Training of oncologists: Results of a global survey.

Abstract

10526 Background: While several studies have highlighted the global shortages of oncologists and their workload, few have studied the characteristics of current oncology training. Methods: An online survey was distributed through a snowball method via national oncology societies and a pre-existing network of contacts to cancer care providing physicians in 57 countries. Countries were classified into low- or lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs) based on World Bank criteria. Results: 273 physicians who trained in 57 different countries responded to the survey; 33% (90/273), 32% (87/273), and 35% (96/273) in LMICs, UMICs and HICs respectively. 60% of respondents were practicing physicians and 40% were in training. The proportion of trainees was higher in LMICs (51%; 45/89) and UMICs (42%; 37/84), than HICs (19%; 28/96; P = 0.013). A higher proportion of respondents from LMICs (37%; 27/73) self-fund their core oncology training compared to UMICs (13%; 10/77) and HICs (11%; 10/89; P < 0.001). Respondents from HICs were more likely to complete an accepted abstract, poster and publication from their research activities compared to respondents from UMICs and LMICs (abstract: 37/72 (51%) from HICs, 18/66 (27%) from UMICs, 24/65 (37%) from LMICs, P = 0.014; poster: (42/72 (58%) from HICs, 28/66 (42%) from UMICs, 13/65 (20%) from LMICs, P < 0.001; publication: 43/72 (60%) from HICs, 32/66 (49%) from UMICs, 24/65 (37%) from LMICs, P = 0.029). Respondents identified several barriers to effective training including skewed service to education ratio and burnout. With regards to preparedness for practice, mean scores on a 5-point Likert scale were low for professional tasks like supervision and mentoring of trainees, leadership and effective management of an oncology practice, and understanding of healthcare systems irrespective of country grouping. Conclusions: Investment in training by the public sector would be vital to decreasing the prevalence of self-funding in LMIC. Gaps in research training and enhancement of competencies in research dissemination in LMIC require attention. Instruction on cancer care systems and leadership need to be incorporated in training curricula in both LMICs and HICs.

Experiences of barriers and facilitators to establishing and sustaining radiotherapy services in low‐ and middle‐income countries: A qualitative study

“…Tailored in-country education and training initiatives are emerging and have proven successful. [27][28][29] Multiple opportunities for regional training, mentoring and network building have been created. They include Africa Radiation Oncology Network (AFRONET) and Virtual University for Cancer Control by IAEA and "train-the-trainers" approach by Radiating Hope, RANZCR, and Medical Physics for World Benefit.…”

“…Sustaining radiotherapy facilities in LMICs is achievable but requires a capable workforce. Tailored in‐country education and training initiatives are emerging and have proven successful . Multiple opportunities for regional training, mentoring and network building have been created.…”