Chemoradiation Phase II Trials: Re-Exploring a World of Missed Opportunities

Abstract

Purpose/Objective(s): Limited opportunities are available for medical students to gain early exposure to radiation oncology. In 2018, our department began offering two-week electives for clerkship-level medical students with broad specialty interests. Herein, we report our experiences one year after program initiation. Materials/Methods: Clerkship-level medical students at our institution were offered the opportunity to select a two-week elective in radiation oncology. Students underwent an abbreviated introductory curriculum followed by a longitudinal clinical experience. Medical students were provided checklists to identify newly acquired skills and exposure to evidence-based practice. End-of-rotation assignments included independent completion of an oncologic history and management plan and anonymous feedback using a Likert-type 5 point scoring scale. Results: Over one year, 13 medical students participated in the elective, nine of whom were in their first six months of clerkship and expressed limited comfort performing core elements of the patient interview and examination. Eleven (85%) medical students either agreed or strongly agreed (score 4-5 out of 5) that the course complemented their clerkship learning and 10 (77%) rated the experience as either very good or excellent (score 4-5 out of 5). Nine (69%) chose the elective out of curiosity, two (15%) intended to use the experience to supplement their future non-radiation oncology specialty interest, and none (0%) had initial interest in pursuing radiation oncology. All medical students reported shadowing as a component of their experience, six (46%) reported observing radiation therapy planning, and four (31%) highlighted participation in brachytherapy procedures and radiation treatments. The most commonly reported strengths were the educational value of the rotation (46%) and positive impact of working with residents (46%). The most common constructive feedback was to increase opportunities for student participation beyond shadowing in clinic. Indeed, only six students (54%) agreed or strongly agreed (score 4-5 out of 5) that the elective advanced their clinical skills. Conclusion: Two-week radiation oncology electives early in medical school offer unique opportunities to engage students undergoing specialty exploration. Clerkship-level students appreciate working with residents and are primarily interested in general oncologic knowledge and increased participation in clinic. This may be challenging for those who are early in their clerkship rotations, but focusing on reinforcing and/or introducing core skills such as preparing patient histories, physical exams, and delivering patient presentations may be future possibilities. Other directions include increasing mentorship opportunities and identifying clerkship students who would be likely to enroll in four-week rotations and encourage their application into radiation oncology residency.