Young Oncologists Research Articles

Young paediatric oncologists and haematologists in Europe – Emerging needs and future perspectives

BackgroundThe “Young NaPHOS” project was launched in 2021, by Young SIOPE, the group for junior members of the European Society for Paediatric Oncology (SIOPE). The Young NaPHOS project aims to build a network of national representatives of young paediatric haematologists and oncologists to discuss organisational and educational aspects at national and European level, differences in the training paths, and the needs to be addressed in the future. MethodsFrom June 2021 until September 2022, three online meetings took place and one online survey was conducted. The meetings focused on presenting the structure and organisational aspects of existing national junior organisations in paediatric haematology and oncology, including their national activities. The survey aimed to investigate the European landscape of national organisations and training paths by inviting 39 young national representatives. ResultsTen out of 34 responders confirmed the existence of a junior organisation in their country. Diversity was noted among the countries for the existence of such organisations, the organisations’ activities, or the membership criteria. Further, the training path to become a paediatric oncologist/haematologist differs a lot. Young paediatric oncologists also shared common concerns, especially regarding networking, international collaboration, and educational opportunities. ConclusionThis project resulted in the creation of a European network among young paediatric oncologists and haematologists, in spreading ideas and offering support, and identified differences and areas for future action of Young SIOPE.

From Data to Manuscript: A Strategy for Young Oncologists to Write a Scientific Paper

AbstractScientific manuscripts are the basis for the transmission of scientific data among physicians in all fields of medicine. To teach young oncologists the skills needed to author a paper, we decided to emulate how experienced clinicians perform this task. The first step is to create a spreadsheet with all the clinical data gathered and submit it to a statistical analysis using a statistical software package. The most important results are presented in the graphs and tables. The results should be explained in a logical and understandable manner. Writing the “Materials and Methods” section follows, with all the technical information that any other researcher may need to reproduce elsewhere the study in question. A critical-thinking stage, in which a review of the pertinent literature is conducted with the use of a reference management software, should provide all the knowledge and questions to write the “Introduction” and “Discussion” sections. The “Abstract” and “Title” are the final sections to be created. Following these steps, the author can correct the first draft of the manuscript for submission to a specific journal. Choosing the right journal and answering the reviewers' comments are also important steps in this process. Even if a young oncologist does not embark on an academic career, learning how to write a scientific manuscript is believed to be the best way to teach them how to read such manuscripts during their lifelong continuous self-education.

Tumor Board Practice and Current Approach of Oncologists in Türkiye

Objective: Interdisciplinary cooperation is essential in treating and following up cancer disease. The primary objective of multidisciplinary tumor councils (MDTCs) is to identify the most suitable and effective treatment strategies for cancer patients through the collective decision-making of experts in oncology. MDTC plays a key role in breaking traditional taboos, providing the most up-to-date approach to the patient, sharing responsibility and accountability, and encouraging interdisciplinary communication and collaboration. Material and Methods: In this study, the perspectives, expectations, and experiences of medical oncologists regarding tumor boards were evaluated. The survey consisted of 10 questions and was conducted as an online survey at the '7th National Immunotherapy and Oncology Congress'. This study was cross-sectional and online. While those who were actively working as medical oncologists and those who wanted to voluntarily participate in the survey were included in the study, those who were not medical oncologists, those who were not actively working, and those who worked in private clinics were not included in the study. Participants were asked various questions about multidisciplinary tumor boards. They were asked about the specialties they most needed on the boards, the other clinics participating in the boards, and the clinics they felt were essential. The necessity of genetic clinics and molecular boards in shaping the future of oncology through molecular assessments was also assessed. The impact of board decisions on patient treatment and management was investigated. Results: A total of 624 oncologists participated in the survey. The majority of the participants were young oncologists. Most participants worked in tertiary healthcare units, including university hospitals and training and research hospitals. Almost all of the participants stated that they did MDTC. The most frequent and regular councils are; thoracic cancers and gastrointestinal cancers. The most needed and hard to reach branch was the medical genetics department. Conclusion: Cancer treatment is a complex process that cannot be confined to a single expertise. Multidisciplinary tumor boards (MDTB) are one of the cornerstones of a comprehensive approach to cancer treatment. In multidisciplinary tumor boards, various topics such as medical treatment planning for patients, diagnosis, surgical and radiotherapy planning, side effect management, and palliative care can be examined. MDTB not only provides effective treatment for cancer patients from a broad perspective but also ensures rapid and comprehensive solutions in case of potential complications.

