Medical Oncology Training Research Articles

Open LEARN: Open access linear accelerator education and augmented reality Navigator

PurposeTo create an open-access Linear Accelerator Education and Augmented Reality Navigator (Open LEARN) via 3D printable objects and interactive augmented reality assets. MethodsThis study describes an augmented reality linear accelerator (linac) model accessible through a QR code and a smartphone to address the challenges of medical physics and radiation oncology trainees in low-to-middle-income countries. ResultsMajor components of a generic linear accelerator are modeled as individual objects. These objects can be 3D printed for hands-on learning and used as interactive 3D assets within the augmented reality app. In the AR app, descriptions are displayed to navigate the components spatially and textually. Items modeled include the treatment couch, klystron, circulator, RF waveguides, electron gun, waveguide, beam steering assemblies, target, collimators, multi-leaf collimators, and imaging systems. The linear accelerator is rendered at nearly 100% of its actual size, allowing users to change magnification and view objects from different angles. ConclusionsThe augmented reality linear accelerators and 3D-printed objects make these complex machines easily accessible with smartphones and 3D-printing technologies, facilitating education and training through physical and virtual interaction.

Global interest in podcasts designed for medical oncology trainees.

9019 Background: Audio podcasts allow for medical education to be disseminated in an on-demand format and are globally accessible. There are currently a limited number of trainee-directed medical oncology podcasts and their global impact has not been shown. “Talking about Tumors with Ryann and Ryan” is an English language, evidence-based, free-to-use podcast that was initiated in April 2022 with a focus on education of trainees new to the field. Methods: Geographic statistics were collected for podcast episodes with greater than 30 days of availability. The proportion of listeners from different regions was compared between episodes. Trends in listeners from North America and global audiences were descriptively analyzed. Results: 34 episodes were included in this analysis, with content in gastrointestinal, breast, thoracic and cutaneous malignancies. Episodes had a median of 115 downloads, with consistently >30% from outside of Canada and the United States (median 37.3 +/- 6.4%). Twenty-four countries had greater than 10 downloads. The largest audience beyond North America was Australia (13%), Israel (4%), United Kingdom (3%), Pakistan (3%), Sweden (2%), India (1%), and Hong Kong (1%). A review of individual cities within countries was relatively constant, suggestive of persistent listenership. Conclusions: There is a global interest for introductory medical oncology education. Presentation in an evidence-based format and awareness of variation in regional approaches to systemic therapy can increase the impact of podcasts, which by their design can reach a global audience. The development of an index for early education oncology podcasts may improve visibility and access to those interested in this medium.

Evaluating Systemic Burnout in Medical Oncology Through a National Oncology Mentorship Program.

Mentorship has a positive influence on trainee skills and well-being. A 2022 Pilot Mentorship Program in New South Wales involving 40 participants revealed high burnout rates in Medical Oncology trainees. As part of an Australia-wide inaugural National Oncology Mentorship Program in 2023 (NOMP23), a national survey was undertaken to assess the prevalence of burnout, anxiety, depression, professional fulfilment, and drivers of distress in the Australian medical oncology workforce. NOMP23 is a 1-year prospective cohort study that recruited medical oncology trainees and consultants using e-mail correspondence between February and March 2023. Each participant completed a baseline survey which included the Maslach Burnout Index (MBI), Stanford Professional Fulfilment Index, and Patient Health Questionnaire-4 for anxiety and depression. One hundred and twelve participants (56 mentors, 56 mentees) were enrolled in NOMP23, of which 86 (77%) completed the baseline survey. MBI results at baseline demonstrated that 77% of consultants and 82% of trainees experienced burnout in the past 12 months. Professional fulfilment was noted to be <5% in our cohort. Screening rates of anxiety and depression in trainees were 32% and 16%, respectively, compared with 7% and 2% for consultants. When assessing reasons for workplace stress, two thirds stated that heavy patient load contributed to stress, while almost three quarters attributed a heavy administrative load. Lack of supervision was a key stressor for trainees (39%), as was lack of support from the training college (58%). Trainees and consultant medical oncologists demonstrate high rates of burnout and low professional fulfilment. The NOMP23 program has identified a number of key stress factors driving burnout and demonstrated concerning levels of anxiety and depression. Ongoing mentorship and other well-being initiatives are needed to address these issues.

