Geographic migration patterns of practicing medical oncologists in the United States, 2020-2025.

Abstract

1527 Background: The regional provision of cancer care in the United States (US) remains plagued by disparities along the continuum of screening, diagnosis, and treatment. The geospatial accessibility and migration patterns of medical oncologists may contribute to these disparities. We aimed to assess urban-rural and state-level migration patterns of practicing medical oncologists in the US using national datasets. Methods: The Doctors and Clinicians national downloadable file was used as the primary dataset for these analyses. Physician data from August 2020 and August 2025 was used to identify changes in geographic location. The specialties “Hematology/Oncology” and “Medical Oncology” were used to identify oncologists. We utilized Rural-Urban Continuum Codes (RUCC) to classify counties as urban (RUCC 1-3) or rural (RUCC 4-9). If oncologists practiced in multiple states, they were included in all relevant states for these analyses. For categorical variables, the chi-squared test was used for statistical significance. For continuous variables, the two-sample t-test was used for statistical significance. Results: There were 12,222 oncologists in 2020 and 13,420 oncologists in 2025. Our final cohort for analysis comprised 10,172 oncologists present in both datasets. 1,233 oncologists (12.1%) began practicing in a new state during this time period. The five states with the largest percentage of oncologists gained from net migration were: Hawaii (10.8%), Montana (6.7%), Vermont (5.5%), Idaho (5.0%), and Nebraska (4.1%). The five states with the largest percentage of oncologists lost from net migration were: Wyoming (-8.7%), West Virginia (-6.2%), Delaware (-6.2%), Alaska (-4.2%), and Arkansas (-4.1%). Female oncologists were more likely to migrate to a new state (12.6%) than male oncologists (11.8%); however, the difference was not statistically significant (p-value = 0.25). The mean number of years since medical school graduation was 25.1 years for oncologists who began practicing in a new state and 28.4 years for oncologists who did not (p-value <0.001). Oncologists in rural areas were more likely to migrate to urban areas (N = 492; 48.7%) than oncologists in urban areas were to migrate to rural areas (N = 380; 4.1%; p-value <0.001). Conclusions: Oncologists in the US exhibit distinct regional and urban-rural migration patterns. Targeted interventions to ensure adequate geospatial supply of physicians should focus on rural areas and states such as Wyoming and West Virginia. Improving understanding of the underlying factors driving oncologist migration patterns is crucial to ensuring a distributed oncology workforce.