Filling the gap in competency-based training for medical oncology with supervised online patient counseling: A qualitative study.

9036 Background: The Higher School of Oncology (HSO) is a collaborative US-Russian postgraduate program that improves learning outcomes for young oncologists. Many HSO medical oncology (MO) residents/graduates are also engaged in online supervised patient counseling, known as ‘Just Ask.’ We aimed to explore the educational role of ‘Just Ask’ in shaping the competency-based learning outcomes of MO graduates, who have recently begun independent clinical practice. Methods: This qualitative study included 10 HSO alumni (2019-2023) who practice MO in Russia. All participants were current or prior ‘Just Ask’ consultants. Anonymous, online semi-structured in-depth interviews were conducted to explore interviewees reflection on competencies obtained at HSO and ‘Just Ask.’ The interview guide included 42 open-ended questions based on the American Accreditation Council for Graduate Medical Education (ACGME) list of competencies for MO physicians. All interviews were recorded and transcribed. Inductive-deductive coding with code categorization was followed by thematic analysis. Themes were mapped against the ACGME competencies. Results: Interviews, with a median duration of 69 (IQR: 54-80) minutes,involved participants with 0.5-3 years of practice. Six (60%) interviewees worked in hospitals, while 2 (20%) were in outpatient and another 2 (20%) were in mixed settings. We identified 85 codes and categorized them into 10 educational experience themes. Interviewees attributed learning an evidence-based approach, basic oncology knowledge, and patient communication skills through the HSO curriculum. Themes associated with learning from online counseling included integration into real-world practice, specific types of expertise (rare tumors), and advanced communication (explaining differences in management, written communication), which are less covered by HSO. This activity enhanced skills in patient navigation, advocacy, and the ability to detect care not supported by evidence. Safe-space learning provided by ‘Just Ask’ was a unique theme reflecting the ability of trainees to hone skills in a secure and resource-enriched environment with easy access to mentoring. The association of the selected 'Just Ask'-related themes with ACGME competencies is presented in the table. Conclusions: Supervised online counseling has emerged as a valuable educational tool aimed at supplementing competencies insufficiently covered by medical oncology postgraduate curriculum. [Table: see text]

Young Oncologists United (YOU)—foundation of a young interdisciplinary group within the DKG

Young Oncologists United (YOU)—foundation of a young interdisciplinary group within the DKG

3175: Research interest in young Romanian oncologists. Results from a multidisciplinary survey

3175: Research interest in young Romanian oncologists. Results from a multidisciplinary survey

Impact of the COVID-19 pandemic on young oncologists: The Greek perspective

Abstract Background The global impact of the Coronavirus Disease 2019 (COVID-19) pandemic on health professionals has been profound. In response to these circumstances, the coordination committee of the Hellenic Group of Young Oncologists (HeGYO) embarked on an investigation into the well-being of its members. Methods For the purposes of this study, we developed a 44-question questionnaire. The responses were electronically collected and exported into data frames, which were then subjected to statistical analyses. Results The study cohort comprised 77 oncologists, of whom 81.7% (n=67) were under the age of 40. Survey responses highlighted the profound impact of the COVID-19 pandemic on young oncologists in Greece, with 67.5% (n=52) feeling that their work lives have not returned to pre-pandemic levels, 74% (n=57) experiencing changes in duties, and 74.0% (n=57) reporting increased working hours. Additionally, 82% (n=63) of participants reassessed their work–life balance. Notably, 92.2% (n=71) expressed fears of COVID-19 contamination, unrelated to the perceived quality of protective measures (p=0.291). Time allocated to clinical and pre-clinical research was also decreased, as reported by 36.4% (n=28) and 41.6% (n=32) respectively. Surprisingly, the pandemic did not prompt the initiation of unhealthy habits, but 51.2% (n=40) reported a reduction in physical activity. Conclusions In summary, this study reveals that the COVID-19 pandemic significantly altered the professional landscape for young oncologists in Greece, impacting work dynamics, research productivity, and overall well-being. These findings underscore the necessity for targeted interventions during emergencies in the healthcare in order to maintain a resilient workforce in oncology.

