EDITORIAL

A small incursion into the history of medical oncology

Alexandru Grigorescu

25 Martie 2022

Taking advantage of the fact that, this year, the ESMO Congress will be face to face, I would like to mention some of the avatars that created medical oncology. A small foray into the history of medical oncology is, in my opinion, important to understand this specialty. Thus, we can consider that this specialty was officially established on March 3, 2011, when the European Commission announced that the discipline of medical oncology was included among the professional qualifications regulated by Directive 2005/36/EC of the European Union (EU). Medical oncology is now mutually recognized as a medical specialty throughout the EU. As a member of the European Society for Medical Oncology (ESMO), we have every reason to celebrate or realize what we have been working on since the founding of our society, in 1975. The scientific and practical development of medical oncology is the basis of ESMO’s mission and all its presidents and executive committees have always kept the goal of recognition at the forefront of their agendas. They were fully supported by ESMO officers and members alike. As the voice of the medical oncology community, ESMO is deeply grateful to all those who have supported us in achieving the status and respect that our discipline deserves. Our united efforts have finally been rewarded. Medical oncology is now stronger in Europe. As a bit of history, on countless occasions, both in public and private meetings, ESMO stressed out that the discipline of medical oncology refers to one of the three ways in which cancer is treated, and today it is healing more and more. In this perspective, I could not understand why we were facing so many obstacles in the official sanctioning of an obvious state of affairs. We have continuously emphasized that multidisciplinarity is the keyword in the treatment of cancer and that the oncologist plays a key role in the clinical team that treats cancer patients.

In addition, the automatic recognition of the professional qualification aids in addressing the labor shortage of oncologists, allowing them the free movement across EU borders. Moreover, the mutual recognition should also help attract more medical students to choose their profession. For patients, the mobility of professionals may reduce their need to travel abroad for healthcare that is not available in their home country. Recognition thus supports a major goal of ESMO: reducing inequalities in cancer care. But there are many determinants of such inequalities: one example today is the changing pattern of reimbursement of new therapies in the EU, which is particularly alarming in a time of economic crisis and rising healthcare costs. Indeed, the free movement of oncologists will help to harmonize the way medical oncology is practiced in the clinic, thus spreading best practices and the quality of cancer care for the benefit of our patients. The application of the EU directive is not without its limitations. The benefits of EU directive regarding medical oncology is for oncologists with a five-year training curriculum. This means that you will benefit from younger prospective colleagues, not retroactively. Establishing and agreeing on a standard training period in Europe have proven to be one of the main reasons for the delay in obtaining recognition. ESMO offered the EU the ESMO-ASCO Recommendations for a Global Curriculum in Medical Oncology, emphasizing the duration and content of the training. However, in some EU countries, the training period is shorter, which is why these countries have not been supportive, although in principle they have been strongly in favor of recognizing medical oncology as a separate medical discipline.

In fact, some EU countries have only recently completed a five-year training period. As a representative of Romania in the ESMO Central Eastern European Task Force, in the period 1995-2005, under the leadership of Professor Haine Hansen, I was in the middle of this struggle for the recognition of medical oncology as an independent specialty both in Europe and, unfortunately, in our country, where, so to speak, some “uninspired people” wanted to abolish medical oncology. I am glad that justice prevailed then and logic triumphed over people with an unjustified pride.

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