Letter to the editor regarding the manuscript entitled: "Variations in gynecologic oncology training in low (LIC) and middle income (MIC) countries (LMICs): Common efforts and challenges" by Carolyn Johnston et al. (Gyneco Oncol Rep 2017; 20: 9-14).

Dear Dr. Karlan,

We were exited to read the article by Carolyn Johnston et al. published in a recent issue of Gynecologic Oncology Reports. (Johnston et al., 2017).

After the introductory paragraph the authors describe, in the following six sections of the manuscript, their views on different gynecologic oncology training programs in different parts of the world. The information for this study, the authors mention, was obtained from US named affiliates or from the corresponding authors who had been directly involved in trainings or assessing trainings in these regions.

In Table 1, the authors explain that Costa Rica has a two year Gynecologic Oncology program. In one paragraph the authors describe gynecologic oncology trainings in Central America, using as an example a training program in Honduras. They describe the gynecologic oncology training program is a part of a surgical oncology program, and there are no multidisciplinary tumor conferences conducted on a regular basis.

The authors also state at the end of the paragraph, that the Central America Gynecologic Oncology Education Program (CONEP), and Health Volunteers Overseas supported by the Society of Gynecologic Oncology (SGO) and the American Society of Clinical Oncology provide external mentorship, a telemedicine-facilitated tumor board, and on-site surgical trainings in Central American countries.

Costa Rica has a three year gynecologic oncology training program (Especialidad en Ginecología Oncológica Costa Rica, n.d.; Especialidad en Ginecología Oncológica Universidad de Costa Rica, n.d.). The gynecologic oncology fellowship is not part of a Surgical Oncology program, multidisciplinary tumor boards are conducted on a weekly basis at the Hospitals, and there has been no external telemedicine-facilitated tumor board or on-site surgical training with the collaboration of the above mentioned organizations for the gynecologic oncology training program (Schmeler et al., 2013).

We thank the authors for their manuscript, whose purpose is to improve the quality standards of gynecologic oncology trainings around the world; and, we agree with their general suggestions to make this happen. However it is also desirable to gather more information in order to have a clear idea of the areas in most need of improvement.

Conflict of interest

The authors declare there are no conflicts of interest.