Trainee Evaluations of Preparedness for Clinical Trials in Medical Oncology-A National Questionnaire.

A standardized approach to the education of clinical trial investigators across Canadian medical oncology (MO) subspecialty training does not exist. With training programs transitioning to competency-based medical education (CBME), studies assessing education practices and competence are paramount to enhancing trainee education. This study aimed to determine whether current education practices in MO subspecialty training programs in Canada prepare trainees for participating in clinical trials as an investigator. From November 2021 to February 2022 a national, bilingual, online questionnaire to understand trainee experiences with self-perceived competence, preparedness, and willingness to participate in clinical trials as investigators was conducted. MO trainees, fellows, and new-to-practice physicians who completed an MO subspecialty training program in Canada were included. A total of 41 responses were received (response rate: 15%). Formal training in how to participate in clinical trials as an investigator was reported by 73% of respondents. At the end of training, 65% of respondents rated competence in clinical trials as fair/poor and 74% rated preparedness in conducting clinical trials as fair/poor. Correlation analysis determined that in-clinic teaching in clinical trials trended toward improved self-evaluations of competence and preparedness (p > 0.05). This is the first study in Canada to assess competencies in any residency training program since the establishment of CBME. Training in conducting clinical trials is highly variable across MO programs in Canada, with most trainees finding current practices not translating into self-perceived competence and preparedness. Further assessment into how to produce competent clinical trial investigators is warranted.

Editorial introductions.

Editorial introductions.

Mainstreaming of genomics in oncology: a nationwide survey of the genomics training needs of UK oncologists

Genomics is rapidly changing treatment paradigms for cancers, obligating oncologists to have good genomics knowledge. Through this survey, we aimed to assess the current understanding of cancer genomics among UK oncologists. We conducted a web-based nation-wide self-assessment survey of the cancer genomics knowledge of UK clinical and medical oncology trainees and consultants. In total, 150 oncologists (81 consultants and 69 trainees) responded, representing 10% of UK oncologists.Formal training in genomics had not been received by 38.7% of oncologists and 92.7% identified a need for additional genomics training.In total, 71.3% self-reported to have good knowledge of defining somatic and germline mutations, falling to 35.3% for understanding principles of gene expression and regulation. Knowledge of cancer-predisposing syndromes was highest for Lynch syndrome (40.7% good knowledge) and lowest for multiple endocrine neoplasia (14.0% good knowledge).Overall, 49.0% of respondents had consented patients for germline testing, but 80.7% reported a lack of training in genetic counselling. Large knowledge gaps have been identified through this survey, highlighting the need for incorporation of improved formal training in cancer genomics for consultants and trainees, with an aim to equip oncologists for advances in clinical practice and to take up genetic mainstreaming confidently.

Survey of medical oncologists and trainee practice on venous thromboembolism prophylaxis and treatment in solid cancers.

Venous thromboembolism (VTE) has a significant adverse impact on the outcomes of patients with active solid malignancies. Prophylaxis is indicated for cancer-associated VTE (CA-VTE) using the Khorana score for risk stratification. We surveyed medical oncology fellows and trainees regarding their practice in CA-VTE. Regarding treatment of CA-VTE, practice was consistent with guidelines. However, regarding prophylaxis for CA-VTE, there was a high degree of uncertainty, which highlights theneed for ongoing education.

An educational initiative to develop radiotherapy-specific teaching following the introduction of the oncology common stem year

Background: Following the GMC’s Excellence by Design report on postgraduate curricula, the clinical oncology (CO) curriculum has been rewritten and includes a shared first year of training – the oncology common stem (OCS) – where medical oncology (MO) and CO trainees have the same curriculum including radiotherapy (RT) skills evidenced with DORPS (direct observation of radiotherapy planning skills) and acute oncology. Radiotherapy planning experience had suffered during the COVID-19 pandemic, with more planning happening remotely.

Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria.

Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.

Editorial introductions.

Editorial introductions.

Where is your lactation room? Lactation policies and practices in oncology trainee and early career physicians.

