Training Of Family Physicians Research Articles

Advancing Equity in Health Care Among Dalits and Tribal People in India: The Progress, Current Realities, and the Way Forward.

The caste system and resulting social exclusion are important social determinants of health inequity in India. This article critically analyzes the influence of the caste system on health inequity in India, starting with a historical perspective and moving to the current status. The article argues that the caste system has deprived Dalits and tribal people in India of achieving health equity. The programs to promote health are often disease-specific and not culturally informed, leading to poor attention at the policy level to the intersecting disadvantages that make Dalits and tribal communities vulnerable, resulting in poor health. The authors suggest strengthening and promoting primary care, improving health access for Dalit and tribal populations, and the need for pivotal changes in the medical education system, shifting the emphasis from specialized care to training family physicians to be oriented toward community health needs, keeping health equity in perspective.

Evaluation of an online “Train the Trainers” course for family physicians in Pakistan: Expectations vs reality

ABSTRACT Aim: Pakistan is in dire need of trained family physicians to enhance the quality of primary health care. To build capacity, there is a need to train the trainers on a large scale through a feasible and accessible program. Therefore, for the first time, a three-month online course was designed and piloted, in collaboration with national and international family medicine faculty. The aim of this study was to determine the gap between the pre-course expectations and the post-program perceptions of the participants for* a unique family medicine “Train the Trainers” course. Methods: A longitudinal-observational study was conducted at a private college of Karachi after approval from the Institutional Review Board. The expectations and perceptions of all (31) participants were recorded through a pre- and post-course questionnaire. Data were analyzed through descriptive and analytical statistics on SPSS-26. The responses to the open-ended questions were analyzed by content analytical approach. Results: Out of 20 quantitative items on the questionnaire, four were associated with a positive gap between the expectations and perceptions. One item showed a negative gap, while the rest did not show any significant difference. The majority of the participants expressed that they expected to see an improvement in their teaching skills because of the online course. Conclusion: The online course was successful in meeting the participants’ expectations. The course delivery can be revisited to further improve its quality according to the participant’s feedback, including an opportunity to ask questions and incorporating some face-to-face sessions.

Cultivating leaders for primary health care: A revised approach for transformative development.

Family physicians require leadership skills to strengthen team-based primary care services. Interviews with South African district managers confirmed the need to develop leadership skills in family physicians. The updated national programmatic learning outcomes for South African family physician training were published in 2021. They sparked the need for curriculum renewal at the University of Cape Town's Division of Family Medicine. A review of the leadership and governance module during registrar training showed that the sessions were perceived to be content heavy with insufficient opportunities for reflection. Following a series of stakeholder engagements, the module convenors co-designed a revised module that was blueprinted on the updated learning outcomes. The module incorporates a group coaching style, facilitating learning through reflection on one's experiences. The revised module was implemented in 2022. It aims to provide a transformative learning experience centred on students' perceptions of themselves as leaders, as well as professional identity formation and resilience building. This short report describes preliminary insights from the revised module's developmental phase and forms part of an ongoing iterative evaluation process.Contribution:Family physicians should lead across all their defined roles. Formal and informal learning opportunities are needed to facilitate their growth as leaders and help them to meet the health needs of communities served by an evolving health care system. This short report describes an example of a revised postgraduate module on leadership and governance, which may be of value to clinician educators and academic departments exploring innovative methods for the African region.

Don't wait for the perfect moment: The national training program in family medicine in Angola.

Like many Sub-Saharan countries, Angola struggles with a shortage of trained health professionals, especially for primary care. In 2021, the Angolan Ministry of Health in collaboration with the Angolan Medical Council launched the National Program for the Expansion of Family Medicine as a long-term strategy for the provision, fixation and training of family physicians in community health centres. Of the 425 residents 411 (96.7%) who entered the programme in 2021 will get their diplomas in the following months and will be certified as family physicians. Three main aspects make this National Programme unique in the Angolan context: (1) the common effort and engagement of the Ministry of Health with the Angolan Medical Council and local health authorities in designing and implementing this programme; (2) decentralisation of the training sites, with residents in all 18 provinces, including in rural areas and (3) using community health centres as the main site of practice and training. Despite this undeniable success, many educational improvements must be made, such as expanding the use of new educational resources, methodologies and assessment tools, so that aspects related to knowledge, practical skills and professional attitudes can be better assessed. Moreover, the programme must invest in faculty development courses aiming to create the next generation of preceptors, so that all residents can have in every rotation one preceptor or tutor responsible for the supervision of their clinical activities, case discussions and sharing their clinical duties, both at community health centres and municipal hospitals.

