ties1 (ABMS) and the membership of related professional societies. For nurses, physical and occupational therapists, social workers, mental health professionals, and other nonphysician providers involved in survivorship care, Table 5-2 shows the number of licensed or certified personnel when applicable and the relevant professional societies.2 The professional societies of physicians, nurses, and other providers are often the main source of continuing medical education for their specialty and so are key to any effort to raise awareness of survivorship care.

Important disciplines relevant to survivorship care are not represented in these tables. The expertise of cardiologists, neurologists, and endocrinologists, for example, may be needed to diagnose and manage cancer’s late effects. Although these estimates are incomplete and imprecise, they point to potential shortages of trained personnel given the size of the survivorship population. Concerns about the future supply of physicians, nurses, and other providers available to care for an older cancer patient population have been voiced since the early 1990s (Kennedy, 1994), but there are few studies of health personnel capacity to gauge the extent of the problem. The Association of American Medical Colleges (AAMC) and the American Society for Clinical Oncology (ASCO) are partnering to study whether the future supply of clinical oncologists will be sufficient to meet future health care needs (ASCO, AAMC to assess clinical oncology workforce, 2005). Better information on all survivorship-related health care personnel is needed to plan for health care delivery and education and training.

STATUS OF PROFESSIONAL EDUCATION AND TRAINING

Cancer survivorship care as a distinct phase of the cancer trajectory is a relatively new construct, and health professional schools’ curricula have generally not included much content in this area. This needs to change, but a larger task is providing continuing medical education to professionals who have completed their formal training and are encountering cancer survivors in their practices. The question of who to train is a complicated one because survivorship care encompasses both medical and psychosocial issues and a diverse set of providers can potentially be involved. The content of any survivorship curricula is also not straightforward. Providers need to be apprised of the risks of cancer treatments, the probabilities of cancer recurrence and second cancers, the effectiveness of surveillance and interventions for late effects, the need to address psychosocial concerns, the

1  

By 2003, more than 85 percent of licensed physicians in the United States were certified by at least one ABMS Member Board (ABMS, 2004b).

2  

Membership in a professional association is a very rough marker for supply of specific types of providers because an organization can include members from various professions.



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