[We have developed] a global curriculum [that] may be considered as a foundational scaffolding for training surgical oncologists worldwide.— Chandrakanth Are, MBBS, MBA, FRCS, FACS, and colleagues
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As reported by Chandrakanth Are, MBBS, MBA, FRCS, FACS, of the University of Nebraska Medical Center, Omaha, and colleagues at the Society of Surgical Oncology (SSO) and European Society of Surgical Oncology (ESSO), the rising global burden of cancer and inequalities in surgical oncology education and training among nations call for development of a global curriculum in surgical oncology. A proposal for such a curriculum was published jointly in Annals of Surgical Oncology and the European Journal of Surgical Oncology.1-4
Study of Training Paradigms
The investigators performed a study to identify regional training paradigms, which included 174 of 211 countries worldwide. Data were analyzed and categorized on the basis of the six World Health Organization (WHO) geographic regions and economic standing stratified by the Human Development Index.1,2 The primary findings of the study follow:
Proposed Global Curriculum
In response to these and other findings, the leaders of SSO and ESSO outlined a framework for a global curriculum in surgical oncology education and training that contains the following primary elements3,4:
Core Domains of General Oncology for the Surgical Oncologist
Knowledge and understanding of the principles of epidemiology of cancer; screening for cancer; chemotherapy; radiation therapy; biologic therapy and immunotherapy; chronic pain management; palliative care; medical imaging; multidisciplinary care; diagnostic pathology; surveillance; cancer biology; research; delivering care across all resource settings; and hereditary cancer syndromes.
Essentials of Core Knowledge Domains of Surgical Oncology for Each Specific Disease Site
Knowledge and understanding of the principles of management of malignancies involving breast; colorectal/anal cancer; esophagus, gastric/gastroesophageal junction; small intestine; pancreas; liver and biliary tract; endocrine; cutaneous oncology; sarcoma; peritoneal surface; thoracic; genitourinary; gynecology; and pathology applied to each disease-specific site.
Core Domains in Pre-, Peri-, and Postoperative Surgical Care for the Surgical
Knowledge and understanding of the principles of surgical procedures and techniques; various surgical approaches; patient selection; risk stratification prior to surgery; operative planning based on imaging/staging; obtaining consent for operative procedures; intraoperative care; postoperative care; and postoperative critical care.
Essential Training in Core Competencies
To attain competency in holistic patient care; medical knowledge; professionalism; interprofessional and communication skills; experiential learning; systems-based practice; operative skills; and understanding of the human/compassionate side of medicine.
The obligation to confront what was learned from this study falls on every individual within every surgical oncology organization, and no one can serve this role better than those societies that possess the needed academic and financial resources.— Daniel G. Coit, MD
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The authors concluded: “[We have developed] a global curriculum [that] may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment.”
In a statement released when the findings and proposal were published, SSO President Daniel G. Coit, MD, remarked, “The obligation to confront what was learned from this study falls on every individual within every surgical oncology organization, and no one can serve this role better than those societies that possess the needed academic and financial resources.” Dr. Coit is Attending Surgeon, Memorial Sloan Kettering Cancer Center, and Professor of Surgery, Weill Cornell Medical College. ■
Disclosure: Drs. Are and Coit reported no potential conflicts of interest.