Background: To meet the rising demand for cancer care in low-middle-income countries (LMIC’s), an accredited Global Health track in Hematology-Oncology Fellowship programs (HOFP) is needed. To determine feasibility, the Geisel School of Medicine at Dartmouth (GSMD) HOFP piloted a bi-annual, one-month elective in Rwanda supervised by GSMD faculty. Objectives included exchange of knowledge in a resource-stratified setting and engagement in scholarly collaborations. Methods: Program objectives were implemented by GSMD HOFP in partnership with the Rwandan Ministry of Health, the NGO Partners In Health, and the Butaro Hospital Cancer Center of Excellence (BCCOE) in Butaro, Rwanda. Mentorship opportunities, formal lectures, organizational changes, research projects and funding sources were tracked. Fellows were evaluated using ACGME clinical competencies. Results: The 2-year pilot program was 100% enrolled by fellows from 3 US HO programs and one rising first year HO fellow (N = 4). Seven educational, research and quality improvement projects and three organizational changes were implemented. Three grant proposals for research collaborations are in process. Fifty percent of participating fellows plan to pursue careers in Global Health. The HO fellows gained perspective on cancer care and capacity-building in a LMIC, and confidence in teaching. BCCOE staff gained knowledge and mentorship, ideas for quality improvement, and increased expertise with treatment protocols. Rwandan colleagues valued the solidarity generated by a long-term partnership. Faculty were funded by a combination of CME, Fellowship and Vacation time. Conclusions: A global oncology fellowship elective is feasible and has a qualitative impact on care delivery and collaboration in LMICs influencing fellows’ career choices and professional growth of colleagues at partner sites. Long-term partnerships complement the task-sharing approach to cancer care. Financial sustainability requires formal institutional support for faculty participation. A Global Health track in HO that includes international applicants from LMICs will encourage multi-disciplinary collaboration and expand our capacity for quality global cancer care.