Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
Mayo Clinic, Rochester, Minnesota, USA.
Pediatr Blood Cancer. 2025 Jan;72(1):e31375. doi: 10.1002/pbc.31375. Epub 2024 Oct 15.
There is growing interest in global health (GH) among medical trainees in the United States. However, providing GH training opportunities at the fellowship level presents several challenges. Understanding of barriers and facilitators to implementing GH training is essential for addressing these challenges.
We developed a comprehensive survey of 65 Likert-scale multiple-choice and open-ended questions to assess perspectives of pediatric hematology/oncology fellowships leaders on GH training. The survey was electronically distributed to program leaders at all ACGME-accredited pediatric hematology/oncology fellowships programs, and data were summarized using descriptive analysis.
Of 73 eligible programs, we had a 45.2% response rate with 27 complete and 6 partial responses. Respondents represented programs across the United States, including 19 (57.6%) affiliated with NCI-Designated Cancer Centers. Fourteen programs (43.8%) currently offer GH training opportunities, whereas 18 programs expressed interest in future opportunities (15, 83.3%) or plan to offer them soon (3, 16.7%). Major barriers identified include competing training priorities (23, 82.1%), lack of faculty mentors in the division (23, 82.1%), and lack of dedicated institutional funding (20, 71.4%). Key facilitators include the interest and initiative of current fellows (27, 96.4%), dedicated institutional funding (26, 92.8%), and having established international partnerships (26, 92.8%).
The study reveals strong interest in GH training in pediatric hematology/oncology fellowships. Despite challenges such as competing priorities and a lack of mentors, significant facilitators include current fellows' initiatives, dedicated funding, and established international partnerships. These insights can help shape future initiatives to incorporate GH into pediatric oncology/hematology fellowship training.
在美国，越来越多的医学受训者对全球健康（GH）产生了兴趣。然而，在 fellowship 阶段提供 GH 培训机会存在一些挑战。了解实施 GH 培训的障碍和促进因素对于应对这些挑战至关重要。
我们开发了一项综合调查，其中包含 65 个李克特量表多项选择题和开放式问题，以评估儿科血液学/肿瘤学 fellowship 负责人对 GH 培训的看法。该调查通过电子邮件分发给所有 ACGME 认证的儿科血液学/肿瘤学 fellowship项目的负责人，使用描述性分析汇总数据。
在 73 个符合条件的项目中，我们的回复率为 45.2%，其中有 27 个完整回复和 6 个部分回复。受访者代表了全美各地的项目，其中 19 个（57.6%）隶属于 NCI 指定的癌症中心。目前有 14 个项目（43.8%）提供 GH 培训机会，而 18 个项目表示有兴趣在未来提供机会（15 个，83.3%）或计划很快提供（3 个，16.7%）。确定的主要障碍包括培训优先级竞争（23，82.1%）、科室缺乏导师（23，82.1%）和缺乏专用机构资金（20，71.4%）。关键促进因素包括现任研究员的兴趣和主动性（27，96.4%）、专用机构资金（26，92.8%）和已建立的国际伙伴关系（26，92.8%）。
该研究表明，儿科血液学/肿瘤学 fellowship对 GH 培训有着浓厚的兴趣。尽管存在优先级竞争和缺乏导师等挑战，但重要的促进因素包括现任研究员的主动性、专用资金和已建立的国际伙伴关系。这些见解有助于制定未来的倡议，将 GH 纳入儿科肿瘤学/血液学 fellowship培训。