11054 Background: Training and early career years coincide with childbearing and raising young families, which places increased demands on new parents. With increasing numbers of female oncologists in the workforce, there is a need to assess and amend current workplace lactation policies. We surveyed Medical and Radiation Oncology trainees and early career faculty to assess policies and practices regarding lactation during training and early career. Methods: An anonymous 48 question cross-sectional survey developed by researchers with expertise in gender equity was distributed via email and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training; program directors (PDs) were surveyed separately. Descriptive statistics were used. Results: Of the 255 complete responses, 26% (65) respondents breastfed for any length of time upon return to work. Of these, 54% (35) were trainees and 46% (30) early career faculty. 69% (45) had access to a designated lactation room; however, 57% (37) noted that duration of their pumping breaks was inadequate to access and use the lactation room. Most (60%, 39) did not feel comfortable asking for protected time to pump. Employment contracts did not specifically include pumping breaks for 66% (43), while 34% (22) were unsure about their contract policies surrounding lactation. Of all breastfeeding mothers, 77% (50) felt their colleagues to be supportive of their needs; a minority reported negative responses due to pumping breaks from faculty (11%), co-fellows/colleagues (8%) and clinic staff (15%). 51% (33) bought a wearable pump prior to return to work, of which 70% (23) found it financially burdensome. Most common reasons for buying a wearable pump were to improve efficiency during work hours (61%, 20) and lack of adequate pumping breaks (39%, 13). Among 23 PDs who responded to the survey, 65% (15) had a program policy regarding lactating trainees, 9% (2) blocked clinic appointments to allow pumping breaks, 91% (21) provided lactation rooms, 83% (19) reported the lactation rooms are easily accessible. Conclusions: Both infrastructure and time accommodations made for the lactating parent are inadequate. There is a disconnect between the trainee and PDs’ perception of provided accommodations. Systemic changes that provide adequate time and space for lactation to busy clinicians and trainees is imperative to ensure retention of women oncologists in the workforce.

The parent penalty: Parental leave and return to work in trainees and early-career faculty in oncology.

11005 Background: Prime childbearing years occur during medical training and early career, leaving physicians with tough choices between family planning and career growth. Restrictive parental leave (PL) policies can affect physician well-being and limit decisions about reproduction. We evaluated Medical and Radiation Oncology trainees and early career faculty to assess policies and practices regarding PL and return to work. Methods: An anonymous 48 question cross-sectional survey developed by researchers with expertise in gender equity was distributed via email and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training. Descriptive statistics were used to compare study groups. Results: 255 physicians completed the survey- 54% female, 65% Medical Oncology and 35% Radiation Oncology, 71% trainees and 29% early career faculty. 46% (117) had no formal PL policy during training. PL impacted selection of first job for 37% (94) participants. Of all responders, 114 used PL, either in early career (18%), as a trainee (69%) or both (13%). Duration of PL during training was ≤4 weeks in 37%, 4-6 weeks in 19%, 6-8 weeks in 12% and ≥8 weeks in 24%. 27% of those who took PL as a trainee had to extend training to allow for this. Only 27%(31) of those who took PL had resources available at workplace to assist with transitioning back to work, primarily from informal mentoring by faculty/colleagues (65%, 20). Other important findings are summarized in the Table. Conclusions: In this study evaluating parental leave in oncology trainees and early faculty, almost half of the participants had no formal parental leave policy during training and majority of those who took parental leave during training had parental leave only for 6 weeks or less. Most participants experienced a parental leave penalty: guilt when seeking help and feeling overwhelmed at return to work. Policies and practices around parental leave need to be restructured to meet the needs of the evolving oncology workforce. [Table: see text]

Piloting virtual mentorship: Evaluating acceptability and influence on wellness and professional identity in medical oncology (MO).

