IAEA Syllabus for the Education and Training of Radiation Oncologists. Endorsed by the American Society for Radiation Oncology (ASTRO) and the European Society for Therapeutic Radiology and Oncology (ESTRO)

Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to making radiotherapy accessible to cancer patients. To ensure a uniformity and consistency in the training that could be undertaken by the various medical institutions running their postgraduate programmes in radiation oncology the IAEA's intent in formulating a syllabus for the education and training of radiation oncologists is to provide guidance for all professionals and administrators involved in the training of this discipline. The syllabus seeks to address the training requirements in developing countries in order to establish a common and consistent framework. It provides both a structure for the organization of the training and a core curriculum. The guidelines outlined in the core curriculum could be adopted by the various Member States as a baseline for national curricula. These guidelines have been framed via consultations with representatives of the Member States - both from developed and developing countries at a Consultants' Meeting held at IAEA headquarters in Vienna on 14-17 August 2006 and were commented on by major national and regional societies of radiation oncology. The IAEA recognizes the variability in the prevalence and spectrum of diseases as well as the variation in the availability of different technologies in the countries and regions. National and regional societies should prioritize the subjects presented in the core curriculum and adapt them to the disease profiles observed in their own countries/regions. Countries with a limited number of radiation oncologists should recognize the fact that cancer care is becoming ever more specialized and other aspects of cancer care such as medical oncology and palliative care should act in collaboration with the radiation oncologists to cover these other partially overlapping disciplines. The IAEA promotes a policy of multidisciplinary decision-making regarding the management of the individual patient, where the radiation oncologist interacts with other disciplines as a competent and independent specialist