The ripple effect of pediatric oncology training programs shows worldwide impact

For parents of children with cancer or other catastrophic diseases, knowing that the healthcare professionals providing medical care are well trained can help build trust. Families deserve the reassurance that no matter where they live, their child has access to knowledgeable specialists, high-quality care and the best possible chance of survival. Yet worldwide, access to specialized training programs, standardized care and pediatric oncology expertise can vary wildly.  

“One of the biggest challenges affecting access to care for children with cancer and other catastrophic diseases globally is access to specialists,” said Daniel Moreira, MD, MEd, St. Jude Global Academy director, Global Neuro-Oncology Program co-director and Department of Global Pediatric Medicine associate member. “In some countries, there may be only one pediatric oncologist serving millions of people. In others, there may be none at all.” 

This reality is a reason why training the clinical workforce became one of the three foundational pillars for St. Jude Global. As part of its mission to improve survival globally, the initiative is working with institutions to expand high-quality training programs by supporting rigorous standards, collaboration and sustainable long-term development. 

“The question for us was ‘How do we partner with institutions already training pediatricians and help expand both the number of physicians being trained and enhance the quality of that training?’” said Moreira.

Training physicians, expanding impact 

The answer to that question came through collaboration. The St. Jude Global Academy’s fellowship programs are modeled after the accredited fellowship training program that already exists in the United States and include bedside teaching, didactics, lectures and research. Rather than a single institution or country, the program works through regional training hubs that tailor the education to a specific geographic region. The approach not only expands access to training but also helps create more consistent educational standards across regions where specialized pediatric oncology expertise is inconsistent. 

“The goal is to identify where the need exists, train physicians in strong regional programs and support them as they return home to care for children with cancer,” said Moreira. “When these physicians return home, they care for more patients and ultimately become advocates for pediatric cancer care within their regions.” 

One example of a regional education hub is in Guatemala, where a long-standing collaboration with Unidad Nacional de Oncología Pediátrica (UNOP) has helped train physicians from countries across Central and South America, including Ecuador, Panama and Brazil. The impact of this model in Guatemala was published in JCO Global Oncology. 

The training model is proving effective by expanding access to care while also helping establish stronger, more consistent standards for pediatric oncology training across regions.

Setting the standard through global accreditation  

In the United States, graduate medical education and training programs are commonly accredited through the Accreditation Council for Graduate Medical Education (ACGME), which establishes nationally recognized standards for physician training programs. Training at an accredited program is required for graduates to become eligible for specialty board examinations and certifications. In many countries, however, accreditation systems are varied. 

Since 2019, St. Jude Global has partnered with the ACGME International (ACGME-I) to help institutions around the world build high-quality programs aligned with internationally recognized standards. Through the partnership, ACGME-I provides external accreditation to help ensure consistent, rigorous training. Accreditation of an international program serves as a designation that reflects the quality of its training programs and demonstrates that they meet rigorous international standards. 

“Accreditation is a way to bring international recognition and greater consistency to physician training programs,” said Jordan Horner, MAT, Global Academy program specialist. “It reflects years of work and continuous improvement while demonstrating the quality of education and training being provided.” 

Guatemala’s UNOP program was the first pediatric hematology-oncology fellowship program in the world to receive ACGME-I accreditation.  

In February 2025, the St. Jude Global Academy became an official ACGME-I Sponsoring Institution. This new accreditation model was designed to accelerate opportunities for partner programs worldwide.  

In February 2026, two additional programs were awarded accreditation by ACGME-I under the oversight of the St. Jude Global Academy: Shanghai Children’s Medical Center’s pediatric hematology-oncology program and UNOP’s hospice and palliative medicine program, which focuses on specialized care aimed at improving quality of life for children with serious illnesses and supporting their families. 

The program accreditation in China marked a particularly significant step forward for pediatric hematology-oncology training in the region. At the time the program was being developed, the concept of a dedicated pediatric hematology-oncology training program was relatively new in the region. Working alongside collaborators at Shanghai Children’s Medical Center and Shanghai Jiao Tong University School of Medicine, the program was built from the ground up, working to establish everything from curriculum structure to evaluation models. Those efforts led to the fellowship program becoming the first program of its kind in mainland China to achieve ACGME-I accreditation. 

The program will serve as a regional training hub, similar to the role Guatemala’s UNOP has played in expanding pediatric hematology-oncology education and training opportunities across neighboring countries.  

Not a one-size-fits-all model 

Because of the complexity of healthcare systems worldwide, international accreditation does not follow a one-size-fits-all model. While accreditation standards are built around core requirements and competencies that programs must meet, there is also flexibility to account for local training systems and educational structures. For example, the pediatric hematology-oncology training program at the UNOP in Guatemala and most programs in the United States are typically three years, while the newly accredited program in China spans four years.  

“We worked closely with our collaborators in China to determine what the training should look like and what would be needed to ensure trainees developed the appropriate clinical knowledge and skills,” Moreira said. “Through those discussions, we decided that an additional year of training would better prepare them for clinical practice.”  

Rather than applying a single curriculum across all institutions, the accreditation process focuses on aligning internationally recognized standards with local training environments and cultural contexts to ensure programs can meet the needs of their regions while maintaining high-quality physician education. “The accreditation process is complex because it requires navigating important cultural differences between training environments,” said Leeana Irwin, MAEd, Global Academy program manager. “In some countries, practices that are common in U.S. training programs may feel unfamiliar or even uncomfortable, but it’s a gradual process that’s a part of building sustainable programs.” 

Developing these tailored, sustainable solutions creates a foundation for lasting success and strengthens institutional capacity. “What we’ve found is that the accreditation process does more than provide a designation or a stamp of quality; it actively strengthens the training programs themselves,” said Irwin. “Trainees report having better educational experiences, more support and stronger overall training environments as programs move through the accreditation process.” 

The ripple effect begins with training 

These milestones represent a broad global effort to strengthen pediatric cancer care by building sustainable, high-quality physician training programs worldwide. “As WHO constantly reminds us, ‘There is no health without a workforce,’” said Carlos Rodriguez-Galindo, MD, executive vice president, St. Jude Global director, Department of Global Pediatric Medicine chair. “Developing high-quality training programs is critical to our goal of advancing care for children with cancer, and our partnership with ACGME-I helps us aim high and far, always pursuing excellence in training and practice to deliver the best care for all the children in the world.” 

For St. Jude Global, the goal extends beyond accreditation itself to create sustainable training systems that deliver the same level of physician education and specialized care, no matter where in the world you are. “Ultimately, this is about making sure children have access to high-quality cancer care regardless of where they live,” said Moreira. “When you invest in training physicians and building sustainable programs, you create a ripple effect that can strengthen pediatric cancer care for generations.”