In the US, prostate cancer is the third most common cancer overall and the most common in men, accounting for approximately 30 000 deaths per year.¹ Metastatic prostate cancer remains incurable despite advances in systemic management for hormone-sensitive² and castration-resistant disease.³

Definitive radiotherapy with androgen deprivation therapy and radical prostatectomy are standard treatment options for patients with high-risk prostate cancer, characterized by initial prostate-specific antigen levels greater than 20 ng/mL, biopsy Gleason score 8-10 disease, or lesions with clinical T stage greater than or equal to 3.¹ Radiotherapy options include external beam radiotherapy (EBRT) alone and EBRT with a brachytherapy boost (EBRT+BT), with the latter constituting extreme dose escalation. Although randomized trials suggest a biochemical control benefit to EBRT+BT over EBRT, no differences in clinical outcomes have been established.^2-4 Whether radical prostatectomy and radiotherapy (either EBRT or EBRT+BT) offer equivalent outcomes for high-risk prostate cancer remains controversial, with no clear evidence from randomized trials.^5-7 Previous comparative retrospective series included patients treated during multiple decades to obtain enough person-years of follow-up to identify sufficient clinical events for valid statistical comparison. Thus, these studies have generally included patients treated with lower doses of radiotherapy⁸ or insufficient androgen deprivation therapy.^9,10 As a result, the relevance of such studies to the contemporary setting is unclear.

Diversification of the physician workforce in the United States remains an ongoing goal,^1,2 yet assessments of graduate medical education (GME) diversity, overall and across specialties are lacking. We assessed GME diversity by race, ethnicity, and sex in 2012.