Association between multimorbidity and cognitive decline in the elderly population of the Eastern Province, Saudi Arabia.

Cognitive decline affects the quality of life, and dementia affects independence in daily life activities. Multimorbidity in older adults is associated with a higher risk of cognitive impairment. This research aims to study the relationship between cognitive decline and multimorbidity in the elderly population in the Eastern Province, Saudi Arabia. This cross-sectional research was conducted from July to October 2022 among adults over 60 years. All patients with two or more comorbidities were contacted for a face-to-face interview and cognitive testing to estimate cognitive function by trained family physicians using St. Louis University Mental State Examination. ANOVA and Chi-square test were used to test for statistical significance. Binary logistic regression was used to show the odds of having cognitive impairment and multimorbidity. All tests were performed at 5% level of significance. The study involved 343 individuals; majority (74.1%) aged 60-75 years and were males (67.9%). Hypertension, diabetes, and chronic pain were reported by 56%, 48%, and 44% participants, respectively. Thirty percent participants had 3 or more comorbidities. About 36% had mild neurocognitive disorder and 31.2% had dementia. The results showed that age, gender (female), diabetes, stroke, chronic pain, and multimorbidity were significantly associated with cognitive impairment. In our study, hypertension, coronary artery diseases, depression, and anxiety were not significantly associated with risk of cognitive decline. Our study found that multimorbidity is significantly associated with cognitive decline. Controlling comorbidities and preventing risk factors in midlife could help in delaying the progression of the disease.

Evaluation of FamMed essentials: a blended-learning program for capacity building of general practitioners in Pakistan

BackgroundTo provide access to primary care and universal health coverage, Pakistan requires 60,000 trained family physicians by 2030. At present, most primary care is provided by general practitioners (GPs) who do not have any post-graduate training. Empowering GPs through competency–based programs, that strengthen their knowledge and skills, may be a cost-effective strategy for improving healthcare quality. We describe the development and evaluation of FamMed Essentials, a modular, blended-learning program to improve clinical knowledge and skills of GPs.MethodsThis is a mixed method study. We used the CIPP (content, input, process and product) framework for course development and evaluation. We describe the steps used in content development, strategies for teaching and assessments, and evaluation of strengths and weaknesses of the program. In depth focus group discussions were conducted to gather insight on participants’ and faculty’s perceptions regarding the program’s effectiveness.ResultsOf the 137 participants who have completed the program, 72% were women and 49% had been practicing for more than five years. We saw a significant improvement in knowledge across all modules (p = < 0.001) and perceived confidence in clinical skills (p = < 0.001). An objective assessment showed participants’ competence in patient management. Participants reported a high level of satisfaction (4.4 ± 0.83 on a 5-point Likert Scale). Focus group discussions revealed a positive impact on clinical practice. Flexibility and use of different teaching and learning strategies were additional strengths. In addition, participants reported an interest in further training. Power outages were highlighted as a major challenge.ConclusionIn resource-constrained health systems, a modular, blended-learning, competency-based program is helpful to upgrade GPs knowledge without impacting their busy schedules. Accreditation of such programs and provision of a career trajectory for the trained GPs are pivotal to expansion of such initiatives.

Assessment of Family Medicine Obstetrics Fellowship Websites in the United States: Content and Usability.

The United States is experiencing maternity care shortages. Family physicians can play a role in addressing these shortages. Family medicine obstetrics fellowships train family physicians in obstetrics care. Fellowship websites are important for promoting programs and attracting applicants. However, whether websites provide sufficient program information is unknown. This study aimed to assess completeness and utility of family medicine obstetrics fellowship websites across the United States. The study analyzed 46 family medicine obstetrics fellowship websites. The component analysis evaluated the presence of 17 components related to orientation, curriculum, program, personnel, and additional content. The qualitative analysis included ratings for navigation and application, information quality, and esthetics. Analysis included percentages for websites and components and average qualitative ratings. Common components included overviews, training requirements, and contact information. Description of the patient population was the least common component. Usability ratings varied across programs, with higher ratings observed for navigation and application, and information quality. Esthetics and visual appeal received lower ratings. Regional analysis indicated that websites from fellowships in the West and Southwest tended to include more components compared to those in the Southeast. Family medicine obstetrics fellowship websites serve as valuable sources of program information for prospective applicants. However, not all websites include essential program details. Some information is rarely provided. Given the shortage of maternity care providers, it is crucial to develop informative and functional websites to attract applicants. Improving website content and design could prove to be a cost-effective strategy to increase the number of applicants.

