Abstract
Purpose
Encouraging research and scientific publication among oncology trainees is a central component of fellowship training, yet opportunities can be limited in resource-constrained settings. The Forum of Research in Oncology (FRON) was established in Lebanon in 2014 to foster clinical research skills, mentorship, and academic output among oncology fellows.
Design
Initially held within a single institution, FRON expanded to include 6 medical schools across Lebanon and neighboring countries, thereby promoting national and regional collaboration. The competition's structure includes abstract submission, preselection, presentations, and evaluation by an expert jury.
Results
Over the past decade, FRON has demonstrated a substantial positive impact on research productivity, with a marked increase in peer-reviewed publications, higher journal impact factors, and enhanced participation of fellows and students.
Conclusion
Beyond measurable academic output, FRON participation has facilitated career advancement and fostered a culture of scientific inquiry by providing a structured, competitive, and mentorship-driven platform.
Introduction
Research training is a vital element of oncology fellowship programs, enabling fellows to develop critical thinking skills and contribute to evidence-based practice. However, fostering meaningful clinical research and encouraging publication among trainees can be challenging, especially in countries with limited financial resources like in Lebanon.1,2 To resolve this issue, structured initiatives such as research competitions may provide valuable incentives.
In this context, we present the establishment of the national Forum of Research in Oncology (FRON) competition detailing its inception, structure, and format. We explore how the event evolved into a key academic milestone, significantly increasing publication output and positively influencing the academic and professional trajectories of participating fellows.
Methods
The FRON
The concept of FRON was suggested by the senior author of this article (JK) and approved since 2014 by the academic board of the Saint Joseph University of Beirut, Faculty of Medicine in Lebanon. The competition has been conducted regularly since its inception, except for a 2-year pause due to the COVID-19 pandemic and the economic crisis, and resumed in 2022. FRON is an annual national competition designed specifically for oncology fellows. Its primary aim is to foster the development of clinical research projects, promote scientific publication, and actively engage students in scientific inquiry, inspiring them to become future leaders in oncology research.
The competition began the first year as an internal event within our institution but has since expanded to include 6 medical schools from Lebanon and neighboring countries, fostering a spirit of national and regional collaboration.
This study is a retrospective, descriptive institutional analysis of FRON's impact, summarizing its impact on academic development, research output, and trainee engagement in oncology without formal hypothesis testing or predefined sample size calculation. Publication data were summarized using descriptive statistics, including annual output, indexing status, distribution by training level, and average journal impact factor, with trends assessed through pre- and post-FRON comparisons. Given the small cohort size and exploratory objective, no inferential statistics, regression modeling, or adjustment for confounders were performed.
Competition Structure
The event is held annually on a Saturday in mid-September. Invitations are extended to the deans of all participating schools, along with 10 independent jury members, including research-active oncologists, public health experts, statisticians, and basic scientists.
Submissions: Abstracts are solicited from the Departments of Hematology–Oncology at participating schools, with fellows and mentors invited by email to submit electronically up to 2 months before the competition, with the final deadline set for September 1.
Preselection: During preselection, case reports and narrative reviews are excluded, while case series, systematic reviews with meta-analysis, and clinical trials are eligible. Approximately 20 abstracts are shortlisted on the basis of scientific merit.
Presentation and Evaluation: On the event day, each candidate delivers a 10-min presentation and discussion of his abstract before the jury members who evaluate the study according to a scoring grid with 10 items. The panel for initial review and presentation judging are not necessarily the same to ensure objectivity in evaluation. Reviewers do not assess applicants from their own department and recuse themselves if professional conflict exists to maintain fairness.
Awards: Based on the highest score recorded by judges, Prizes are awarded to the top one presentation in 3 different categories: clinical oncology, hematology and basic/translational research. These awards distributed at the closure of the event by our Dean, provide recognition and motivation for research excellence.
The event includes also a 15-min session entitled “our publications,” where we exposed our list of peer-reviewed publications achieved after the last FRON.
This structured, competitive format incentivizes fellows and their mentors, every year, to develop robust clinical trials and research projects, thereby integrating research planning into their training programs.