Management of Patients with Hypersensitivity to Platinum Salts and Taxane in Gynecological Cancers: A Cross-Sectional Study by the European Network of Young Gynaecologic Oncologists (ENYGO).

Platinum and taxane chemotherapy is associated with the risk of hypersensitivity reactions (HSRs), which may require switching to less effective treatments. Desensitization to platinum and taxane HSRs can be used to complete chemotherapy according to the standard regimen. Therefore, we aimed to investigate the current management of HSRs to platinum and/or taxane chemotherapy in patients with gynecologic cancers. We conducted an online cross-sectional survey among gynecological and medical oncologists consisting of 33 questions. A total of 144 respondents completed the survey, and 133 respondents were included in the final analysis. Most participants were gynecologic oncologists (43.6%) and medical oncologists (33.8%), and 77.4% (n = 103) were involved in chemotherapy treatment. More than 73% of participants experienced >5 HSRs to platinum and taxane per year. Premedication and a new attempt with platinum or taxane chemotherapy were used in 84.8% and 92.5% of Grade 1-2 HSRs to platinum and taxane, respectively. In contrast, desensitization was used in 49.4% and 41.8% of Grade 3-4 HSRs to platinum and taxane, respectively. Most participants strongly emphasized the need to standardize the management of platinum and taxane HSRs in gynecologic cancer. Our study showed that HSRs in gynecologic cancer are common, but management is variable and the use of desensitization is low. In addition, the need for guidance on the management of platinum- and taxane-induced HSRs in gynecologic cancer was highlighted.

Young oncologists benefit more than experts from deep learning-based organs-at-risk contouring modeling in nasopharyngeal carcinoma radiotherapy: A multi-institution clinical study exploring working experience and institute group style factor.

To comprehensively investigate the behaviors of oncologists with different working experiences and institute group styles in deep learning-based organs-at-risk (OAR) contouring. A deep learning-based contouring system (DLCS) was modeled from 188 CT datasets of patients with nasopharyngeal carcinoma (NPC) in institute A. Three institute oncology groups, A, B, and C, were included; each contained a beginner and an expert. For each of the 28 OARs, two trials were performed with manual contouring first and post-DLCS edition later, for ten test cases. Contouring performance and group consistency were quantified by volumetric and surface Dice coefficients. A volume-based and a surface-based oncologist satisfaction rate (VOSR and SOSR) were defined to evaluate the oncologists' acceptance of DLCS. Based on DLCS, experience inconsistency was eliminated. Intra-institute consistency was eliminated for group C but still existed for group A and group B. Group C benefits most from DLCS with the highest number of improved OARs (8 for volumetric Dice and 10 for surface Dice), followed by group B. Beginners obtained more numbers of improved OARs than experts (7 v.s. 4 in volumetric Dice and 5 v.s. 4 in surface Dice). VOSR and SOSR varied for institute groups, but the rates of beginners were all significantly higher than those of experts for OARs with experience group significance. A remarkable positive linear relationship was found between VOSR and post-DLCS edition volumetric Dice with a coefficient of 0.78. The DLCS was effective for various institutes and the beginners benefited more than the experts.

Medical oncology workload, workforce census, and needs in Spain: two nationwide studies by the Spanish Society of medical oncology.

Growing complexity and demand for cancer care entail increased challenges for Medical Oncology (MO). The Spanish Society of Medical Oncology (SEOM) has promoted studies to provide updated data to estimate the need for medical oncologists in 2040 and to analyse current professional standing of young medical oncologists. Two national, online surveys were conducted. The first (2021) targeted 146 Heads of MO Departments, and the second (2022), 775 young medical oncologists who had completed their MO residency between 2014 and 2021. Participants were contacted individually, and data were processed anonymously. Participation rates reached 78.8% and 48.8%, respectively. The updated data suggest that 87-110 new medical oncologist full-time equivalents (FTEs) should be recruited each year to achieve an optimal ratio of 110-130 new cases per medical oncologist FTE by 2040. The professional standing analysis reveals that 9.1% of medical oncologists trained in Spain do not work in clinical care in the country, with tremendous employment instability (only 15.2% have a permanent contract). A high percentage of young medical oncologists have contemplated career paths other than clinical care (64.5%) or working in other countries (51.7%). Optimal ratios of medical oncologists must be achieved to tackle the evolution of MO workloads and challenges in comprehensive cancer care. However, the incorporation and permanence of medical oncologists in the national healthcare system in Spain could be compromised by their current sub-optimal professional standing.