Continuity of care and Family Physician training: How to reconcile?

Introdução: A longitudinalidade é um atributo essencial da Atenção Primária à Saúde e deve ser treinada durante a formação do médico de família e comunidade. Durante a residência médica, a troca de residentes ao longo dos atendimentos pode ser um obstáculo para o seu desenvolvimento. Objetivo: Compreender como a longitudinalidade do cuidado é percebida por residentes e preceptores de um programa de residência de medicina de família e comunidade de uma capital brasileira. Métodos: Foi realizada uma pesquisa qualitativa com dois grupos focais com preceptores e com residentes do programa. Após a realização dos grupos, as falas foram transcritas e categorizadas. Foi realizada uma leitura flutuante do material, examinado e discutido por meio de análise de conteúdo. Resultados: Entre os principais achados, foram levantados o papel da postura do preceptor e o seu lugar de orquestrador do cuidado do paciente e o uso do prontuário como forma de descrever o cuidado e o planejamento na manutenção da longitudinalidade. A importância da discussão de casos entre novos e antigos residentes também foi incluída como forma de manutenção do atributo. Conclusões: Observou-se que os participantes percebem que a continuidade do cuidado do paciente pode ser mantida, mesmo com o desafio acarretado pela troca dos residentes. Este texto é fruto do programa de pós-graduação stricto sensu Mestrado Profissional em Saúde da Família (PROFSAÚDE). Palavras-chave: Medicina de Família e Comunidade; Continuidade da Assistência ao Paciente; Internato e Residência; Atenção Primária à Saúde.

Family doctors as healthcare coordinators. Matrix of family doctors' competences for unlocking health workforce potential - the case of Poland

The article presents the results of the research on the competences of family doctors in the Polish healthcare system. According to the 2017 bill on primary health care (PHC) introducing integrated care to PHC, family physicians are obliged to coordinate the care delivered to their populations and to manage the PHC teams. First contracts on integrated care with the National Health Fund have been concluded in 2022. &#x0D; The regulation evoked the necessity of redefining the role of family physicians in the healthcare system. Before that they were habitually deprived of chances to manage the care they provide. The author claims that their role should be perceived as managerial. It is crucial for patients and decision makers to understand family physicians' role in the system and properly manage the PHC workforce, especially when new professions and functions are being introduced to PHC. The regulation is not clear enough in regard to the definition of healthcare coordinator and leaves space to terminological inconsistency and, as a consequence, inadequate use of health workforce potential. The observations that led to designing the research were shared and consulted with the PHC community (focus group consisted of family doctors and PHC facilities’ staff members from lubuskie voivodeship). The research has been shared within academia (results of each stage of the research have been published and peer reviewed).&#x0D; The author has developed the matrix of family doctors’ competences to show the scope of competences they demonstrate. It is an ordered aggregation of competences classified according to the roles performed by family doctors in the healthcare system. It includes the indication of classified sources of formal requirements of those competences (in brief: sources of competences). One of the six roles presented in the matrix is a healthcare coordinator. Comparative text analyses have been performed to assess the relation between the range of family physicians’ and healthcare coordinators’ competences. &#x0D; The results show that family physicians have a full set of competences, including managerial, to coordinate the care, which means that they are predisposed to play the role of healthcare coordinator. The author proposes a precise competence-based description of the role of family doctor as a healthcare coordinator. The author further suggests introducing a new function of healthcare coordinator’s assistant. &#x0D; Since one of the sources of competences included in the matrix are WHO’s recommendations on competence clusters for coordinated care the results of this research may be found particularly interesting by international audiences. Especially when the shift towards integration of care is common for most of the healthcare systems and many of them are in preliminary stages of introducing the changes when comparing practice is of great value. &#x0D; The research will be followed by qualitative study of family physicians’ experience in playing the role of healthcare coordinator. The aim of this study is to develop a framework for competence training for family physicians delivering coordinated care.

