Training of Pediatric Oncologists: An Assessment of Institutional Training Capabilities in the Middle East and South Asia

Background: The pediatric hematology-oncology (PHO) workforce has substantial variability in countries across the Eastern Mediterranean (EM) and South Asian (SA) regions, with variable certification requirements to ensure competency for safe and effective practice. To date, the quality of the training provided has not been evaluated across these regions. To assess this, we conducted a survey of PHO training by comparing the programs against international standards. Methods: A cross-sectional survey was conducted between January and May 2024. The survey was based on the American Council of Graduate Medical Education (ACGME) requirements and implemented through RedCap^R. Descriptive statistics were generated, and p values <0.05 were considered statistically significant. Findings: Ninety-eight institutions from 21 countries across the EM and SA regions responded to our survey. Of these, 59.1% reported PHO training programs. A core pediatric residency was present within the proximity of the fellowship program in 63.7%. Public sector institutions were more likely to have a training program than private centers. A median of two fellows [1–20] were recruited annually, with a median faculty:fellow ratio of 2. While most programs provided exposure to the entire breadth of hematologic and oncologic diseases, 17% of programs did not offer care to patients with high-risk/advanced malignancies, identifying an experiential deficiency. Across all domains, programs were deficient in the availability of molecular and genetic diagnostics, impacting trainee learning. Accreditation oversight was provided to 87.5% programs. Only a minority of programs facilitated program directors to oversee training. Interpretation: Our survey provides a baseline overview of the capabilities of training programs in the EM and SA regions. While a majority of programs fulfilled standard requirements necessary for optimal training of PHO fellows, the quality of the exposure could not be ascertained.