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The European population is strongly affected by cancer. Radiotherapy is roughly used in 50% of cancer patients in European countries. The increased cancer burden demands a new generation of radiation/clinical oncologist (RO/CO) that, besides a strong evidence-based oncological knowledge, will be ready for leadership in cancer care. The mutual recognition of professional qualifications of Radiation/Clinical Oncology in the EU needs training harmonization. The European Society of Radiotherapy and Oncology (ESTRO) and the European Union for Medical Specialties (UEMS) made important efforts toward a European Common Curriculum for RO/CO leadership in cancer care. If qualifications are mutually recognized, the training supporting these qualifications should be also harmonized. Since 1991, ESTRO produced several editions of the Core Curriculum in Radiation Oncology (1991, 2004, 2012, 2019). These Core Curricula were endorsed as European Training Requirements by the UEMS in 2004, 2013, and 2019. A core curriculum for clinical oncology was also produced to provide this harmonization tool to countries where radiation oncology is practiced inside the broader specialty of clinical oncology. New initiatives are in place to continuously adapt the training programs to the rapidly evolving cancer care organization. [ABSTRACT FROM AUTHOR]

Surgical oncology is a defined specialty within the European Board of Surgery within the European Union of Medical Specialists (UEMS). Variation in training and specialization still occurs across Europe. There is a need to align the core knowledge needed to fulfil the criteria across subspecialities in surgical oncology. The core curriculum, established in 2013, was developed with contributions from expert advisors from within the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy and Oncology (ESTRO) and European Society of Medical Oncology (ESMO) and related subspeciality experts. The current version reiterates and updates the core curriculum structure needed for current and future candidates who plans to train for and eventually sit the European fellowship exam for the European Board of Surgery in Surgical Oncology. The content included is not intended to be exhaustive but, rather to give the candidate an idea of expectations and areas for in depth study, in addition to the practical requirements. The five elements included are: Basic principles of oncology; Disease site specific oncology; Generic clinical skills; Training recommendations, and, lastly; Eligibility for the EBSQ exam in Surgical Oncology. As evidence-based care for cancer patients evolves through research into basic science, translational research and clinical trials, the core curriculum will evolve, mature and adapt to deliver continual improvements in cancer outcomes for patients. [ABSTRACT FROM AUTHOR]

• A clinical oncology module for the ESTRO core curriculum has been developed. • It is based on CanMEDS 2015 containing 20 enabling competencies. • Proficiency is defined by a range of Entrustable Professional Activities for each tumour site. Clinical oncologists are physicians with the competencies to manage cancer patients through the entire disease pathway combining the competencies of radiation and medical oncologists. The 4th edition of the European Society for Radiotherapy and Oncology Core Curriculum for Radiation Oncology/Radiotherapy (ESTRO curriculum) has received wide support by the clinical oncology community. The aim was to develop a clinical oncology module that could be combined with the ESTRO curriculum to enable clinical oncology trainees to follow a single curriculum. A range of stakeholders including National Society representatives, an oncologist from a low- middle-income country, and a recently appointed specialist, developed and commented on iterations of the curriculum. Further modifications were made by the ESTRO Education Council. The module is based on the CanMEDS 2015 framework and identifies 20 enabling competencies in the Medical Expert role that are required in addition to the ESTRO curriculum for the training of clinical oncologists. Recommendations are made for the levels of Entrustable Professional Activities (EPAs) to be attained by the end of training. The Clinical Oncology module, when combined with the ESTRO curriculum, covers the entire cancer pathway rather than being modality specific. It is hoped it will aid in the development of comparable standards of training in clinical oncology across Europe and may also have utility in low- and middle-income countries as well as providing a single curriculum for trainees. [ABSTRACT FROM AUTHOR]

• The ESTRO core curriculum for radiation oncology/radiotherapy has been revised. • It is based on CanMEDS 2015 containing 14 entrustable professional activities (EPAs) • The manager role has been replaced by the leader role. • Proficiency is defined by ranges of EPAs for each tumour site. In 2017 it was decided to revise the European Core Curriculum for Radiation Oncology/Radiotherapy to produce a 4th edition. The aims of the ESTRO curriculum are to develop comparable standards for training across Europe and to facilitate free movement of specialists across borders. It is also hoped that it will improve the level of training across Europe and will make the non-medical expert roles more explicit. A wide range of stakeholders including National Society representatives, trainees, recently appointed specialists, members of the European Union Medical Specialists Radiotherapy section, an RTT, a radiobiologist, a physicist and lay members from ESTRO staff developed and commented on iterations of the curriculum. The 4th edition is based on the CanMEDS 2015 framework and identifies 14 Entrustable Professional Activities (EPAs) and the competencies required to perform these. The manager role is replaced by competencies related to leadership. The levels of proficiency required for tumour sites is defined as levels of EPAs. It is hoped that the inclusive method of developing the 4th edition has resulted in a document that will have utility in the wide range of environments in which radiation oncology is practised in Europe. [ABSTRACT FROM AUTHOR]

• The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. • This may be a result of wide representation in the curriculum development process. • Barriers to curricular implementation are identified at the organizational and systems level. • Future opportunities to address these implementation challenges include advocacy for educational resources as well as the creation of online educational materials including assessment tools. Global curricula exist across medical specialties however, the factors which influence their implementation are not well understood. The purpose of this study is to report the perceived factors that impact the implementation of the ESTRO Core Curriculum. An anonymous, 37-item, survey was designed and distributed to the Presidents of the National Societies who have endorsed the ESTRO Core Curriculum (n = 29). The survey addressed perceptions about implementation factors related to context, process and curriculum change. The data was summarized using descriptive statistics. Twenty-six (90%) National Societies completed the survey. One respondent perceived that the values of the training system of their country would be incompatible with the proposed ESTRO Core Curriculum. The most common contextual barriers to implementation was a lack of support from the government (57%), a lack of internal organizational support (35%) and a 'poor fit' between the ESTRO Core Curriculum and the broader political and economic context (35%). Perceived implementation process barriers included insufficient numbers of faculty (44%), poor coordination between the government and training institutions (48%), and a lack of an influential person leading the implementation (44%). Two barriers related to curriculum change were a lack of funding and lack of assessment tools. The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. Barriers to curricular implementation are identified at the organizational and systems level and include insufficient teaching faculty, lack of coordination and the need for influential leadership. [ABSTRACT FROM AUTHOR]