Introduction by Svetlana D. Jezdic, MD, Head Office, European Society for Medical Oncology (ESMO), and Doug Pyle, Senior Director, International Affairs, ASCO

	Dr. Lopez, Dr. Jezdic, and Doug Pyle during the Global Curriculum Meeting at the 2011 ASCO Annual Meeting. (Photo by © GMG/Silas Crews 2011)

The ESMO/ASCO Recommendations for a Global Curriculum in Medical Oncology are a set of guidelines, with a global perspective, for the clinical training required for physicians to qualify as medical oncologists. The first edition of the Curriculum was published by ASCO and ESMO in 2004 and has been formally adopted in whole or in part as the framework for medical-oncology specialist training by respective authorities in Australia, New Zealand, Ireland, Japan, India, Latvia, Belgium, the Republic of Panama, and China. It has also been translated in 10 languages, including Spanish, Italian, French, Portuguese, German, Chinese, Japanese, Latvian, Bulgarian, and Russian.

In the years since the first edition of the Curriculum was published, the ESMO/ASCO Global Curriculum Task Force received feedback from all over the world, representing a variety of perspectives and experiences. In parallel, the oncology community has seen a rapid growth in medical technology and advances in fundamental knowledge of cancer cell biology, with effects on genetics, screening, early diagnosis, staging, and overall treatment of cancer.

In light of these developments, ASCO and ESMO conducted a thorough review and updated the Global Curriculum in 2010. The second edition of the Curriculum is based on contributions from experts around the world with special emphasis on the following topics: prevention; molecular biology; cancer genetics; pathology; translational research; targeted therapies and biologic agents in various solid tumors and hematologic malignancies; palliative care and end-of life care; communications; administration of cytotoxic agents; importance of multidisciplinarity in oncology; and skills in which medical oncologists should be trained.

Newly added content reflects:

• translational research and targeted therapies in relevant disease tracks
• complications of treatment
• imaging
• special issues in the diagnosis and treatment of cancer in adolescents and young adults
• cancer and pregnancy
• geriatric oncology
• neuroendocrine cancers
• thyroid cancer
• tumor assessment
• cancer care delivery in low-resource environments

The updated Curriculum represents a broad range of recommendations for national educational and health bodies to adopt, based on the resources and conditions of their country. The diversity of health and educational systems around the world may render some Curriculum recommendations aspirational at this stage, even for those systems with well-developed training programs in medical oncology.

In the interview that follows, Roberto López, MD, of Centro Oncológico Punta Pacífica, discusses with ASCO Connection how the ESMO/ASCO Global Curriculum has been adopted in the Republic of Panama.

AC: What led oncology professionals in Panama to adopt the ESMO/ASCO Global Curriculum?

Dr. López: Throughout the decade leading up to the adoption of the Global Curriculum, Panama faced an increase in cancer incidence, and cancer has been widely recognized as a primary cause of death throughout the nation. Despite the significant national cancer burden, the country only had six oncologists and no oncology training programs available. Following the publication of “Recommendations for a global core curriculum in medical oncology,” in the Journal of Clinical Oncology, medical oncologist Dr. Juan Carlos Alcedo Velarde (who at the time was Director of Training Affairs at the National Oncology Institute in Panama) and myself (who at the time was Medical Director of the same institution) started working on the creation of a formal training program for medical oncologists in Panama. We took the opportunity to follow the ASCO/ESMO Global Curriculum and use it as the framework for a formal medical oncology training program.

AC: What obstacles did you and your colleagues face in trying to adopt the Curriculum?

Dr. López: Some of our colleagues’ busy schedules left little time for them to add teaching responsibilities to their slate of activities. They were especially reluctant to participate when the program was still new and not yet approved, leaving only three physicians—Dr. Alcedo Veldarde, Dr. Omar Castillo Fernandez of the National Oncology Institute, and myself—to start the program. However, once the program was approved by our health authorities and it officially began, others joined the teaching team, which has helped the program immensely.

AC: How has the implementation affected oncology practice in Panama?

Dr. López: Since starting our medical oncology residence program, based on the Global Curriculum, we trained three medical oncologists who work full-time at our institution. They finished their training in June 2010 and have been participating in the program as teachers. A resident also finished the program this June, and we expect to have two new residents join the program this month. As a result of these achievements, we were able to organize “tumor teams” at our institution. We know there is still more work to be done, but the Global Curriculum has already helped us improve the quality of our daily work.

AC: What advice do you have for those considering implementing the Global Curriculum?

Dr. López: The global recommendations are an opportunity for oncology professionals around the world to unite. They are universal and facilitate communication among the global oncology community, regardless of any differences in customs or medical practices.

AC: Is there anything else you would like to share?

Dr. López: I would like to thank ASCO and ESMO for giving me the opportunity to share Panama’s experience of implementing the Global Curriculum. Through continued improvements to our medical oncology training program, we are ultimately helping our patients.

To download the updated edition ofthe ESMO/ASCO Recommendations fora Global Curriculum in Medical Oncology, please visit asco.org/gcc. For more information or to request a print copy, please send an email to international@asco.org.

Svetlana D. Jezdic, MD, works in the HeadOffice of ESMO and is a former medical oncologist at the Department of Medical Oncology at the Institute for Oncology and Radiology of Serbia.

Roberto López, MD, is Head of the Medical Oncology Department at the National Oncology Institute and Medical Director at Centro Oncológico Punta Pacífica, in the Republic of Panama. Dr. Lopez is also a past member of ASCO’s International Affairs Committee and current member of the ESMO/ASCO Global Curriculum Task Force.