11022 Background: Despite extensive literature on the value of mentorship in academic medicine, little evidence exists to inform mentorship practices in MO. In 2021, the Canadian Association of Medical Oncologists (CAMO) piloted a national, 6-month virtual mentorship program consisting of 2 group mentoring events and additional 1-on-1 mentoring activities, to better support the needs of MO trainees. Feedback was obtained from participants to gain insight into how virtual mentorship might impact physician wellness and formation of professional identity, and to inform future iterations of CAMO’s virtual mentorship strategy. Methods: All Canadian MO residents/fellows were invited to participate in the program. Electronic surveys were completed by participants at baseline, after each group event, and at program completion. Surveys evaluated the program content and format, and used validated questionnaires for evaluating physician wellness/burnout (Stanford Professional Fulfillment Index [SPFI]), and professional identity (Macleod Clark Professional Identity Scale [MCPIS]). Cohort characteristics and survey responses were summarized using descriptive statistics. Procedures for survey data collection and analysis were ethics approved. Results: At baseline, respondents (n = 38) were predominantly female (63%), and &lt; 35 years (76%). 50% were married. On average, 78% of respondents ranked the virtual group mentoring events as meeting expectations. Program strengths identified by participants included meeting mentors outside of their own centre, meeting other trainees from across the country, and learning more about work-life balance/physician wellness. The main critique was insufficient time for interaction. Of the 34 MCPIS respondents, 94% were pleased to belong to the profession of MO, 91% identified positively with members of their profession and 77% felt like a member of the profession themselves. The average score on the SPFI scale was 2.73±0.71 (n = 34). Although 85% of respondents found their work meaningful, 71% satisfying, and 50% felt they were contributing professionally in valued ways, only 38% met criteria for professional fulfilment (score ≥3.00). 27% met criteria for burnout (score ≥1.33), 15% found their work physically exhausting and 9% found their work emotionally exhausting. Conclusions: CAMO’s pilot virtual mentorship program highlights that technology can be successfully leveraged to facilitate mentoring. The majority of MO trainees identified positively with their profession, yet only 38% reached the threshold for professional fulfillment and nearly a third met criteria for burnout. Longitudinal follow-up among mentored trainees is needed to provide insight into whether mentorship may influence physician wellness and professional identity over time.

Pilot Study Demonstrating the Value of Interdisciplinary Education on the Integration of Radiation Therapy in Lung Cancer Management.

This study aimed to understand baseline knowledge of basic principles of radiation therapy for lung cancer among medical oncology, thoracic surgery, and pulmonology trainees and practicing physicians and also assess whether a didactic lecture will improve objective knowledge and perceived comfort level in making appropriate referrals to radiation oncology (RO). Radiation oncologists at 8 academic institutions offered a presentation covering indications, logistics, efficacy, and toxicity of thoracic radiation. Participants completed a survey to assess their prior exposures to RO and perceived value of the lecture, and objective knowledge gained based on pre/post-lecture questions. Among 121 attendees, 76 completed the pre-test, and 25 the post-test (response rates 62.8% and 20.7%, respectively). Fifty-seven (75.0%) had never previously experienced a RO didactic about lung cancer, 62 (81.6%) had never seen a linear accelerator, and 65 (85.5%) had never rotated in a RO department. The mean pre-test score was 53.5% (SD 17.6%), with a trend (p = 0.066) towards thoracic surgeons (61.5%) performing better than medical oncologists (55.5%) or pulmonologists (48.3%). Level of training (p = 0.130), and prior RO exposures (p = 0.240), did not significantly impact pre-test scores. The mean post-test score of 75.1% (SD 3.6%) was significantly higher than mean pre-test score (p < 0.001). After the lecture, 25 participants (100%) felt more knowledgeable about RO, and 24 (96%) felt more comfortable making appropriate referrals to RO. A didactic lecture about RO for trainees and physicians who treat lung cancer at 8 academic institutions was feasible, filled a gap in exposure, and improved knowledge.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13187-022-02158-8.

Editorial introductions.

Editorial introductions.

Improving Palliative Radiotherapy Training: A Multi-professional, Combined Clinical and Training Improvement Project

Background: Palliative radiotherapy (RT) is an essential component of oncology training. A survey of South Wales oncology trainees identified a need for further RT training opportunities. With the new oncology curriculum (August 2021), medical (MO) and clinical oncology (CO) trainees will need experience in palliative RT. A new consultant/radiographer led palliative RT service at Velindre Cancer Centre providing rapid access to RT was used to improve training in palliative RT planning.

