WFSOS-SOSP SURGICAL ONCOLOGY TRAINING PROGRAM
1999

Requirements:

A training program in surgical oncology must be linked with a university or a comprehensive cancer center. Ideally, the center should have expertise in other associated areas, including general surgery, medical oncology, orthopedics, thoracic surgery, urology, radiation oncology, pathology, radiology, internal medicine, gynecologic oncology, and plastic surgery. The candidates for this program will have successfully completed their training in general surgery requirements as required by the various national licensing bodies.

 

Objectives:

The training program should accomplish its objective in two years, completing rotations through medical oncology, radiation oncology, pathology, and a minimum of one year in general surgical oncology. Three months of this training should be taken in a subspecialty area in general surgical oncology that reflects the needs of the center of the community where the surgeon will be practicing. Some of those programs might be sarcoma, melanoma, head and neck cancer, gastric cancer, colon cancer, breast cancer or lung cancer. As well, a research component of a minimum of six months with both basic and clinical research components is an important element of such program.

The fellow must have the opportunity to:

1. Become an expert in the diagnosis, assessment and medical and surgical management of cancer in all phases, including prevention, and to be knowledgeable and have expertise in the systemic treatment of malignant diseases and their complications.

2. Develop skills in communicating with the patient and family and in providing continuing care for the patient with progressive illness and psychosocial problems.

3. Obtain experience in the interdisciplinary management of cancer patients and the interaction with other health professionals contributing to the total care of the patients.

4. Participate in clinical trials and their formulation and the evaluation of results.

5. Gain experience in either basic or clinical research in areas of interest in general surgical oncology.

6. Have knowledge of screening and early diagnosis.

7. Become knowledgeable in the basic principles of biomedical ethics as it applies to general surgical oncology.

8. Assume leadership in teaching physicians, students and other professionals in surgical oncology.

 

Clinical Program:

The clinical programs must provide training for the fellow in the following areas; head and neck, breast, digestive cancers, skin tumors, sarcomas, and lymphomas. These should also include the ability to perform endoscopy of the upper aerodigestive tract as well as the colon. Fellows must not only have the ability to perform the standard surgical oncological operations but must have extra skills in hepatic resections, pelvic exenteration, major head and neck resections, plus craniofacial limb salvage surgery, and reconstructive surgery if that is a requirement of the country or community in which the surgeons will be practicing. A fellow may specialize in areas such as esophagus, stomach, pancreatic or biliary, colon, rectum, sarcoma, melanoma, and head and neck surgery as appropriate to her or his future cancer. A thorough understanding of both preoperative and postoperative adjuvant treatments for all cancers must be obtained. Knowledge of surgical palliation, pain control, vascular access, and oncological emergencies is required.

 

Resources:

To obtain these objectives, a training program including rotations in medical and radiation oncology is necessary. On site pathology, internal medicine, intensive care unit and full radiological testing, including CT scan, MRI, nuclear medicine, and ultrasound are desirable as well as a full range of diagnostic facilities, including biochemistry, hematology, microbiology, cytology, and genetics. The residents must have extensive exposure to outpatient clinics and ambulatory care in order to evaluate both short-term and long-term results of the various cancer treatment approaches. A didactic educational component in basic sciences of epidemiology, biostatistics, embryology, anatomy, physiology, biochemistry, pharmacology, genetics and pathology of cancer, as well as the clinical aspects of surgical oncology, must be included.

 

Evaluation:

The program must have ongoing mechanisms of evaluation of the fellow's performance at the end of each rotation or a minimum of six months in the areas of knowledge, clinical skills, technical skills, and attitudes towards patients. A clinical or basic research project will be included in the final submission. The candidates will be tested by an essay examination and oral examination by outside examiners as part of the certification process.

 

Accreditation:

Programs wishing to be accredited by the World Federation of Surgical Oncology Societies will have documentation as to the requirements and on-site inspection that will include evaluation of the facility interviews with the teaching staff and the residents. Re-accreditation will occur in a 10-year cycle.

 

Required Operations:

Skin Tumors

5

Soft Tissue Sarcomas

3

Head and Neck

Oral Cavity

5

Mandible

2

Neck dissection

4

Salivary gland

4

*Maxilla

2

Thyroid

10

Breast

Mastectomy

15

Breast Conservation

3

Esophagus

2

Gastrectomy

3

Pancreaticoduodenectomy

2

Major Liver Resection

2

Bile Duct Tumors

2

Colon

5

Rectal

APR

3

Sphincter Saving Operation

5

*Pelvic Exenteration

2

*Major Amputation

2

*Optional

Mandatory Rotation:

Medical Oncology

3 months

Gynecologic Oncology

1 month

Radiation Oncology

2 months

Pain Control & Hospice Care

1 month

Vascular Access

1 month

Pathology of Cancer

2 months

Other Requirements:

 

Internal Evaluation:

Quarterly clinical evaluation

Yearly written examination

Yearly oral examination

External Evaluation:

Board certification

 

Qualification of Trainors: 5 Members of SOSP