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.
Highlights
Health systems worldwide face diverse challenges related to a global health workforce crisis [1]
Our study aimed to describe oncologists’ preparedness for practice based on their training across lower-middle-income countries (LMICs), upper-middle-income countries (UMICs) and high-income countries (HICs)
273 physicians practising in 57 different countries, 33% (90/273), 32% (87/273) and 35% (96/273) in LMICs, UMICs and HICs, respectively, were included in our study
Summary
Health systems worldwide face diverse challenges related to a global health workforce crisis [1]. This burden is increasing with a 45% projected increase in global cancer deaths by 2030 estimated by the WHO This trend poses a particular threat in LMICs that are ill-equipped to deal with complex and expensive cancer treatments [3, 4]. Scaling up educational programs to produce more healthcare professionals is beneficial, these efforts need to be accompanied by educational reforms that will provide graduates with the necessary competencies [1]. It is not uncommon for the patients in LMICs with potentially curable disease to receive sub-optimal radiotherapy and systemic therapy [5]
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