Fortifying the Workforce: A National Survey of Hematology/Oncology Fellowship Program Leaders Regarding Training Fellows for Community-Based Careers

PURPOSE Hematology/oncology (HO) care in the United States is predominantly delivered in community-based (CB) settings. We aimed to explore attitudes of HO fellowship program leaders (PLs) surrounding CB-HO training. METHODS We conducted a cross-sectional electronic survey of 194 HO fellowship PLs in the United States. The primary outcome was assessing PLs' attitudes regarding inclusion of CB-HO training during fellowship. Secondary outcomes included assessing whether programs currently have clinical and/or nonclinical training experiences relevant to CB-HO careers. RESULTS We received 109 responses (response rate, 56.1%) from HO fellowship PLs across the United States. Most fellowship programs (74.3%) are based in tertiary care academic centers, and the largest share (30.3%) are located in the Northeast. A third (33.3%) of PLs indicate that their trainees often pursue CB careers. The majority of respondents (81.6%) believe that CB-HO training should be available for HO trainees, and 60% believe that graduating fellows are adequately prepared for CB careers as is. Roughly two thirds (67%) of PLs provide CB clinical training experiences in their programs currently; 30% offer nonclinical training relevant to CB careers. CONCLUSION Although the vast majority of HO training programs in the United States are embedded within academic centers, nearly all respondents indicate training fellows who will pursue careers in the community post-graduation. PLs believe that experiences tailored to CB-HO practice should be available to their fellows. Although many respondents' programs offer CB clinical rotations, rigorous and relevant nonclinical skill development opportunities are lacking. Goal-concordant pathways for career development during HO fellowship can be optimized—particularly as they relate to training individuals to pursue careers in CB settings, a growing need within the HO workforce.