# Retention packages so trained oncology staff stay: bonds, top-ups, working equipment

Source: https://onco.cc/ideas/idea-acc-retention-packages-oncology/  
OnCo record `idea-acc-retention-packages-oncology` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed 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

## Sources

- 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): https://doi.org/10.1200/JOP.2013.001319

## Connected records

- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/)
- key papers: [Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage](https://onco.cc/key-papers/paper-yang-j-oncol-pract/)

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