Developing a Surgical Oncology Workforce in West Africa: A Needs Assessment and Environmental Scan

Introduction: There is a critical lack of surgical capacity for the growing burden of cancer care in West Africa. To address this gap, the development of a surgical oncology fellowship training program was proposed. However, given the limited data needed to inform the creation of this program, a comprehensive needs assessment and environmental scan of the current surgical oncology landscape in the West African region was conducted. Methods: A convergent parallel mixed-methods design was employed. Stakeholders from eight flagship West African cancer centers were surveyed on the existing clinical capacity and scope of current practice. Data were supplemented by site visit observations and informal interviews with stakeholders. The American Society of Clinical Oncology resource-stratified guideline was used to comparably evaluate the clinical capacity for cancer care across institutions. The educational capacity was described and analyzed using qualitative description. Results were presented using a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Results: Thirty-seven individuals representing the eight institutions completed the needs assessment survey. Capacity within various clinical domains essential to the delivery of comprehensive cancer care was reported and compared between institutions. A comprehensive list of surgical procedures that should form the basis of surgical oncology training was produced by consensus. Educational capacity including teaching, assessment, evaluation and expansion was described. Aggregate results from all data sources were presented as a SWOT analysis. Conclusion: This needs assessment represents a crucial first step towards establishing a robust surgical oncology fellowship program tailored to the needs and available resources in West Africa.