title: Barriers to a Career Focus in Cancer Prevention: A Report and Initial Recommendations From the American Society of Clinical Oncology Cancer Prevention Workforce Pipeline Work Group.
abstract: OBJECTIVE
  To assist in determining barriers to an oncology career incorporating cancer prevention, the American Society of Clinical Oncology (ASCO) Cancer Prevention Workforce Pipeline Work Group sponsored surveys of training program directors and oncology fellows.
  
  
  METHODS
  Separate surveys with parallel questions were administered to training program directors at their fall 2013 retreat and to oncology fellows as part of their February 2014 in-training examination survey. Forty-seven (67%) of 70 training directors and 1,306 (80%) of 1,634 oncology fellows taking the in-training examination survey answered questions.
  
  
  RESULTS
  Training directors estimated that ≤ 10% of fellows starting an academic career or entering private practice would have a career focus in cancer prevention. Only 15% of fellows indicated they would likely be interested in cancer prevention as a career focus, although only 12% thought prevention was unimportant relative to treatment. Top fellow-listed barriers to an academic career were difficulty in obtaining funding and lower compensation. Additional barriers to an academic career with a prevention focus included unclear career model, lack of clinical mentors, lack of clinical training opportunities, and concerns about reimbursement.
  
  
  CONCLUSIONS
  Reluctance to incorporate cancer prevention into an oncology career seems to stem from lack of mentors and exposure during training, unclear career path, and uncertainty regarding reimbursement. Suggested approaches to begin to remedy this problem include: 1) more ASCO-led and other prevention educational resources for fellows, training directors, and practicing oncologists; 2) an increase in funded training and clinical research opportunities, including reintroduction of the R25T award; 3) an increase in the prevention content of accrediting examinations for clinical oncologists; and 4) interaction with policymakers to broaden the scope and depth of reimbursement for prevention counseling and intervention services.
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX. cfabian@kumc.edu.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Fabian
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Meyskens
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Dean F
authors.initials: DF
authors.lastname: Bajorin
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: George
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Jeter
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Shakila
authors.initials: S
authors.lastname: Khan
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Tyne
authors.affiliation: Carol J. Fabian, University of Kansas Medical Center, Kansas City, KS; Frank L. Meyskens Jr, University of California at Irvine, Irvine, CA; Dean F. Bajorin, Memorial Sloan Kettering Cancer Center, New York, NY; Thomas J. George Jr, University of Florida, Gainesville, FL; Joanne M. Jeter, University of Arizona, Tucson, AZ; Shakila Khan, Mayo Clinic, Rochester, MN; Courtney A. Tyne, Feinstein Kean Healthcare, Washington, DC; and William N. William Jr, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: William N
authors.initials: WN
authors.lastname: William
mesh_terms: D002321:Career Choice; D005257:Fellowships and Scholarships; D006801:Humans; D008495:Medical Oncology / Q000193:education*; D009369:Neoplasms / Q000517:prevention & control*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States