Uta Schmidt-Straßburger, a scientific director of the Advanced Oncology Study Programme at the University of Ulm, presents a summary of a 10-year experience in continuous development and improvement of b-learning program created for oncologists and their colleagues. By implementing ESMO/ASCO recommendations for a global curriculum in oncology and organizing the material into seven modules, the program assured standardization and comprehensiveness. Adding soft skills workshops, for example, in negotiation or presentation, and assuring personal coaching and international environment created a unique opportunity for participants to build a very strong and supportive network. Probably the biggest potential in the studies lies in the strong interpersonal interactions among participants, staff, and associated researchers and tutors that have already resulted in numerous projects and led to further development of former students even after the graduation from the program. Such a network plays a role not only in exchanging opinions, experience, and views but also is a solid ground for building didactic, scientific, translational, and clinical projects.
Similar to the master classes in clinical oncology organized by the European School of Oncology (ESO) together with ESMO, the personal interactions between participants, organizers, and faculty create long-lasting positive associations with a lifelong learning experience in oncology and encourage participants to join networks of continuing medical education like e-ESO and to convene at ESMO annual meetings.
A good example on how to build the local curriculum for oncologists basing on the ESMO/ASCO recommendations can be provided by Zeinab Elsayed and Mohamed Reda Kelany—oncologists working in Egypt. The transfer of know-how cannot be direct in such situations as the socioeconomic and cultural background since, for example, former specialist training requirements, accreditation and organization of oncology centers, and the financing system are completely different. Some of the obstacles are common for a majority of countries, whereas others are cultural and financially dependent. Factors such as the risk of burnout or difficulties in motivating the busy faculty staff to devote the time to residents’ training are more general, and oncologists all over the world face these problems. On the other hand, limited facilities, shorter duration of a specialty training, and lack of research options are more specific for LMICs (Murali and Banerjee 2018; Burki 2018; Jalan et al. 2020).
Ahmed Magdy Rabea shares some practical solutions that were introduced in one of the oncology centers in Luxor. He managed to transfer and propagate well-known solutions such as regular educational lectures, clinical pharmacists’ meetings, and daily clinical rounds for residents and fellows. Supporting international training of the residents can bring future benefits to the parent unit, but one needs to be aware that it means loss on manpower at the beginning of such investment.
Building from scratch a national network for sarcoma treatment in Egypt seems extremely challenging. Mohamed Reda Kelany presents strengths, weaknesses, opportunities, and threats of the proposed sarcoma network. It is highlighted that even such project created from scratch needs patient advocate groups and the stakeholders representing different discipline involvements so as to make the effort lasting and sustainable.
The number of obstacles to face with and a massive effort while building an oncology educational program from the beginning is presented by Layth Mula-Hussain, a lecturer in radiation oncology from Iraq. The first board-certified residency program in radiation oncology was launched between 2013 and 2017 in Iraq (Mula-Hussain et al. 2019). Sharing this experience is extremely valuable as the problem was defined not only in the lacking procedures but also lack of staff or facilities. It is not an exaggeration to say that the presented example addressed almost all the challenges of postgraduate medical education, both general and specific for oncology, those present all over the world, and characteristic for LMICs. Four years after the program’s establishment, its authors can pass the updated knowledge and know-how to other colleagues. Ten physicians completed the training in radiation oncology between 2017 and 2020 allowing the care for the population of over ten million people. When trying to find the main factors responsible for this success, two facts cannot be neglected: the preparation period was long including technical and logistical planning and the faculty setup to create the syllabus consisted of local and external specialists. That would not be possible without the preexisting network organization.
How to set up a new program is also a topic for Blanca Iciar Indave Ruiz, a research assistant currently working at the International Agency for Research on Cancer and World Health Organization (WHO) Classification of Tumours Group. However, this time the goal is to build an online training program named Evi-Pat and propagate high-quality and well-functioning scientific activities, that is, further work on the WHO Classification of Tumours by an evidence-based approach in order to improve adopting these methods. The main educational obstacles in this situation are more specific for e- and b-learning. Apart from obvious ones, choosing the proper virtual learning environment (VLE) or evaluation methodology, new challenges appeared, for example, how to advertise internationally, how to define and reach proper course recipients, and how to obtain additional funding to build such a program. To deal with potential issues, a collaboration between partners was established: the Master Online Advanced Oncology program at the University of Ulm, the Cochrane Netherlands, the Universidade Estadual de Campinas in Brazil, and the WHO Classification of Tumours. This is a new initiative, where in order to keep the reliability of tumor classification, addressing critical questions and finding research gaps seem crucial.
The presented list of real-life examples is not limited to transferring knowledge from high- to low-income countries or supporting to build other successful online programs. A great model of how the activities of current and former students and staff can serve also in high-income country is presented by Judy Vicente de Paulo, a medical oncologist from Portugal and a president of the Young Oncologists Committee of the Portuguese Society of Oncology in a section: Continuing education for the young oncology workforce in Portugal. These initiatives are frequent in developed countries where oncologists in training take over partial responsibility for their training and its improvement with a support from ESMO or national societies. The Nucleus of Interns and Young Specialists of the Portuguese Society of Oncology was founded in 2015. The chapter summarizes the challenges that young oncologists face during the residency program in Portugal and the solutions implemented to meet these challenges including soft skills workshops or additional training to cover hot topics in oncology like oncological emergencies. Currently, a similar initiative has been born in Poland.