The Red and Yellow Flag Awareness Level of Family Physicians in Low Back Pain

Aim: This study aims to determine the level of attitude and awareness of family physicians about red and yellow flags in patients with low back pain. Methods: A total of 395 family physicians were included in the study between February 2022 and April 2022. A questionnaire that evaluates the physicians’ non-mechanical causes of low back pain, red flag symptoms and findings, yellow flag signs, and the rate of questioning them in clinical practice was created and used. Results: Although 70.1% of the participants specified cauda equina symptoms, 65.3% non-mechanical nature of pain, 63.5% systemic illness findings, 62.5% history of severe trauma and malignancy as red flag symptoms and findings, 71.1% the presence of catastrophic thoughts as a yellow flag sign in low back pain, they could not achieve the same success in other red and yellow flag signs. The rate of questioning red and yellow flags in patients who applied to family physicians with low back pain was 60.7% and 34.5%, respectively. Conclusion: The results of our study show that family physicians have a deficiency in questioning the red and yellow flags. When it is considered that patients with low back pain consult family physicians frequently, we think that training family physicians on red and yellow flags may help to the quick determination of non-mechanical causes of low back pain and to prevent low back pain from becoming chronic. Keywords: low back pain, awareness, physicians, family

135 Exploring Family Physician Training Needs to Improve Cancer Patient Care

135 Exploring Family Physician Training Needs to Improve Cancer Patient Care

E-Learning in Health: Investigation of Technology Acceptance and Usage of Family Physicians According to Demographic Factors

E-learning is the changing and renewing face of education in health as in many fields. Developments in technology prepare a suitable environment for the realization of various structural changes in the continuing education of health professionals. Since e-learning provides asynchronous learning opportunities to health professionals working in different geographical regions, it provides various opportunities for the career development of health professionals. One of Turkey's most significant e-learning projects in the health field was carried out by the Family Medicine Distance Education Centre (AHUZEM). The e-learning project prepared for family physicians aimed to provide much more accessible, effective, and faster training for family physicians. This study aims to reveal family physicians' adoption of e-learning applications according to demographic factors. In the study, the Unified Technology Acceptance and Use Model (UTAUT) developed by Venkatesh et al. (2003) by examining many theories and models was used as a data collection tool. In addition, the author integrated the attitude towards technology use dimension consisting of 4 questions into the model by examining the relevant literature. In addition, the research was organized according to a 5-point Likert-type scale. The data was obtained from 429 family physicians who agreed to participate in the online survey shared on social networks nationwide by convenience sampling. The results obtained by entering the data into AMOS 18.0 program were analyzed in t-test and ANOVA tests. According to the results of the analyses, a significant difference was found in the intention to use e-learning and UTAUT according to age, specialty, working time, and e-learning experience. However, no significant difference was found according to gender.

Exploring Family Physician Training Needs to Improve Cancer Patient Care.

Family physicians have multifaceted roles in cancer patient care and oncology education among this group is unfortunately inadequate. This study explored the needs and perspectives of family physicians regarding their oncology training and experiences. As well, physician cancer care experiences, knowledge use, and continuing education practices were elucidated. The authors employed a qualitative approach with family physicians participating in semi-structured interviews. General practitioners in oncology were excluded. Purposeful sampling was used, with recruitment through Ontario regional primary cancer care leads and social media. Interviews were transcribed, and thematic analysis was conducted. Thirteen participants were interviewed-1.6:1 female: male, ages 30-39, practicing for an average of 9 years (0.5-30 years), with urban and suburban practices. Most trained in Canada as undergraduates and completed their residency in Ontario; 62% had participated in at least one oncology continuing medical education session. Three major themes emerged: delineation of roles, oncology knowledge and education, and palliative care. Participants reported role uncertainty after cancer diagnosis, with oncology teaching at all levels described as lacking relevance. Palliative care rotations were an avenue for oncology education and where participants returned to cancer care. Changing existing teaching, information access, and avenues of oncology experiences may be the next step to supporting successful cancer care by family physicians.