Results
Impact on Research and Publication
Participation in FRON has encouraged a cultural shift toward research among oncology trainees. Publishing in peer-reviewed international journals is a mandatory component of fellowship training, as it strengthens the curriculum vitae, improves academic competitiveness, and opens career opportunities. 3 Notably, in our department, the number of annual publications increased dramatically, from fewer than 3 before 2014 to more than 40 by 2024 (Figure 1). This substantial growth reflects the positive impact of FRON on research engagement and output.
Annual number of publications from 2013 to 2024, illustrating a consistent upward trend with a notable peak following the establishment of FRON in 2014. X-axis represents the year, and the y-axis shows the total counts of publications.
The data presented in Table 1 are based on an institutional review of publication output from the Department of Hematology and Oncology. The department's publication system is not externally funded, and no changes in funding occurred before or after the implementation of FRON that could explain the observed increase. Additionally, the number of trainees accepted and trained each year in our institution has remained the same during this period.
Number and Quality of Publications by Fellows, Students and Others Before and After FRON Implementation.
Abbreviations: PGY: postgraduate year; IF: impact factor; Avg: average; FRON, Forum of Research in Oncology.
Prior to FRON's introduction in 2013, only 3 publications were recorded, of which 2 were PubMed-indexed and 1 was self-reported (an abstract). Following FRON's implementation, a marked increase was observed: by 2015, 2 years postimplementation, the total number of publications had risen to 25, with 84% being PubMed-indexed. By 2018, 4 years postimplementation, the upward trend continued, reaching 42 publications in total 39 of which are PubMed-indexed, alongside growing participation by students and fellows in notable publications (ranging from 2 to 11 among them). The growth factor for each group—fellows, students, and physicians/others, is clearly illustrated in Figure 2.
Research output growth flow chart. The x-axis represents the year, and the y-axis shows the number of publications. The legend identifies the 3 groups of contributors. Growth in research output from 2013 to 2015 and 2018, showing a marked increase among fellows and students mainly, and in other groups.
In addition to the increase in volume, there was a notable rise in the average journal impact factor across training levels, from 1.9 in 2013 to 2.55 in 2015, and exceeding 3 by 2018, reflecting enhanced visibility and quality of scholarly output. Moreover, the department's leadership structure remained stable throughout the study period, ruling out leadership changes as a plausible explanation for the increase in publications.
Discussion
Taken together all the results, the findings support the role of FRON as a catalyst for both the quantity and quality of publications within the department.
This kind of competition encourages the incorporation of research activities into fellowship training curricula. 4 By setting clear deadlines for abstract submission, the event helps shift research from an optional or extracurricular task to a core expectation of oncology training. As noted in the literature, developing a strong research program is a bidirectional learning process: mentors remain active in clinical science while guiding fellows through study design, data analysis, and presentations, enabling fellows to develop independent critical thinking and measurable improvements in research skills. 5 Moreover, increased research output from program fellows may enhance the institution's international ranking, as publications are key metrics in global assessment. 6
Educational Collaboration
It is well known that implementing structured mentorship programs that connect students offers development and inspiration. 7 The FRON succeeded in fostering interinstitutional collaboration between universities and creating a national research community in oncology. In fact, many of the studies presented were multicenter research projects, with coauthorship. The event consistently attracts a large audience of medical students, internal medicine residents, and other healthcare trainees, serving as an educational platform with shared databases. This sustained participation and the emergence of multiinstitutional research projects suggest a meaningful impact of the initiative in promoting research engagement. This is particularly important, as it could serve as a model for regional oncology collaboration in the Middle East, where common challenges such as limited resources, research infrastructure, and publication barriers are shared across institutions.
FRON in the Context of Similar Initiatives
While FRON is not the only initiative in research education, its strength lies in its relevance for low- and middle-income countries. The Indian experience in 2019 underscored barriers such as rigid authorship rules, indexing pressures, costly plagiarism checks, and limited recognition of research outside high-impact journals. Suggested solutions included easing procedural hurdles, welcoming new ideas, and valuing all research that benefits public health. 8 FRON embodies this approach: it promotes local ownership, inclusivity, and academic integrity while giving fellows a platform to develop and present research without traditional obstacles. With formal accreditation and links to open-access indexing, FRON could further overcome these barriers.
