THYROID CANCER TREATMENT PROGRAMME

This project is dealing as many other activities with the consequences of the Chernobyl accident in the regions Byelorussia, Russia and Ukraine.

The objective of the TACIS 1993 Regional Programme deals with support to Chernobyl affected regions and may be summarised as:

Facilitating the resumption of normal social and economic activities in the affected regions, through the provision of Technical Assistance to beneficiaries from Governmental organisations associated with health the environment and agriculture, as well as state committee/ministries with particular post accident management responsibilities.
Definition and implementation of a phased programme of education and training for selected medical staff engaged in some aspects of the prevention, diagnosis, treatment and post treatment management of thyroid cancer, particularly amoung children.
Expected outputs were: Upgrading of the technical level of knowledge and practical skill of the medical staff involved in the treatment of thyroid cancer, in Russian Federation, Belarus and Ukraine.
Target Groups were: medical staff from Belarus, Russia and Ukraine, involved in the diagnosis and treatment of thyroid cancer and indirectly, populations from these countries, treated by these medical professionals.

The overall time schedule for the planning preparation and implementation of the training for medial staff in the use of equipment associated with the treatment of thyroid cancer was 18 months.
This period was split into 2 phases:
Phase 1: planning and preparation;
Phase 2: implementation.
Due to the existing organisation of the cancer of thyroid treatment in each country, co‑ordinated by a national reference centre, it has been decided to select the trainees in close relationship with the senior reference experts, in charge of the national reference centre in each country, who were:

Prof. Tsyb, Director of Medical Radiological Research Centre, for Russian Federation;
Prof. Demidchik, Head of R and D Centre of Thyroid Cancer for Belarus;
Prof. Tronko, Director of Komissarenko Institute of Endocrinology and Metabolism for Ukraine.
The training has been done in 2 steps:

Three theoretical Seminars, held mid January in Obninsk Russian Federation;
A practical training, customised and adapted to the individual needs, in Western Europe Centres.
Trainees have been trained either in France, Belgium, Germany or Italy.
In addition, all the Pathologists have spent 2 weeks in Cambridge (United Kingdom).66 specialists had to be trained at the end of the�programme.
The length of the stay of the trainees, in the Western Europe Centres had to be adapted, according to the needs, assessed in the terms of reference, and agreed upon by the Steering Committee of the project, in detail:

Physicians (endocrinologists) have spent 6 weeks;
Surgeons have spent 2 weeks;
Anaesthetists have spent 2 weeks;
Pathologists have spent 8 weeks (6+2);
Biologists have spent 2 weeks;
Specialists in nuclear medicine have spent 2 weeks;
Technicians and nurses have spent 2 weeks.
The performed Training is described herafter in more detail.
Theoretical Training
According to the Terms of Reference of the Project, three seminars were held to prepare the practical sessions. They took place in Obninsk (Russian Federation) on January 16th, 17th and 1th, 1996.
The goal of these seminars were:

to train the future participants who would be admitted in the Western Europe Centres for the practical training, and to give them a common background;
to validate as much as possible the selection of the trainees made by each country (22 per country);
to determine the breakdown an distribute these trainees in the different training centres in France, Belgium, Italy, United Kingdom, Germany, according to their language skill and specialisation;
to address the dates of these practical sessions.
Beside, in addition to the 66 trainees sponsored by the TACIS Programme, and the three senior reference persons (Prof. Tsyb for Russian Federation, Prof. Demidchik for Belarus, Prof. Tronko for Ukraine) more than 150 observers were invited by the Russian Academy of Medical Sciences (medical staff from different specialised medical centres in Bryansk, Kaluga, Tula, Moscow) to join the seminars.
This event gathered many officials and was widely covered by the press (news papers, TV and radio).
Practical Sessions
As planned in the project, and confirmed during the Obninsk seminars, the trainees have been distributed in 10 training centres in Western Europe.
The distribution was as follows:

Specialists from Belarus have been sent to France, Italy (and United Kingdom for the Pathologists).
Specialists from Russia have been sent to France, Belgium, Italy (and United Kingdom for the Pathologists).
Specialists from Ukraine have been sent to France, Germany (and United Kingdom for the Pathologists).
According to the contract, the duration of the practical sessions in Western Europe was from 2 weeks to 8 weeks, as follows:

6 weeks for the Endocrinologists;
2 weeks for the Surgeons;
2 weeks for the Biologists;
2 weeks for the Anaesthetists;
2 weeks for the specialists in Nuclear Medicine;
2 weeks for the Nurses and Technicians in Pathology and Biology;
6 weeks for the Pathologists.
In addition, the Pathologists (Technicians in Pathology) completed their training of 2 weeks in Cambridge, in Prof. Williams'Institute
Evaluation of the Practical Sessions
One of the supervisor's duty in the Western Europe training centres was to give to each of the trainee admitted some evaluable training objectives, to control the everyday attendance of the trainee and to evaluate the level of achievement of these objectives.
The reports made by the Western Europe tutors were very positive. In addition, an evaluation report was made by the Russian, Ukrainian and Belarus counterpart which was also very positive.
Involvement and Motivations of the Trainees
The motivation of the trainees was very strong. Most of them were very involved in the activity of the hospital service during their stay.
Selection of the Trainees
The Steering Committee had prior recommended to select the trainees according to 3 criterias:

age under 45;
to be presently involved in the process of diagnosis, treatment and follow‑up of thyroid cancer in the country of origin;
to have some knowledge in one of the Western European languages.
4) Comments
The project has been successfully performed and the results were fully in line with the objectives, defined in the Terms of Reference.