Preparing Fellows for Graduation: Perspectives on Career Guidance

Defining the Educational Needs for a Community-Based Hematology/Oncology Career: A National Needs Assessment

PURPOSE

Little is known about the specific needs during training for hematology/oncology providers practicing in community-based settings. We conducted a national survey of hematologists/oncologists employed in community or academic-community hybrid settings to delineate their educational needs.

METHODS

An electronic questionnaire was developed and distributed nationally through professional organizations. We primarily assessed whether survey participants received any specific training during fellowship for community-based practice. Participants were also surveyed regarding training experiences that might have affected their preparation. Relative risk (RR) and 95% CI were calculated using modified Poisson regression to identify factors associated with receiving training specifically for community-based settings.

RESULTS

Of 125 participants from across 25 states, 63% were male and 58% identified as White. Less than half (41.6%, binomial 95% CI, 32.8 to 50.7) received any training in a community-based setting. Participants identified rotations in community settings (47%), direct mentorship from community-based physicians (40%), and longitudinal clinic in a community setting (36%) as experiences that would have been valuable. Specific curricula of interest included medical operations and administration (63%), health policy (35%), and quality improvement (27%). Respondents in clinical practice for <10 years were more likely to have received any training specifically for a community-based career (RR, 2.13 [95% CI, 1.18 to 3.86]).

CONCLUSION

Our study demonstrates substantial unmet needs as they relate to deliberately training fellows destined for community-based careers. Prospective design of clinical training and curricula emphasizing longitudinal exposures to and key aspects of health care delivery in the community setting are paramount to achieving optimal goal-concordant hematology/oncology training during fellowship.

Oncology Medical Training and Practice: Managing Jordan's Brain Drain Through Brain Train-The King Hussein Cancer Center Experience

PURPOSE

The medical education system in Jordan is one of the most advanced education systems in the Middle East. Yet many medical school graduates leave the country to seek specialty and subspecialty education and training abroad, and the majority of graduates continue their careers there.

METHODS

We explored reasons behind this so-called “brain drain” and how to slow it, along with capacity building opportunities and strategies for better local training.

RESULTS

By taking advantage of various international collaborative opportunities, the King Hussein Cancer Center has managed to offer strong local training programs and an enhanced working environment, which has enabled us to improve the educational level of our graduates so they can help staff the Center, the country, and the region.

CONCLUSION

Strong local training programs coupled with international partnerships can result in better training for physicians and offset the problem of brain drain without putting any restraints on the graduates.