mean age was 39.2 years, 25% were residents and 75% were practitioners. Among the practitioners, 42% were practicing in a cancer center, 25% in a teaching university hospital, and 23% in a private institution. The career satisfaction rate was 92%, with no gender difference. Gender had a negative impact on the career in 65% of the women, social origin had a negative impact in 37% of the responders, and ethnic origin in 25%. People who had been discriminated on the basis of their ethnic origin had a lower rate of job satisfaction (8.7% versus 91%, p<0.001). Moreover, 20% of respondents have been racially discriminated by a patient. Sixty-two percent of women reported having experienced inappropriate behavior or sexual harassment in the workplace, and 4% sexual assault. Thirty-eight percent of women felt that having a child had “extremely" or "very" impacted their career against 8.5% of men (p<0.001). Ten percent of women felt that there had been no change in gender equality compared to 1% of men (p<0.001). The most popular proposals for improvement were the "Creation of specific educational programs" (42% of women versus 22% of men, p<0.01), the creation of a "Network of women radiation oncologists" (41% versus 3.3%; p<0.001), and the "Addition of quotas in institutions, associations and key positions" (39% versus 10%; p<0.001).

This study is the first one establishing an inventory of the various discriminations experienced by radiation oncologists in France. Additionally, it has allowed us to identify the main obstacles met in their career by women and to analyze the factors that may explain these inequalities. We make a few propositions for improvement to guarantee the best working and training conditions, regardless of the origin and gender.