Навчання лікарів неспеціалізованих закладів охорони здоров’я надавати допомогу людям з психічними розладами на основі розробленого тренінгу ВООЗ із клінічного ведення психічних розладів за програмою mhGAP

This text is the abstract for the qualifying graduation thesis on the topic "Training of doctors of non-specialized health care institutions to provide assistance to people with mental disorders based on the training developed by WHO on the clinical management of mental disorders according to the mhGAP program." The following is devoted to the importance of training family physicians in the skills of working with the mentally ill.

Maternity Access in Rural America: The Role of Family Physicians in Providing Access to Cesarean Sections.

As an increasing number of rural hospitals close their maternity care units, many of the approximately 28 million reproductive-age women living in rural America do not have local access to obstetric services. We sought to describe the characteristics and distribution of cesarean section-providing family physicians who may provide critical services in maintaining obstetric access in rural hospitals. Using a cross-sectional study design, we linked data from the 2017 to 2022 American Board of Family Medicine's Continuting Certification Questionnaire on provision of cesarean sections as primary surgeon and practice characteristics to geographic data. Logistic regression determined associations with provision of cesarean sections. Of 28,526 family physicians, 589 (2.1%) provided cesarean sections as primary surgeon. Those who provided cesarean sections were more likely to be male (odds ratio (OR) = 1.573, 95% confidence limits (CL) 1.246-1.986), and work in rural health clinics (OR = 2.157, CL 1.397-3.330), small rural counties (OR = 4.038, CL 1.887-8.642), and in counties without obstetrician/gynecologists (OR = 2.163, CL 1.440-3.250). Although few in number, family physicians who provide cesarean sections as primary surgeon disproportionately serve rural communities and counties without obstetrician/gynecologists, suggesting that they provide access to obstetric services in these communities. Policies that support family physician training in cesarean sections and facilitate credentialing of trained family physicians could reverse the trend of closing obstetric units in rural communities and reduce disparities in maternal and infant health outcomes.

Strategies to improve the early detection and management of ectopic pregnancies in primary care

Even in the advanced era of today, maternal morbidity and mortality are quite high; however, most pregnancy-related complications can be successfully prevented by early diagnosis and timely management. The primary care setting is of utmost importance in this regard, as it is the first line of contact between patients and physicians, and regular antenatal care services are provided by most of primary care settings. Ectopic pregnancy is one of the most prevalent pregnancy disorders and is further associated with high-risk complications and mortality. The clinical manifestations may mimic non-ectopic pregnancy conditions, making it difficult to develop diagnostic standards. However, ultrasonography and human chorionic gonadotropin (β-hCG) levels can ensure early diagnosis. Conservative treatment is pursued since surgical management is linked to multiple significant side effects. In most situations, pharmacotherapy using methotrexate in a single- or multi-dose regimen is the preferred course of treatment. Performing ultrasonography as soon as a pregnancy is confirmed to determine the location of the pregnancy, monitoring β-hCG levels, and ensuring prompt referral in the event of a possible ectopic pregnancy that cannot be treated conservatively are all important ways that primary care settings can play a significant role in early diagnosis and prompt management. Additionally, obstetric ultrasonography training for family physicians can help in the early detection of ectopic pregnancy, which can lead to favourable results. The purpose of this research is to review the available information about strategies to improve the diagnosis and management of ectopic pregnancy in primary care.

Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians.

Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. To address rural/urban disparities in parental and child health, family medicine must provide robust OB training to prepare family physicians to care for parent-newborn dyads in rural communities. This mixed-methods study aimed to inform policy and practice solutions. We surveyed 115 rural family medicine residency programs (program directors, coordinators, or faculty) and conducted semistructured interviews with personnel from 10 rural family medicine residencies. We calculated descriptive statistics and frequencies for survey responses. Two authors conducted a directed content analysis of qualitative survey and interview responses. The survey yielded 59 responses (51.3%); responders and nonresponders were not significantly different by geography or program type. Most programs (85.5%) trained residents to provide comprehensive prenatal and postpartum care. Continuity clinic sites were predominantly rural across all years and OB training was largely rural in postgraduate year 2 (PGY2) and PGY3. Almost half of programs listed "competition with other OB providers" (49.1%) and "shortage of family medicine faculty providing OB care" (47.3%) as major challenges. Individual programs tended to report either few challenges or multiple challenges. In qualitative responses, common themes included the importance of faculty interest and skill, community and hospital support, volume, and relationships. To improve rural OB training, our findings support prioritizing relationships between family medicine and other OB clinicians, sustaining family medicine OB faculty, and developing creative solutions to interrupt cascading and interrelated challenges.

