European Undergraduate Education in Oncology: A report of the EORTC Education Branch

Abstract

By the year 2000 it is estimated that approximately two million Europeans per year will be afflicted by cancer and that the annual death rate will be of the order of one million. Despite the numerical extent of the problem, the high mortality and the very considerable morbidity associated with uncontrolled cancer, it is the general view of experts in the field that the teaching of oncology to undergraduates remains extremely unsatisfactory in many medical schools. In recent years there has been substantial progress in cancer research and in the management of cancer patients due to developments in diagnosis and treatment. It is clear that, with available knowledge and technology, screening programmes designed to detect cancers at an earlier stage and programmes of public education aimed at prevention could substantially contribute to a reduction of our present cancer problem. If the newly-qualified doctor is to be provided with the necessary knowledge and skills to participate as a nonspecialist in the prevention, early diagnosis and management of malignant disease, it is essential that attention is focused on the development of a satisfactory curriculum for undergraduate education. The problem of an integrated undergraduate oncology training programme in Europe was reviewed by a UICC Regional Conference in Oncology held in Cracow in 1972 (1) and subsequently by a UICC/WHO meeting in 1981 (2). The objective of the Education Branch of the EORTC is to identify requirements for cancer education in Europe at both the undergraduate and postgraduate level. The Education Branch, which was set up in 1986, has directed its attention initially to the problem of undergraduate oncology education and, as a basis for making recommendations, in 1987 carried out a survey by questioning 165 deans of medical schools in Europe. Of 124 responses received by July 1987, 94 were considered valid, since 30 were either double-registered from the same university or did not concern undergraduate education. The information obtained from 94 medical schools in 14 countries (UK, France, Netherlands, Italy, Germany, Spain, Denmark, Belgium, Portugal, Ireland, Switzerland, Greece, Iceland, Sweden) is summarized in Fig. 1. As shown, approximately 60% of the centres have a course in oncology and a chair in oncology. In some institutions the courses were of a very short duration whereas optional in others. Only 41% of schools reported that they had a curriculum in oncology. Less than 50% had a pre-degree training period (that is a specific allocation of time for oncology in the final clinical year). Only one-third of the schools had an examination in oncology. It is of interest to examine the schools’ preferences for the future evolution of undergraduate education in ontology. Of the universities without corresponding facilities, 86% indicated that they would like a specific course in oncology, 81 % a chair in oncology, and 70 % a curriculum in oncology. A common European curriculum would be favoured by 95 % of all universities (Fig. 2). A striking finding of the inquiry was the wide variation in educational practice between different universities in the same country (Table). Approximately only 50 % of the medical schools in the United Kingdom, Germany, Spain and Denmark, for example, had courses in oncology. There were also substantial differences between individual countries. Thus all 16 French medical schools responding to the inquiry reported a course in oncology, whereas none of the 12 Italian medical schools had such a course. However, the Italian Government has recently approved