Jalan Divyanshi, Rubagumya Fidel, Hopman Wilma M, Vanderpuye Verna, Lopes Gilberto, Seruga Bostjan, Booth Christopher M, Berry Scott, Hammad Nazik
McMaster University, Hamilton ON L8S 4L8, Canada.
Rwanda Military Hospital, Rwanda 0000.
Ecancermedicalscience. 2020 Jul 17;14:1074. doi: 10.3332/ecancer.2020.1074. eCollection 2020.
While several studies have highlighted the global shortages of oncologists and their workload, few have studied the characteristics of current oncology training. In this study, an online survey was distributed through a snowball method for cancer care providing physicians in 57 countries. Countries were classified into low- or lower-middle-income countries (LMICs), upper-middle-income countries (UMICs) and high-income countries (HICs) based on World Bank criteria. A total of 273 physicians who were trained in 57 different countries responded to the survey: 33% (90/273), 32% (87/273) and 35% (96/273) in LMICs, UMICs and HICs, respectively. About 60% of respondents were practising physicians and 40% were in training. The proportion of responding trainees was higher in LMICs (51%; 45/89) and UMICs (42%; 37/84), than HICs (19%; 28/96; = 0.013). A higher proportion of respondents from LMICs (37%; 27/73) self-fund their core oncology training compared to UMICs (13%; 10/77) and HICs (11%; 10/89; < 0.001). Respondents from HICs were more likely to complete an accepted abstract, poster and publication from their research activities compared to respondents from UMICs and LMICs. Respondents identified several barriers to effective training, including skewed service to education ratio and burnout. With regard to preparedness for practice, mean scores on a 5-point Likert scale were low for professional tasks like supervision and mentoring of trainees, leadership and effective management of an oncology practice and understanding of healthcare systems irrespective of country grouping. In conclusion, the investment in training by the public sector is vital to decreasing the prevalence of self-funding in LMICs. Gaps in research training and enhancement of competencies in research dissemination in LMICs require attention. The instruction on cancer care systems and leadership needs to be incorporated in training curricula in all countries.
虽然多项研究强调了肿瘤学家的全球短缺及其工作量,但很少有研究关注当前肿瘤学培训的特点。在本研究中,通过雪球抽样法对57个国家提供癌症护理的医生进行了一项在线调查。根据世界银行的标准,这些国家被分为低收入或中低收入国家(LMICs)、中高收入国家(UMICs)和高收入国家(HICs)。共有273名在57个不同国家接受培训的医生回复了调查:LMICs、UMICs和HICs分别占33%(90/273)、32%(87/273)和35%(96/273)。约60%的受访者为执业医生,40%为受训人员。LMICs(51%;45/89)和UMICs(42%;37/84)中回复的受训人员比例高于HICs(19%;28/96;P = 0.013)。与UMICs(13%;10/77)和HICs(11%;10/89;P < 0.001)相比,LMICs中更高比例的受访者(37%;27/73)自筹核心肿瘤学培训费用。与UMICs和LMICs的受访者相比,HICs的受访者更有可能完成其研究活动中被接受的摘要、海报和出版物。受访者指出了有效培训的几个障碍,包括服务与教育比例失衡和职业倦怠。关于实践准备,无论国家分组如何,在对受训人员的监督和指导、肿瘤学实践的领导和有效管理以及对医疗保健系统的理解等专业任务方面,5分制李克特量表的平均得分都很低。总之,公共部门对培训的投资对于降低LMICs中自筹资金的比例至关重要。LMICs在研究培训方面的差距以及研究传播能力的提高需要引起关注。所有国家的培训课程都需要纳入癌症护理系统和领导力方面的指导。