Importance of interdisciplinarity in modern oncology: results of a national intergroup survey of the Young Oncologists United (YOU).

Modern, personalized treatment concepts in oncology require an interdisciplinary and multiprofessional collaboration. In addition to its relevance in patient care, interdisciplinary collaboration is also becoming increasingly important in clinical research as well as medical education and resident training in oncology. Between November 2021 and March 2022, an online survey was conducted among German early career research groups, represented by Young Oncologists United (YOU). The aim was to identify the status and need for interdisciplinarity at clinic, educational, and research levels. A total of 294 participants completed the questionnaire in full. 90.7% of the respondents fully or predominantly agreed with the statement that interdisciplinary work plays a major role in their daily clinical work. 78.9% wished for more interdisciplinary collaboration. Of the 49.7% of participants who have never participated in an interdisciplinary research project, 80.1% said they would like to participate in such a study project in the future. Lack of time resources, too much organizational effort, and possible political conflicts between institutions were identified as factors that make practical implementation difficult. 74.1% declared their willingness to become active in an oncology early career research group. Interdisciplinary collaboration has become increasingly important in oncology. Networks that span different disciplines could help to promote interdisciplinary research projects among young scientists and improve exchange in professional practice and education with the implication of improved patient care.

Fighting against COVID‐19: Innovations and applications

Fighting against <scp>COVID</scp>‐19: Innovations and applications

A new perspective on the future of Turkish Society for Radiation Oncology: Young Radiation Oncologists Group (TROD/GROG 001).

Radiation oncology is a field of medicine that has been rapidly growing with advances in technology, radiobiology, treatment algorithms and quality of life of modern radiotherapy over the last century. In the context of these advances, it is critical to be aware of the role of the young radiation oncologists and enable them to discover new perspectives. For this purpose, "The Young Radiation Oncologists Group" (GROG) has been established by the Turkish Society for Radiation Oncology (TROD), a subgroup which has focused on the professional developments, early career and integrating into the TROD family while supporting education and innovative research of young radiation oncologists. The purpose of this paper was to outline the structure and responsibilities of GROG and its scientific and social activities within TROD and in its own right.

Excitement and Concerns of Young Radiation Oncologists over Automatic Segmentation: A French Perspective

Segmentation of organs at risk (OARs) and target volumes need time and precision but are highly repetitive tasks. Radiation oncology has known tremendous technological advances in recent years, the latest being brought by artificial intelligence (AI). Despite the advantages brought by AI for segmentation, some concerns were raised by academics regarding the impact on young radiation oncologists' training. A survey was thus conducted on young french radiation oncologists (ROs) by the SFjRO (Société Française des jeunes Radiothérapeutes Oncologues). The SFjRO organizes regular webinars focusing on anatomical localization, discussing either segmentation or dosimetry. Completion of the survey was mandatory for registration to a dosimetry webinar dedicated to head and neck (H & N) cancers. The survey was generated in accordance with the CHERRIES guidelines. Quantitative data (e.g., time savings and correction needs) were not measured but determined among the propositions. 117 young ROs from 35 different and mostly academic centers participated. Most centers were either already equipped with such solutions or planning to be equipped in the next two years. AI segmentation software was mostly useful for H & N cases. While for the definition of OARs, participants experienced a significant time gain using AI-proposed delineations, with almost 35% of the participants saving between 50-100% of the segmentation time, time gained for target volumes was significantly lower, with only 8.6% experiencing a 50-100% gain. Contours still needed to be thoroughly checked, especially target volumes for some, and edited. The majority of participants suggested that these tools should be integrated into the training so that future radiation oncologists do not neglect the importance of radioanatomy. Fully aware of this risk, up to one-third of them even suggested that AI tools should be reserved for senior physicians only. We believe this survey on automatic segmentation to be the first to focus on the perception of young radiation oncologists. Software developers should focus on enhancing the quality of proposed segmentations, while young radiation oncologists should become more acquainted with these tools.

