March 17, 2016, American College of Surgeons, CHICAGO: Many low- and middle-income countries do not have a defined medical specialty in surgical oncology and lack an educational infrastructure to respond to the local burden of cancer, but a Memorial Sloan Kettering Cancer Center (MSKCC) fellowship is succeeding in addressing this problem by training foreign medical graduates (FMG) in surgical oncology. Results of the MSKCC oncology fellowship program are reported on in an "article in press" on the Journal of the American College of Surgeons website in advance of print publication later this year.

Cancer care is a major public health priority worldwide. For patients with solid tumors, surgeons are at the center of care in countries that have few if any medical or radiation oncologists. This concern is the driving force behind the International General Surgical Oncology Fellowship at MSKCC. By educating and training FMGs, there is the possibility of a significant intervention in cancer care through the establishment of a qualified surgical oncology workforce "that understands local needs and can foster change towards care improvement, creating a sustainable model of intellectual and technological infrastructure for cancer management," study authors noted.

Historically, there has been a high rate of FMGs who stay in the U.S. permanently after training here. MSKCC is working to change this scenario and have FMGs return to their country of origin to help improve cancer care. The program accomplishes this goal by actively enrolling surgeons who have a long-term plan of practice and development back home. These steps have enabled the MSKCC program to see 80 percent of its trainees return to their home countries after their fellowships conclude. Not only can these surgeons use the skills they acquired to treat patients, they can also pass along those skills to others so that the training continues beyond their experience.
"This fellowship training program is more than just teaching trainees technical aspects of operations," said lead study author Sir Murray F. Brennan, MD, FACS, vice president for international programs; Benno C. Schmidt Chair in Clinical Oncology; and director, The Bobst International Center, at MSKCC, New York, N.Y. "There is a heavy emphasis on these surgeons becoming good educators, learning about databases, and how to evaluate surgical outcomes."

Study authors tracked FMGs who completed the MSKCC fellowship from 1994 to 2014. During that time, 39 trainees from 24 countries came through the program--17 from Europe, eight from Australia/New Zealand, six from the Middle East, five from Latin America, and three from Asia. The study authors said 69 percent of fellowship graduates were involved in academic positions with a high level of job satisfaction.

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