{"entity":{"id":"idea-acc-retention-packages-oncology","kind":"idea","name":"Retention packages so trained oncology staff stay: bonds, top-ups, working equipment","aka":[],"tldr":"Radiation oncologists and physicists from poorer countries who train abroad commonly emigrate, and money alone does not keep them. A package combining a return-of-service bond, salary top-ups, a guarantee of working equipment, academic links and a predictable career path, co-funded by government and donors, should be trialled with five-year retention measured.","summary":"Training a radiation oncologist or physicist abroad and losing them to emigration is a common outcome. The evidence from other specialties suggests that money alone does not retain staff; working equipment, professional development, academic links, and predictable career paths matter as much. A retention package co-funded by government and donors, tied to training scholarships, with a return-of-service bond and a functioning-equipment guarantee, could be trialled and its five-year retention measured.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Not enough oncologists, nurses, pathologists, physicists): Yang et al., Projected supply of and demand for oncologists and radiation oncologists through 2025 (JOP 2014)","url":"https://doi.org/10.1200/JOP.2013.001319"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-workforce","b-global-access"],"keyPapers":["paper-yang-j-oncol-pract"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Trainees under a combined retention package will show at least 80% in-country retention at five years, compared with substantially lower historical rates for scholarship recipients without such packages.","rationale":"Return-of-service schemes work when the returning post is credible; combining them with equipment and academic support addresses the reasons people leave.","test":"Follow a prospective cohort of 200 scholarship trainees across several countries with package versus standard scholarship, tracking retention, productivity, and job satisfaction.","maturity":"speculative","actor":"policy","cost":"medium","horizonYears":5},"route":"/ideas/idea-acc-retention-packages-oncology/","neighbours":{"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"}],"paper":[{"id":"paper-yang-j-oncol-pract","kind":"paper","name":"Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage","route":"/key-papers/paper-yang-j-oncol-pract/"}]}}