Division of Gynecologic Oncology, The Massachusetts General Hospital, Boston, Massachusetts, USA.
Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, India.
Int J Gynaecol Obstet. 2021 Oct;155 Suppl 1(Suppl 1):115-122. doi: 10.1002/ijgo.13869.
Women in low- and middle-income countries (LMICs) are significantly more likely to develop and die from invasive cervical cancer, while rates of other gynecologic malignancies are comparable to those faced by women in high-income countries. Despite this increased need, there are few specialist physicians in LMICs available to treat women with gynecologic cancers. Training specialists in low-resource settings faces multiple challenges, including ensuring protected time from other clinical demands, access to best practice guidelines, training that is tailored to the specific challenges faced in the trainee's environment, and isolation from other fully trained professionals and securing support services. In addition, training specialists from LMICs in high-resource settings is costly and return of trainees to their own country is not guaranteed. Here we describe two approaches to gynecologic oncology training in LMICs. The International Gynecologic Cancer Society (IGCS) developed the Global Curriculum Mentorship and Training Program (Global Curriculum) to support gynecologic oncology fellowships in regions of the world that do not currently have formal training in gynecologic oncology. In India, on the other hand, leaders in world-class gynecologic oncology centers must find a way to meet the training needs of a vast and disparate country.
在中低收入国家（LMICs），女性更有可能患上侵袭性宫颈癌并因此死亡，而其他妇科恶性肿瘤的发病率与高收入国家的女性相当。尽管存在这种更高的需求，但在 LMICs 中，能够治疗妇科癌症的专科医生却寥寥无几。在资源匮乏的环境中培训专家面临着诸多挑战，包括确保从其他临床需求中获得受保护的时间、获得最佳实践指南、根据受训者所在环境面临的具体挑战进行培训，以及与其他完全受训的专业人员隔离并获得支持服务。此外，培训来自 LMICs 的专家到高收入国家的成本很高，而且培训生返回自己的国家也无法得到保证。在这里，我们描述了两种在 LMICs 中进行妇科肿瘤学培训的方法。国际妇科癌症学会（IGCS）制定了全球课程指导和培训计划（全球课程），以支持在世界上尚未开展妇科肿瘤学正式培训的地区的妇科肿瘤学奖学金。另一方面，在印度，世界级妇科肿瘤学中心的领导者必须找到一种方法来满足这个幅员辽阔、差异巨大的国家的培训需求。
