Finland has long suffered a lack of oncologists, doctors specialized in the diagnosis and treatment of cancers. The shortage is now especially acute in eastern and northern parts of the country. Jouko Isolauri, an advisor at the Ministry of Social Affairs and Health, estimates the shortfall in oncologists at 30-40, with the greatest need in the cities of Kotka, Joensuu and Kuopio. At major university hospitals and the large hospitals in southern urban areas, the situation is considered good, but positions at small medical units are often filled by temporary means. Post-op problems The shortage of oncologists is most evident in post-op care and follow-ups. Nationally, there has been a trend to shift the responsibility for longer-term post-op care away from specialists to basic medical services. The Deputy Chief Executive Officer of the Finnish Medical Association, Risto Ihalainen, says that in practice, in most cases the first stage of cancer treatment is carried out without delay. However, post-op treatments such as chemotherapy or radiation therapy still need input from oncologists. It is at this point, he says, the shortage of specialists becomes evident. General shortage of physicians There are slightly fewer doctors per capita in Finland than the European average. The low number of oncologists is a part of the general shortfall. While methods have improved and recovery rates risen, specialists are still needed, especially as the population ages. Also, nearly a third of the 140 oncologists practicing in the country are over 55 years of age. The Finnish Medical Association says that the specialization process for oncologists should be sped up. YLE