Perceptions of oncology as a career choice among the early career doctors in Pakistan

BackgroundLack of oncologists is a growing global concern. With the rise in cancer burden across the world, the supply–demand mismatch of the oncology workforce is projected to increase. Furthermore, oncology is a low-ranked field of choice among medical students, and without understanding the perceptions and concerns of early-career doctors regarding oncology, any investments made in cancer care will be futile. This study aims to determine the opinions of young doctors and the factors most affecting their preferences in order to devise focused strategies to attract more doctors into oncology.MethodsA cross-sectional study was conducted on 300 early-career doctors across various public and private hospitals in Pakistan, from March to November 2019. A close-ended, self-administered questionnaire was used to assess their opinions in terms of the workplace environment, scope, and the emotional and financial aspects of oncology. Data was analyzed using SPSS version 23 and the influence (positive or negative) of the perceptions on the choice of oncology as a career was determined by binary logistic regression analysis.ResultsAlmost three-quarters of the participants did not want a career in oncology. The top positive perceptions about oncology in descending order were: progressive field, gender-neutral, stable working hours, financially healthy, and work-family balance. Top negative perceptions were: lack of oncologic facilities in hospitals, radiation exposure, need for private practice, poor patient prognosis, high patient load, and depressing environment. Participants who attended private medical school (p < 0.10), planned to live abroad (p < 0.10), had an oncologist (p < 0.05), cancer survivor or death due to cancer in the family (p < 0.05), were more likely to adopt oncology as a career. Those who believed that poor patient prognosis can have an impact on career choice were less likely to prefer oncology (p < 0.05).ConclusionDespite the rising cancer burden, early career doctors are reluctant to join oncology. Curricular, infrastructural and policy changes are needed at the level of medical school, oncology training and practice to recruit more young doctors and minimize the existing paucity of the oncologic workforce.

Diversity Trends by Sex and Underrepresented in Medicine Status Among US Radiation and Medical Oncology Faculty Over 5 Decades

It remains unclear how the historical exclusion of women and racial and ethnic minority groups from medical training, and therefore the oncologic subspecialties, has contributed to rates of faculty diversity among oncology departments over time. Oncologic faculty diversity is an important initiative to help improve care and address health disparities for an increasingly diverse US population with cancer. To report trends in academic faculty representation by sex and by race and ethnicity for radiation oncology (RO) and medical oncology (MO) departments and to describe comparisons with the general US population, medical students, RO and MO trainees, clinical department chairs, and faculty in other departments. This cross-sectional analysis used data from the Association of American Medical Colleges to analyze trends by sex and by race and ethnicity among full-time US faculty in RO and MO departments from 1970 through 2019. Data were analyzed between October 2020 and April 2021. Proportions of women and individuals from underrepresented in medicine (URM) racial and ethnic groups (Black, Hispanic, and Indigenous individuals) were calculated among RO and MO academic departments; trends were analyzed over 5 decades. These proportions were compared with cohorts already described. In addition, proportions of women and URM individuals were calculated by faculty rank among RO and MO departments. In 1970, there were 119 total faculty in RO (10 women [8.4%] and 2 URM [1.7%]) and 87 total faculty in MO (11 women [12.6%] and 7 URM [8.0%]). In 2019, there were 2115 total faculty in RO (615 women [29.1%] and 108 URM [5.1%]) and 819 total faculty in MO (312 women [38.1%] and 47 URM [5.7%]). Total faculty numbers increased over time in both RO and MO. Faculty representation of URM women proportionally increased by 0.1% per decade in both RO (95% CI, 0.005%-0.110%; P <. 001 for trend) and MO (95% CI, -0.03% to 0.16%; P = .06 for trend) compared with non-URM women faculty, which increased by 0.4% (95% CI, 0.25%-0.80%) per decade in RO and 0.7% (95% CI, 0.47%-0.87%) per decade in MO (P < .001 for trend for both). Faculty representation of URM men did not significantly change for RO (0.03% per decade [95% CI, -0.008% to 0.065%]; P = .09 for trend) or MO (0.003% per decade [95% CI, -0.13% to 0.14%]; P = .94 for trend). Representation of both women and URM individuals among both specialties was lower than their representation in the US population in both 2009 and 2019. Across all cohorts studied, RO faculty had the lowest URM representation in 2019 at 5.1%. At every rank in 2019, the number of total URM faculty represented among both MO and RO remained low (MO: instructor, 2 of 44 [5%]; assistant professor, 18 of 274 [7%]; associate professor, 13 of 177 [7%]; full professor, 13 of 276 [5%]; and RO: instructor, 9 of 147 [6%]; assistant professor, 57 of 927 [6%]; associate professor, 20 of 510 [4%]; full professor, 18 of 452 [4%]). This cross-sectional study suggests that RO and MO academic faculty have increased the representation of women over time, while URM representation has lagged. The URM trends over time need further investigation to inform strategies to improve URM representation in RO and MO.