Enhancing family medicine training to build capacity in Pakistan: a call for action

ABSTRACT A high-performing, integrated, primary healthcare system is essential to achieve universal health coverage (UHC) goals and improve health indicators. There is enough evidence that healthcare is cost-effective with significantly better outcomes in countries where primary care is delivered through trained family physicians. The concept of “Family Practice approach” is relatively new in developing countries like Pakistan, where majority of basic healthcare is provided by doctors without a formal postgraduate training. The intention to adopt this approach in primary care has increased in recent years in an effort to attain UHC, yet implementation requires a paradigm shift with intervention at multiple levels. There is an opportunity to learn from better developed primary care models for example in UK and Australia to develop a pragmatic and collaborative approach to develop the specialty of family medicine in primary care. This calls for academic interventions at multiple levels, such as mandating family medicine inclusion in undergraduate medical curricula, and ensuring quality of postgraduate training by investment in developing primary care sites for training, curricula, assessment, and quality assurance structures. Encouraging medical students and general practitioners to pursue a post graduate qualification in family medicine would also require promoting family medicine as a worthwhile career and developing a higher esteem for qualified family physicians than the conventional GPs in public and private sector healthcare institutions. These interventions would help evolution of locally grounded solutions to improve the quality of primary care, hence the health outcomes of the larger population of Pakistan.

Border Health Training for Family Physicians: Is There a Need and Interest?

The United States-Mexico border has unique health care challenges due to a range of structural factors. Providers must be trained to address these barriers to improve health outcomes. Family medicine as a specialty has developed various training modalities to address needs for specific content training outside of core curriculum. Our study assessed perceived need, interest, content, and duration of specific border health training (BHT) for family medicine residents. Electronic surveys of potential family medicine trainees, faculty, and community physicians assessed appeal, feasibility, preferred content, and duration of BHT. We compared responses from participants from the border region, border states and the rest of the United States in their opinions about modality, duration, content of training, as well as perceived barriers. Seventy-four percent of survey participants agreed that primary care on the border is unique; 79% indicated a need for specialized BHT. Most border-region faculty were interested in participating as instructors. Most residents expressed interest in short-term rotation experience, yet most faculty recommended postgraduate fellowship. Respondents selected language training (86%), medical knowledge (82%), care of asylum seekers (74%), ethics of cross-cultural work (72%), and advocacy (72%) as the top-five needed training areas. Results of this study indicate a perceived need and sufficient interest in a range of BHT formats to warrant developing additional experiences. Developing a variety of training experiences can engage a wider audience interested in this topic; that should be done in a way ensuring maximum benefit to border-region communities.

Training General Practitioners in Oncology: Lessons Learned From a Cross-Sectional Survey of GPOs in Canada.

Many countries face a significant shortage of medical oncologists. To mitigate this problem, some countries, including Canada, have established training programs for general practitioners in oncology (GPOs), which train family physicians (FPs) in the fundamentals of cancer care. This type of GPO training model may be useful in other countries facing similar challenges. Therefore, Canadian GPOs were surveyed to learn from their experiences and inform the development of similar programs in other countries. A survey was designed and administered to Canadian GPOs to understand the methods and outcomes of GPO training and practice in the Canadian context. The survey was active from July 2021 to April 2022. Participants were recruited through personal and provincial networks and an email list provided by the Canadian GPO network. The survey received 37 responses for an estimated response rate of 18%. Although only 38% of respondents indicated that family medicine training sufficiently prepared them to care for patients with cancer, 90% indicated that GPO training did. Clinics with oncologists were found to be the most effective mode of learning, followed by small group learning and online education. Critical knowledge domains and skills most relevant for GPO training were identified as the treatment of side effects, symptom management, palliative care, and breaking bad news. Participants in this survey felt that a dedicated GPO training program offered value beyond family medicine residency in preparing providers to adequately care for patients with cancer. GPO training can be done effectively through virtual and hybrid content delivery. Critical knowledge domains and skills identified as the most important in this survey may be valuable for other groups and nations implementing similar training programs to increase their oncology workforce.