Training of oncologists: results of a global survey

Abstract

While several studies have highlighted the global shortages of oncologists and their workload, few have studied the characteristics of current oncology training. In this study, an online survey was distributed through a snowball method for 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. A total of 273 physicians who were 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. About 60% of respondents were practising physicians and 40% were in training. The proportion of responding 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. Respondents identified several barriers to effective training, including skewed service to education ratio and burnout. With regard 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. In conclusion, the investment in training by the public sector is vital to decreasing the prevalence of self-funding in LMICs. Gaps in research training and enhancement of competencies in research dissemination in LMICs require attention. The instruction on cancer care systems and leadership needs to be incorporated in training curricula in all countries.

Oncology Training Needs Assessment Among Health Care Professionals in Nigeria

“…Similar findings have been reported in studies in different regions of the world. 14 , 28 - 31 Findings from a study in Europe revealed that a majority of medical students rated clinical exposure to the management of patients with cancer as unsatisfactory. 28 Similarly, in Turkey, more than half of the nurses in one study did not receive any training regarding oncology palliative care.…”

“…Ability versus inability to self-fund has implications for workforce selection and may increase disparities within and between countries, which may adversely affect the most disadvantaged populations and diminish the social accountability of training programs. 14 The majority of respondents in our study would like to have structured trainings on cancer research and statistical analysis. The demand for capacity building in cancer research that we identified aligns with findings in East Africa.…”

“…Quantitative data were collected using a semistructured, online questionnaire developed through a review of the literature. 14 , 26 , 27 The instrument comprised six sections: sociodemographic characteristics of respondents, opportunities for oncology-focused training, preparedness and competency in oncology practice and research, interprofessional practice, and specific cancer-focused training needs. Competency in oncology research was assessed with 26 items in the instrument, each requiring a response on a one- to five-point self-rating scale (maximum score of 130).…”

“…Of greater significance is the lack of adequate curriculum for advanced training in health professions and structured career pathways in academic medical centers to facilitate the development of independent cancer researchers. 13 , 14 Standard training in oncology in most developed countries consists of a graduate program or a board certification fellowship guided by a curriculum that is in line with the recommendations of the European Society for Medical Oncology and ASCO. 16 , 17 Without leadership and a structured curriculum, there is weak interprofessional collaboration to improve quality of cancer care in Nigeria and other LMICs.…”

“…Identified impediments to pursuing this goal included lack of mentorship and guidance in the conduct of research and lack of structured teaching in clinical settings. 14 To build on the findings from this global survey and explore the needs for training in cancer research and clinical practice in Nigeria, we developed a survey to investigate the status of training in oncology practice and research for clinicians in Nigeria.…”