Background/Purpose
Despite increasing numbers of cancer survivors, non-oncology physicians report discomfort and little training regarding oncologic and survivorship care. This pilot study assesses medical student comfort with medical oncology, surgical oncology, radiation oncology, hospice/palliative medicine, and survivorship care.
Methods
A survey was developed with input from specialists in various fields of oncologic care at a National Cancer Institute-designated comprehensive cancer center. The survey included respondent demographics, reports of experience with oncology, comfort ratings with oncologic care, and five clinical vignettes. Responses were yes/no, multiple choice, Likert scale, or free response. The survey was distributed via email to medical students (MS1-4) at two United States medical schools.
Results/Findings
The 105 respondents were 34 MS1s (32%), 15 MS2s and MD/PhDs (14%), 26 MS3s (25%), and 30 MS4s (29%). Medical oncology, surgical oncology, and hospice/palliative medicine demonstrated a significant trend for increased comfort from MS1 to MS4, but radiation oncology and survivorship care did not. MS3s and MS4s reported the least experience with survivorship care and radiation oncology. In the clinical vignettes, students performed the worst on the long-term chemotherapy toxicity and hospice/palliative medicine questions.
Discussion
Medical students report learning about components of oncologic care, but lack overall comfort with oncologic care. Medical students also fail to develop an increased self-assessed level of comfort with radiation oncology and survivorship care. These pilot results support development of a formalized multi-disciplinary medical school oncology curriculum at these two institutions. An expanded national survey is being developed to confirm these preliminary findings.
We present a model of hepatic colorectal metastases which represents monoclonal cell lines double-labeled by luciferase and tdTomato. These cells form liver metastasis in varying numbers and patterns similar to those observed in patients. Using in vivo and ex vivo luminescent and fluorescent imaging we determine the growth kinetics and clonogenic frequency of tumor cells colonizing liver. Molecular profiling detected stable expressional differences between clones consistent with their phenotypes. The data indicate that clinically relevant phenotypes of liver metastases can be modeled in vivo.
Purpose
Many medical school clerkships have structured curricula, however most radiation oncology clerkships do not. The Radiation Oncology Education Collaborative Group (ROECSG) implemented a curriculum for fourth-year radiation oncology clerkships at 14 institutions. We hypothesized that students completing clerkships with the curriculum would report greater subjective knowledge and comfort to function as a radiation oncology resident compared with students completing clerkships without the curriculum.
Methods and Materials
The ROECSG curriculum included three 1-hour lectures and a 1-hour hands-on radiation treatment planning workshop. Applicants to a single radiation oncology residency program in the 2014–2015 academic year were sent an anonymous, validated clerkship experience survey. Students indicated if clerkships were completed at a curriculum site. Likert-type data (1=not at all, 5=extremely) are reported as median(interquartile range).
Results
Respondents described 276 clerkship experiences of which 64(23.2%) were completed at a curriculum site. Students whose first clerkship was at a curriculum site perceived greater post-clerkship confidence in knowledge of radiation biology (3 (3–4) vs 2(2–3), p<0.01), treatment set-up/positioning (3(2–3) vs. 2(2–3), p<0.05), treatment planning (3(2–3) vs. 2(2–3), p<0.01), and ability to integrate evidence-based medicine into treatment (4(2–4) vs. 3(2–4), p<0.05). Students who completed any clerkship with the curriculum had greater post-clerkship confidence to function as a radiation oncology resident (3(3–4) vs. 3(2–3), p<0.05).
Conclusions
These results support the curriculum’s ability to increase student knowledge in radiation oncology, especially in the students’ first clerkship. Further, these findings suggest that expanded implementation of such curricula may ensure a rewarding educational experience during radiation oncology clerkships.
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