Unlike Project ECHO, which focuses on clinical capacity through hub-and-spoke tele-mentoring, FRON adapts the model to research. Moreover, mentorship-based projects often lack systematic evaluation of their outcomes, as shown in experiences from a medical college in India. 9 By contrast, FRON incorporates its own built-in assessment, since the competition culminates in the listing of fellows’ publications and outputs, providing both self-assessment and a tangible measure of impact. By combining mentorship, peer review, and competition-based incentives, it builds research skills at the point of care, is accessible online across borders, and avoids reliance on centralized training in high-income settings. 10 Its simplicity, scalability, and growing impact position FRON as a practical pathway to strengthen oncology research capacity compared with other research internships such as the Mitacs program in Canada, and summer internships programs for cancer research interns which offer international exposure opportunities but require relocation and significant financial resources.11,12 Such factors are often not feasible for many trainees, who may also find it difficult to interrupt their ongoing clinical training. Even though international research programs are cross-disciplinary and attract diverse participants they often focus on solution-generation over sustained training. FRON, by contrast, is oncology-specific and somewhat less competitive in scale, but this narrower scope allows it to focus strongly on developing rigorous research methodology skills among fellows. FRON is planned to be further developed through fundraising and partnerships with industry, including potential collaborations with pharmaceutical companies to provide monetary rewards and incentives for participants in order to encourage wider participation and recognize outstanding scientific contributions. Figure 3 illustrates how FRON integrates both mentorship and a research-focused approach alongside other initiatives.
FRON among other initiatives.
Career Advancements
Besides the short-term publication impact, participation in competitions such as FRON help influence the long-term academic or clinical careers of participants. The importance of publishing oncology research varies across stages of a medical career, with the greatest significance often placed during the early years, particularly for fellows. 13 The ability to present original research at a national level reflects both initiative and scholarly commitment. Our fellows have reported increased confidence in our educational tools during fellowship both locally and abroad. 14 This academic visibility not only reinforces the importance of research within training but also facilitates access to research positions and opportunities in international institutions. Between 2013 and 2024, 2 to 3 fellows per year completed the specialty program in our institution, making it difficult to assess long-term trends in academic positions. Despite the small cohort size, an increasing proportion of fellows pursued research fellowships, while the majority engaged in clinical fellowships. Several graduates expanded their professional activities internationally, including in France and the United States. Notably, one alumnus is currently leading initiatives in the ESMO Young Executive Research program, and another has obtained a dedicated research fellowship at MD Anderson reflecting enhanced opportunities for career development among program graduates.
Conclusion
The FRON competition demonstrates how a structured, competitive approach can effectively cultivate a research-oriented culture among oncology fellows. By providing clear expectations, mentorship, and formal evaluation, FRON has successfully increased both the quantity and quality of scholarly output, even in the context of limited financial resources. By providing a national platform for presenting and evaluating research projects, FRON has helped increase scientific productivity and foster a commitment to academic excellence in oncology training. By bridging institutions and empowering fellows through structured mentorship and competition, it sets a replicable model for advancing clinical research in the region.
Limitations
This study did not include a formal sample size calculation, it is a single-institution, retrospective, narrative analysis, which limits generalizability. The reliance on descriptive statistics without inferential testing, combined with the small number of fellows per year, restricts statistical power and limits assessment of long-term career outcomes. Also, no formal survey was conducted to systematically evaluate participants’ perceptions of the initiative. Additionally, publication counts and journal impact factors were used as surrogate markers of research quality, which do not fully reflect scientific impact but does have methodological rigor. Finally institutional heterogeneity across participating centers was not formally evaluated. Future research should incorporate multiinstitutional comparisons, formal statistical analyses, and prospective outcome assessment.
Footnotes
Acknowledgments
No acknowledgments to declare for this article.
Ethical Statement
This study did not involve patient-level data; therefore, institutional review board approval was not required.
Author Contribution
Review of literature, drafting, and critical writing: J.G. Kattan and T.A. Najdi; collection and assembly of data: C.J. Kattan; correction and critical writing: T.A. Najdi; outline of the article, correction and final approval: J.G. Kattan and E.F. Nemr.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.