An IDEA That Can Change Practice

By Saroj Niraula and Ian F. Tannock
Division of Medical Oncology and Hematology
Princess Margaret Hospital and University of Toronto, Canada

The IDEA (International Development and Education Award) program provides an opportunity for young oncologists in low- and middle-income countries to experience an ASCO Annual Meeting, and receive mentoring from a senior and junior oncologist during a visit to their North American institution. Through IDEA, every year a diverse group of young aspiring oncologists meet with each other; share backgrounds; talk about the differences and similarities they experience, difficulties they face, and possible ways of minimizing the problems encountered in their respective countries; and above all, learn from each other. Being assigned to mentors who host a visit to their cancer center is a wonderful opportunity for lasting interactions and collaboration. Dr. Niraula, first author of this article, had the opportunity to experience this program as a recipient of the IDEA award in 2007, which provided him with the opportunity to meet his current advisor (Dr. Tannock, second author for this article) and subsequently to undertake a clinical research fellowship in Toronto.  

This year, the wheel has turned full circle, and we have had the opportunity to act as senior and junior mentors to a 2011 IDEA recipient from Brazil, Claudia Schavinski. This experience has enriched each of us: Dr. Niraula could identify with Claudia’s enthusiasm as she observed patient care and research in a different setting, while Dr. Tannock continues to appreciate how oncologists strive to provide optimal care to cancer patients in countries with fewer resources. We discussed with Claudia the differences and similarities in cancer care not only between Brazil and Canada but also between Brazil and Nepal, where Dr. Niraula is from. All IDEA volunteers and awardees are stimulated by a similar learning experience.

The program has two essential components.  At ASCO’s Annual Meeting, we advised Claudia how to select from the numerous sessions at this major meeting and to make sensible choices to enhance her interests. “No, Claudia, you simply can’t go to every session - you need some time to relax and unwind.”  In Toronto, Claudia spent time observing in clinics, meeting our staff, fellows, nurses and research assistants, learning how and where our patients are treated, and how they are encouraged to participate in clinical trials.  Lunch with fellows and dinner cooked by one of us (with some Brazilian wine, of course) provided more informal interactions.  Claudia has already applied to return to Princess Margaret Hospital for a 2-month elective, and is enthusiastic about returning later for a longer clinical research fellowship.

From our discussions, it is evident that patient care shares similar fundamental principles throughout the world, regardless of whether it takes place in a state-of-the-art cancer center or in a remote facility in a developing country. What is important is the art of making the most of whatever therapeutic and supportive options are available. Understanding and comparing how these principles are applied is a true learning experience.  The effective practice of oncology requires frequent review of the changing literature, which is less accessible in the developing world. Attending a major cancer meeting and a complimentary subscription to the Journal of Clinical Oncology gives IDEA awardees an opportunity to keep up-to-date with the most recent developments in oncology and to stimulate their interest in research.

Both at the ASCO meeting and while visiting the host institution IDEA recipients observe the emphasis assigned to clinical research. Only through well-conducted research can the outcome of people with cancer improve, and that research can extend from developing sophisticated new drugs to better application and distribution of existing therapies. Limited resources can be a hurdle to carrying out research in the developing world but there are several important areas of clinical research that require less monetary resources. As part of his fellowship, Dr. Niraula is completing a graduate degree in clinical epidemiology that will provide appropriate research tools when he returns to Nepal.

It has been an exciting experience for one of us to be a recipient of an IDEA award and for both of us to act as co-mentors to Claudia, and we thank ASCO and the Conquer Cancer Foundation for providing such opportunities.