Radiation Oncology Training for Non-Oncology Specialists: A National Mixed-Methods Evaluation of a French Cross-Specialty Program.

The French Formation Spécialisée Transversale in oncology (FST), introduced in 2017, aims to provide oncological competencies to residents from non-oncology specialties through a one-year curriculum combining theoretical oncology teaching with two mandatory six-month rotations in medical and radiation oncology. Evidence regarding the educational outcomes of the radiation oncology part of the program remains limited. We conducted a national cross-sectional mixed-methods study between June and August 2025 among physicians who had completed the FST radiation oncology rotation between 2018 and 2025 (n = 203 respondents) and radiation oncology supervisors (n = 16 respondents). Primary outcomes included trainee satisfaction across nine radiation therapy (RT) learning domains (10-point scale), supervisor-assessed competencies, and post-training professional engagement. Multivariable analyses explored predictors of satisfaction and outcomes. Participants had a mean age of 29.6 ± 2.4 years, 65.5% were female, and the most represented specialties were hepato-gastroenterology (33.5%) and pulmonology (30.5%). Satisfaction varied markedly across domains, with highest ratings for patient communication (7.45 ± 2.47; 75.4% ≥7) and lowest for clinical research training (4.02 ± 2.68; 24.1% ≥7). General satisfaction differed by specialty, ranging from 7.90 ± 1.15 in neurology (85.7% high satisfaction) to 5.67 ± 2.05 in hepato-gastroenterology (32.4%). In retrospective supervisor assessments, theoretical RT knowledge was rated at 3.06 ± 1.39 for the beginning of the rotation and 7.19 ± 1.05 for rotation completion. Specialty-relevant RT competencies received the highest ratings (8.00 ± 1.26; 87.5% ≥7). High oncological engagement (≥ 70% clinical time) was observed in 55.7% of participants and showed no significant association with rotation satisfaction (r = 0.08, p = 0.25). The FST radiation oncology rotation was associated with heterogeneous trainee experiences across domains and specialties. Trainees reported strong satisfaction for communication and toxicity management but limited satisfaction for research training and autonomy, while supervisors reported favorable assessments of theoretical knowledge and specialty-relevant competencies at rotation completion. These findings support the development of specialty-adaptive curricula within a standardized national training framework.