Gender-related differences in career development among gynecologic oncology surgeons in Europe. European Network of Young Gynecologic Oncologists' Survey based data.

Gender-related differences in career development are well known issues in various professions. An international survey on gender-related differences was performed among young gynecologic oncology surgeons in Europe to identify potential gender inequalities in career development. A survey on demographics, clinical and academic working environment, family/parenting, career development, salary and leadership was sent to all members of the European Network of Young Gynecologic Oncologists (ENYGO), which is a network within the European Society of Gynecologic Oncology (ESGO). Gynecologic oncology surgeons and obstetricians/gynecologists who actively work in this field in Europe were included in the study. Responses were analyzed from 192 gynecologic oncology surgeons of whom 65.1% (125/192) were female (median age 37, IQR: 34 - 42) and 34.9% (67/192) were male (median age 38, IQR: 36 - 41). Male reported to perform a median of 15 and female a median of 10 operations per month (p = .007). Among female, 24.8% had a leadership position vs. 44.8% among male, crude OR = 2.46, 95% CI 1.31-4.62, p<.01. When stratifying for age under 41 and having children, 36.7% of male and 5.6% of female had a leadership position, adjusted OR 10.8, 95% CI 3.28-35.64, p<.001.A significantly higher proportion of female compared to male believed they earned less than their gender counterparts at the same clinical position and with same qualifications (30.4% vs. 2.5%, p<.001). There was not a statistically significant gender difference in the academic qualification PhD degree or professorship (p = .92 and p = .64, respectively). In the previous year, male published more peer-reviewed articles than female (median 3 vs. median 2; p = .017). This first comprehensive survey on gender-differences in gynecologic oncology in Europe revealed that there are gender gaps concerning several aspects during the critical time of career development in the young generation of gynecologic oncology surgeons. These gender gaps are particularly reflected by a lower rate of female leadership positions. ENYGO and ESGO are dedicated to work on solution to overcome the identified obstacles and to support closing gender gaps.

Current professional standing of young medical oncologists in Spain: a nationwide survey by the Spanish Society of Medical Oncology + MIR section

BackgroundThere is a lack of knowledge about the career paths and employment situation of young medical oncologists. The aim of our study was to evaluate the current professional standing of these professionals in Spain.MethodsThe Spanish Society of Medical Oncology + MIR section conducted a national online survey in May 2021 of young medical oncology consultants (< 6 years of expertise) and final year medical oncology residents.ResultsA total of 162 responses were eligible for analysis and included participants from 16 autonomous communities; 64% were women, 80% were consultants, and 20% were residents. More than half of the participants performed routine healthcare activity and only 7% research activity. Almost three quarters (73%) were subspecialized in a main area of interest and almost half of these chose this area because it was the only option available after residency. Half of the respondents (51%) considered working abroad and 81% believed the professional standing in Spain was worse than in other countries. After finishing their residency, only 22 were offered a job at their training hospital. Just 16% of participants had a permanent employment contract and 87% were concerned (score of ≥ 5 on a scale of 1–10) about their job stability. In addition, one quarter of the participants in our study showed an interest in increasing their research activity.ConclusionsThe choice of subspecialty in medical oncology may depend on job opportunities after residency rather than personal interest. The abundance of temporary contracts may have influenced the job stability concerns observed. Future mentoring strategies should engage in building a long-term career path for young medical oncologists.

1442P Prevalence and factors associated with professional burnout in Polish oncologists: A nationwide survey by Young Oncologists Section of Polish Society of Clinical Oncology

High rates of burnout are observed among healthcare professionals, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout oncologists in Poland. A survey was conducted using the validated Maslach Burnout Inventory - Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout. 211 physicians participated in the study. The majority were females (71.6%) and ≤40- years of age (70.1%). Clinical oncology/hematology was the most common specialization (79.6%). The median time of working in cancer care was 10 years (range 1-45), and 30.8% of participants were in-training. 65.9% have reported a subjective feeling of burnout. Based on the MBI-HSS, 74.9% showed evidence of burnout (burnout subdomains: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%), with no differences between specialization (oncology/hematology - 75.6%, radiotherapy - 72.1%), career stage, gender or age groups. The most commonly reported symptoms of burnout were feeling of excessive workload (71.9%) and lack of energy (71.1%). The main feeling associated with work were anxiety (55.7%), nervousness (36.4%), and indifference (32.0%). Lack of work/life balance was the only significant factor associated with the risk of burnout in logistic regression (RR 2.6; 95%CI 1.3-5.4). Only 20.9% had access to psychological support in their workplace; however, 70.1% wished to have it, mainly through individual consultations (56.4%). Three main factors impacting burnout in cancer care workers were: bureaucracy/administrative duties overload (63.2%), a high number of patients (49.1%), and poor work culture (40.4%). Burnout is common among medical and radiation oncologists in Poland. There is a high need for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among healthcare professionals.