Oncology Trainee Perceptions of the Prior Authorization Process: A National Survey

PurposeThe medical trainee perspective regarding the prior authorization process has not been previously assessed. Here we evaluate the perceptions of radiation and medical oncology trainees regarding the prior authorization process and its effect on their training and patient care. Methods and MaterialsA 12-question, nonincentivized, electronic national survey of radiation and medical oncology trainees at all Accreditation Council for Graduate Medical Education accredited oncology programs was conducted. Participation, perspectives, and experiences with the prior authorization process were assessed by Likert scale, free response, and multiple response selection. ResultsBetween January and March of 2019, the survey was distributed to 1505 trainees at 76 institutions with responses from 174/616 radiation (28.2%) and 139/889 medical oncology trainees (15.6%). The majority (69.2%) reported participating in the prior authorization process (radiation: 78.2% vs medical: 57.6%; P < .01). Most trainees (71%) reported concern for decline in the quality of patient care due to the prior authorization process. The majority of trainees (77.1%) reported decreased enthusiasm for work and choice of profession, with a higher incidence in medical oncology trainees (83.1% vs 73.7%, P = .04). The most commonly recommended modifications by trainees included that the insurance reviewer be in the same specialty as the ordering provider (87.7%), providers be compensated for participation (82.7%), and turnaround time be more rapid (74.3%). ConclusionsThese data indicate that trainees in US oncology programs are active participants in the prior authorization process and report that prior authorization approvals negatively influence their medical training and the quality of patient care. Additional efforts to revise the insurance approval process are warranted.

Current landscape of ESMO/ASCO Global Curriculum adoption and medical oncology recognition: a global survey

BackgroundWith the implementation of multidisciplinary treatment and development of multiple novel anticancer drugs in parallel with expanding knowledge of supportive and palliative care, a need for separate training and specialisation in medical oncology emerged. A Global Curriculum (GC) in medical oncology, developed and updated by a joint European Society for Medical Oncology/American Society of Clinical Oncology (ESMO/ASCO) GC Task Force/Working Group (GC WG), greatly contributed to the recognition of medical oncology worldwide.Material and methodsESMO/ASCO GC WG carried out a global survey on medical oncology recognition and GC adoption in 2019.ResultsBased on our survey, medical oncology is recognised as a separate specialty or sub-specialty in 47/62 (75%) countries participating in the survey; with a great majority of them (39/47, 83%) recognising medical oncology as a standalone specialty. Additionally, in 9 of 62 (15%) countries, medical oncology is trained together with haematology as a specialty in haemato-oncology or together with radiotherapy as a specialty in clinical oncology. As many as two-thirds of the responding countries reported that the ESMO/ASCO GC has been either fully or partially adopted or adapted in their curriculum. It has been adopted in a vast majority of countries with established training in medical oncology (28/41; 68%) and adapted in 12 countries with mixed training in haemato-oncology, clinical oncology or other specialty responsible for training on systemic anticancer treatment.ConclusionsWith 75% of participating countries reporting medical oncology as a separate specialty or sub-specialty and as high as 68% of them reporting on GC adoption, the results of our survey on global landscape are reassuring. Despite a lack of data for some regions, this survey represents the most comprehensive and up-to-date information about recognition of medical oncology and GC adoption worldwide and will allow both societies to further improve the dissemination of the GC and global recognition of medical oncology, thus contributing to better cancer care worldwide.