Global Approach to Oncology Leadership: The GOLD Program

Leadership is essential for addressing global challenges in cancer care. Equipped with leadership skills, health care providers can respond effectively to complex oncology issues in diverse settings, including resource-constrained environments. The Princess Margaret Global Oncology Leadership Development (GOLD) program provides accessible, interdisciplinary leadership training to support this. Each year, roughly 165 clinical fellows train at the Princess Margaret Cancer Centre, most of whom are internationally trained. GOLD offers leadership training to any fellow interested in global oncology, supporting their ability to tackle complex challenges worldwide. This study describes the development, implementation, and outcomes of the first 5 years of the GOLD program.

GOLD is a hybrid, multiformat leadership training program integrating experiential learning, mentorship, and systems-level thinking. It is offered free of charge and is open to all fellows in oncology to eliminate common barriers such as selection/promotion bias, travel, and cost. McNemar's test and T-tests were used to compare rankings with pre- and postprogram survey and session evaluations. Inductive thematic analysis was conducted to analyze semistructured interviews.

Participants (53% female, 47 countries represented) showed statistically significant improvements in confidence across 24 leadership competencies. No associations were found between confidence gains and participants' geographic or economic backgrounds. Thematic analysis identified four key themes: improved preparedness for leadership roles, sustained global networking and mentorship, enhanced understanding of leadership across diverse contexts, and growth in intrapersonal skills.

The GOLD program demonstrates the effectiveness of inclusive, experiential leadership training in oncology. By removing barriers to access and prioritizing diversity, it supports a new generation of global cancer leaders. Ongoing evaluation and adaptation will ensure that the program remains relevant across diverse sociocultural and economic contexts, contributing to more equitable and effective leadership in cancer care worldwide.