Opportunities and challenges for young surgical oncologists

Opportunities and challenges for young surgical oncologists

European Enhanced Recovery After Surgery (ERAS) gynecologic oncology survey: Status of ERAS protocol implementation across Europe.

To acquire a comprehensive assessment of the current status of implementation of Enhanced Recovery After Surgery (ERAS) protocols across Europe. The survey was launched by The European Network of Young Gynecologic Oncologists (ENYGO). A 45-item survey was disseminated online through the European Society of Gynecological Oncology (ESGO) Network database. A total of 116 ESGO centers participated in the survey between December 2020 and June 2021. Overall, 80 (70%) centers reported that ERAS was implemented at their institution: 63% reported a length of stay (LOS) for advanced ovarian cancer surgery between 5 and 7 days; 57 (81%) centers reported a LOS between 2 and 4 days in patients who underwent an early-stage gynecologic cancer surgery. The ERAS items with high reported compliance (>75% "normally-always") included deep vein thrombosis prophylaxis (89%), antibiotic prophylaxis (79%), prevention of hypothermia (55%), and early mobilization (55%). The ERAS items that were poorly adhered to (less than 50%) included early removal of urinary catheter (33%), and avoidance of drains (25%). This survey shows broad implementation of ERAS protocols across Europe; however, a wide variation in adherence to the various ERAS protocol items was reported.

The need to develop the career pathway in oncology as an opportunity to improve the satisfaction of young oncologists in Spain: A national survey by the Spanish Society of Medical Oncology (SEOM) + mir section.

11038 Background: A long-term planning of the oncologists’ career path is essential to approach the continuous changes in the oncology field given the need of further subspecialization after the training period. Our aim is to evaluate the current professional development of young medical oncologists in Spain and seek improvement strategies to enhance their careers in order to guarantee commitment with research and improve in patient care and outcomes. Methods: The SEOM +MIR Section launched a national online survey in May 2021 aimed at young medical oncology consultants (&lt;6 years of experience) and last year medical oncology residents. Spanish professionals were invited to participate via email through the SEOM database. A descriptive analysis was performed using R software v4.1.2. Results: A total of 162 responses were eligible. 103 (64%) were women. 129 (80%) were consultants and 33 (20%) were residents. 92 (68%) performed standard clinical care and 11 (7%) research activity. 118 (73%) were subspecialized in a main area of interest and almost half of them, 70 (59%), chose it because it was the only option available after finishing residency. 87 (54%) had considered different employment opportunities other than standard clinical care and 38 (23%) showed an interest in enhancing their research activity. 141 (87%) showed relevant concern about their employment stability (table attached). 82 (51%) had considered working abroad: 33 (44%) outside European Union. The main reasons were: 132 (81%) believed the professional standing in Spain was worse than other countries, 41 (25%) thought it might increase their professional development and 33 (20%) argued for better salary conditions abroad. Among them, 21 (13%) had signed at least 4 contracts and 66 (41%) had ≥5 employment contracts in the last 5 years. 27% of respondents indicated that the figure of the boss had been the most contributing professional in their professional career. The mentor (20%) and the tutor (18%) also stand out as relevant figures in terms of professional development. Up to 27% of the sample refers not to have obtained any help from the figures mentioned. Conclusions: An absence of engagement in the long-term career paths of young medical oncologists in Spain was observed. Research is not defined in the current early professional life. Furthermore, there is a lack of contractual quality and planning for the entry into the labour market of newly trained oncologists. The lack of such a career pathway has consequences that encourage the search for employment opportunities different from clinical care and in other countries. [Table: see text]