Survey of practices around pharmaceutical company funding for continuing professional development among medical oncologists and trainees in Australia.

BACKGROUND: The completion of continuing professional development (CPD) is mandatory for medical oncologists and trainees (MO&T). Pharmaceutical companies may fund some CPD activities, but there is increasing debate about the potential for conflicts of interest (COI). AIM: To assess current practices around funding to attend CPD activities. METHODS: An electronic survey was distributed to Australian MO&T. The survey asked questions about current practices, institutional policies and perceptions about attending CPD funded by pharmaceutical companies. The design looked at comparing responses between MO&T as well as their understanding of and training around institutional and ethical process. RESULTS: A total of 157 of 653 (24%) responses was received, the majority from MO (76%). Most CPD activities attended by MO&T were self-funded (53%), followed by funding from institutions (19%), pharmaceutical companies (16%) and salary award (16%). Most institutions allowed MO&T to receive CPD funding from professional organisations (104/157, 66%) or pharmaceutical companies (90/157, 57%). A minority of respondents (13/157, 8%) reported that the process to use pharmaceutical funds had been considered by an ethics committee. Although 103/157 (66%) had received pharmaceutical funding for CPD, most (109/157, 69%) reported never receiving training about potential COI. The lack of education was more noticeable among trainees (odds ratio (OR) 8.61, P = 0.02). MO&T acknowledged the potential bias towards a pharmaceutical product (P = 0.05) but believed there was adequate separation between themselves and pharmaceutical companies (P < 0.01). CONCLUSION: Majority of CPD attended by MO&T is self-funded. There is lack of clarity in institutional policies regarding external funding support for CPD activities. Formal education about potential COI is lacking.

Workforce shortages in medical oncology: a looming threat to quality cancer care.

Supply must meet demand to maintain our high standards of cancer care.

The shortage of medical oncologists: the Australian Medical Oncologist Workforce Study.

OBJECTIVE: To determine current and projected supply, demand and shortfall of medical oncologists (MOs) and the Australian chemotherapy utilisation rate. DESIGN, SETTING AND PARTICIPANTS: A 2009 cross-sectional observational study of Australian adult medical oncology practice work patterns. INSTRUMENT: Electronic or paper self-administered questionnaire. MAIN OUTCOME MEASURES: The 2009 and projected (2014) supply, demand and shortfall of full-time equivalent (FTE) MOs, and the chemotherapy utilisation rate. RESULTS: 476 medical oncology positions comprising 234 FTE MOs were identified. Of the 150 medical oncology practices, 117 (78%) were in metropolitan locations and 33 (22%) were in rural locations. The average number of new patients seen per FTE MO was 270 patients (ranging by state from 191 to 343). The demand for FTE MOs was estimated at 326 to 391 in 2009 and 361 to 432 in 2014. The shortfall of FTE MOs was estimated at 92 to 157 in 2009 and 84 to 156 in 2014. The chemotherapy utilisation rate was 19%. CONCLUSIONS: The current shortage of MOs is expected to persist in the future. National strategies are needed to increase the capacity of the medical oncology workforce and the chemotherapy utilisation rate.

Reaching further with online education? The development of an effective online program in palliative oncology.

Patients in rural and remote Australia have less access to specialist oncology services and rely more on local health professionals for provision of cancer care. We have developed a 7.5-h online educational program on palliative oncology for health professionals focused on the needs of rural providers. There were 501 active (enrolled) users and 268 ad hoc (non-enrolled) users, with 90 completing evaluation. Eighty-two (91%) indicated that their learning needs were partially or entirely met. Sixty-five (75%) respondents planned to review or change their practice as a result. The online program is effective in meeting learning needs of Australian health providers, reaching high numbers with high acceptability.

The Australian Medical Oncologist Workforce Survey: The profile and challenges of medical oncology.

BACKGROUND: The aim of this study was to understand the current and future challenges for the Australian medical oncologist workforce. METHODS: Utilising an on-line self-administered questionnaire, this cross-sectional study collected data from members of the Medical Oncology Group of Australia on workforce-related issues. Participants consisted of medical oncology specialist advanced trainees, early-career oncologists (ECOs), and medical oncology consultants. FINDINGS: Of the 633 members, 354 completed the questionnaire, representing a 55.9% response rate. Based on Medical Oncology Group of Australia membership, the number of medical oncologists has increased since the previous workforce study in 2009, with an uncertainty among junior medical oncologists regarding their future career prospects. The majority of participants worked in capital cities and metropolitan areas within the three most populous Australian states. Almost half (45%) of ECOs and consultants are undertaking or have completed a higher degree. A large number of advanced trainees (93%) and half of ECOs in this study were concerned about their future career prospects. For these participants, most were satisfied with the supervision they received (60% trainees and 69% ECOs) but only half of these participants (47% trainees and 52% ECOs) received any mentoring in their current or previous role. Compared to trainees and ECOs, consultants reported spending significantly more hours on administration per week; trainees 5.3 hours, ECOs 5.8 hours, consultants 7.5 hours (P < .031) and see a significantly greater number of patients per week; trainees 34 patients, ECOs 34 patients and consultants 49 patients (P < .001). INTERPRETATION: Workforce challenges were unique across different career stages in oncology; trainees, ECOs and consultants. Work intensity, mentorship and career prospects were amongst the emergent issues highlighted in this study.

A mixed methods analysis of experiences and expectations among early-career medical oncologists in Australia.

AIM: A viable and sustainable medical oncology profession is integral for meeting the increasing demand for quality cancer care. The aim of this study was to explore the workforce-related experiences, perceptions and career expectations of early-career medical oncologists in Australia. METHODS: A mixed-methods design, including a survey (n  =  170) and nested qualitative semistructured interviews (n  =  14) with early-career medical oncologists. Recruitment was through the Medical Oncology Group of Australia. Qualitative data were thematically analyzed and for the survey results, logistic regression modeling was conducted. RESULTS: Early-career medical oncologists experienced uncertainty regarding their future employment opportunities. The competitive job market has made them cautious about securing a preferred job leading to a perceived need to improve their qualifications through higher degree training and research activities. The following themes and trends were identified from the qualitative and quantitative analyses: age, career stage and associated early-career uncertainty; locale, professional competition and training preferences; participation in research and evolving professional expectations; and workload and career development opportunities as linked to career uncertainty. CONCLUSION: Perceived diminished employment opportunities in the medical oncology profession, and shifting expectations to be "more qualified," have increased uncertainty among junior medical oncologists in terms of their future career prospects. Structural factors relating to adequate funding of medical oncology positions may facilitate or inhibit progressive change in the workforce and its sustainability. Workforce planning and strategies informed by findings from this study will be necessary in ensuring that both the needs of cancer patients and of medical oncologists are met.