Background: Pediatric hospice and palliative medicine (PHPM) is a growing subspecialty worldwide; however, formal graduate medical education pathways remain limited in low- and middle-income countries, including most of Latin America, constraining workforce development and access to specialized care. Objective: To describe an educational innovation that provides formal fellowship training in PHPM to physicians in Latin America. Methods: From 2023 to 2026, Unidad Nacional de Oncología Pediátrica (Guatemala), St Jude Children’s Research Hospital, and the University of Utah developed and implemented a PHPM fellowship program in Latin America. The curriculum emphasizes culturally responsive training and ACGME International (ACGME-I) core competencies. Program outcomes, feasibility, and acceptability were assessed using mixed methods. Quantitative data were collected via anonymous ACGME-I program evaluation surveys completed by 10 participants over 2 years, representing a 100% response rate from fellows (n=2) and a 57% response rate from core faculty mentors (n=8 of 14 eligible). Qualitative data were obtained from written reflections and monthly structured debriefings with faculty (n=14) and fellows (n=2) from March to August 2025. Results: Three fellows completed or are completing training, and the program received ACGME-I initial accreditation in February 2026. Graduates demonstrated early workforce impact, including expansion of PHPM services in Chile and planned implementation of the Dominican Republic’s first non-oncologic public PHPM program. All survey respondents agreed that the program provided a high-quality curriculum and effective career preparation. Qualitative analysis identified themes of strong mentorship, clinical relevance, and feasibility. Conclusions: This trilateral PHPM fellowship is an internationally partnered, regionally grounded training that demonstrates early feasibility, acceptability, and educational value.

Background: Radiotherapy technology has undergone significant advancements, driven by the pursuit of improved tumor control probabilities and reduced normal tissue complication probabilities. This has been achieved primarily through innovative approaches that prioritize high dose conformity on complex treatment targets. The CONVERAY project introduces a groundbreaking teletherapy system featuring a convergent X-ray beam, which enables highly conformal dose distributions by converging photons to a focal spot, thereby achieving exceptionally high fluence rates. Methods: Customized Monte Carlo subroutines have been developed to simulate particle fluence and associated dosimetry effects for the CONVERAY device. This simulation approach facilitated a detailed, step-by-step characterization of radiation fluence and interaction processes, enabling seamless integration with a conventional clinical linear accelerator head. Key physical properties of the radiation beam have been comprehensively characterized for various CONVERAY configurations, providing a solid foundation for evaluating the corresponding dosimetry performance. Results: Monte Carlo simulations successfully tracked the phase state of the CONVERAY device, characterizing the influence of individual components on convergent photon beam production. Simulations evaluated dosimetry performance, confirming the device’s capability to achieve high dose concentrations around the focal spot. Preliminary tests on realistic scenarios (intracranial and pulmonary irradiations) demonstrated promising spatial dose concentration within tumor volumes, while gantry rotation significantly improved dose conformation. Conclusions: This proof-of-concept Monte Carlo study of the CONVERAY prototype provided critical insights into the generation of convergent X-ray beams, validating the device’s ability to achieve its primary objective. Notably, simulation results reveal the potential for exceptionally high dose concentrations within complex treatment volumes, demonstrating promising dosimetry performance.