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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 556-559

Becoming an oncologist: What is the optimal training duration?


1 Department of Internal Medicine, University of Connecticut, Farmington, CT, USA
2 Joslin Diabetes Center, Harvard Medical School, Boston, USA
3 Department of Medical Oncology, Ernakulam Medical Centre, MOSC Medical College, Kochi, Kerala, India

Date of Submission11-Aug-2021
Date of Acceptance14-Sep-2021
Date of Web Publication08-Oct-2021

Correspondence Address:
Aju Mathew
MOSC Medical College, Medical College Road, P. O. Kolenchery, Kochi - 682 311, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_188_21

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How to cite this article:
Thomas VM, Roy N, Mathew A. Becoming an oncologist: What is the optimal training duration?. Cancer Res Stat Treat 2021;4:556-9

How to cite this URL:
Thomas VM, Roy N, Mathew A. Becoming an oncologist: What is the optimal training duration?. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Dec 9];4:556-9. Available from: https://www.crstonline.com/text.asp?2021/4/3/556/327778



More than 9.6 million deaths worldwide in 2017 were attributed to cancer.[1] There are large disparities in cancer care between and within nations. Globally, there is a shortage of health-care workers.[2] This disparity also translates to the number of oncologists across the world, with a smaller number of oncologists available in low- and middle-income countries.[3] To address the disparity in the number of oncologists, health-care training programs must cater to the needs of the geographical area. To our knowledge, no study has addressed the duration of oncology training.

We surveyed practicing oncologists on the duration of clinical and medical oncology training programs across the world through an online questionnaire, which was distributed through personal contacts, email listserv, and social media. We also reviewed the websites of training programs in countries where such data were provided. We aimed for a snowball sampling methodology in disseminating the survey. The participants were self-identified oncologists. We received 46 responses from 43 different countries. Of these, 35 (76%) were from medical oncologists and 11 (24%) from clinical oncologists. Seventeen responses (37%) stated that their countries did not require mandatory training in internal medicine and they could directly transition to oncology training. The median duration of the core oncology training program was 3 years (range, 1.5–6 years), and the median number of years from joining medical school to completing oncology training was 12 years (range, 7.5-15 years).

There was considerable variation in the number of years required for medical training between these countries [Table 1]. Such a variation could be due to differing requirements before starting core oncology training in different countries. For instance, some countries require mandatory training in internal medicine, while others might provide the option of transitioning to oncology training straight after medical school. The length of medical school training also varies in different countries.
Table 1: Summary of results

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With the ever-increasing burden of cancer, there is a greater demand for oncologists across the world.[1] To address the rising cancer burden, oncology training must be optimized for quality. A prolonged training program may dissuade doctors from taking up oncology specialization. Competency-based education in which earlier oncology focused training during residency can help in shortening the duration to become a practicing oncologist.[4] A shorter duration can also increase training efficiency, decrease training costs, and speed up the pathway to the resident's career goals.[5] On the contrary, longer training does not always equate to better quality. Longer duration of training may result in professional burnout as well. What is the right training duration? The answer to that question eludes us now. However, it is a question that must surely be addressed.

We implore global professional associations such as the American Society of Clinical Oncology and the European Society of Medical Oncology (ESMO) to collaborate with national associations to conduct a formal evaluation process. It will be a significant first step in rationalizing oncology training and thereby impact the quality of cancer care globally.

Acknowledgment

The authors wish to acknowledge the assistance provided by Ashish Vankara, BE in creating the survey.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1736-88.  Back to cited text no. 1
    
2.
World Health Organization (2011). Transformative Scale Up of Health Professional Education: An Effort to Increase the Numbers Wof Health Professionals and to Strengthen their Impact on Population Health.Available online at: https://apps.who.int/iris/handle/10665/70573. [Last accessed on 2021 Aug 10].  Back to cited text no. 2
    
3.
Mathew A. Global survey of clinical oncology workforce. J Glob Oncol 2018;4:1-12.  Back to cited text no. 3
    
4.
Asad ZU, Tunnell C. ABIM/ACC Competency-Based Education Pilot in Internal Medicine-Cardiology: A fellow's perspective. J Am Coll Cardiol 2018;72:1422-6.  Back to cited text no. 4
    
5.
Campbell ST, Dave DR. Two sides to every story: Early specialization in medical education. Med Sci Educ 2018;28:243-6.  Back to cited text no. 5
    



 
 
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