Abstract 831: State of medical and surgical oncology training in India: An infrastructural challenge to delivering high-quality cancer care

Introduction: Cancer care delivery in low- and middle-income countries (LMICs) is significantly influenced by the number and distribution of oncologists, which are products of the state of oncology training in those LMICs. In LMICs like India, where the number of trained oncologists is low, cancer care is often delivered by generalists, resulting in poorer outcomes. India, with a population of 1.38 billion people, was projected to have needed over 5000 oncologists in 2020. But, the Global Survey of Clinical Oncology Workforce reported only 1500 clinical oncologists here in 2018. Therefore, we sought to systematically determine and describe the current state of accredited oncology training in India. Methods: We searched, in October 2020, the databases of two major accrediting bodies, the National Medical Council (NMC) and the National Board of Examinations (NBE) to determine the total number of programs and the positions therein for the fields of medical, surgical, and gynecological oncology. We correlated our search with the current regulations from NMC and NBE. Results: Both the NMC and NBE currently offer training for 3-year specialty oncology training after 3-years of medical or surgical residency. We found India currently has a total of 166, 139, and 22 training positions for surgical, medical, and gynecological oncology respectively (Table 1). Significant variation in the number of positions exists, with a few institutions providing training to over 10 fellows, leading to concerns about the volume of training and exposure to cases. There is a clustering of training programs in major metropolitan cities. Discussion: India is currently training a highly insufficient number of clinical oncologists for its increasing cancer burden. Clustering of training programs in metropolitan cities results in a greater likelihood of trained physicians practicing in the same location. Both of these may cause greater disparities in cancer care delivery. Table 1.State of accredited oncology training programs and positions in India.SubspecialtyMCI-accredited trainingNBE-accredited trainingNumber of training programsTotal number of positionsMedian (IQR) number of positions per programNumber of training programsTotal number of positionsMean number of positions per programSurgical oncology23983 (2.5)36682Medical Oncology18762 (4)30632Gynecologic Oncology8152 (0.5)472 Citation Format: Ahmad Ozair, Faique Rahman, Kaushal K. Singh. State of medical and surgical oncology trainin