Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey.

Gerard M Walls,Ciara Lyons,Rebecca Prince,Orla A Houlihan,Aidan J Cole,James J Mcaleer,Katie Spencer,Ciaran Mooney,Christopher Mark Jones

doi:10.1259/bjr.20210614

Abstract

Objectives:Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic.Methods:A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19.Results:Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1–6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19.Conclusions:RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors’ already constrained exposure to radiotherapy.Advances in knowledge:This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.

Highlights

Radiotherapy plays a key role in the curative and palliative cancer treatment settings
Four complete submissions were received from Republic of Ireland (RoI), representing 67% of the six RoI medical schools
One additional medical school in RoI and five further United Kingdom (UK) medical schools provided limited responses relating only to the extent to which oncology teaching is integrated into medical curricula within their institution

Summary

Introduction

Radiotherapy plays a key role in the curative and palliative cancer treatment settings. In the United Kingdom (UK) and Republic of Ireland (RoI), just over half (51–54.4%) of patients diagnosed with cancer require at least one radiotherapy course.[1,2] both countries treat less than 70% of the optimal radical indications for radiotherapy [2]. This underuse extends to the palliative setting, where knowledge gaps relating to radiotherapy are known to impact on referral from settings such as primary care.[3,4,5]. A growing cohort of clinicians are likely to be responsible for patients who have had radiotherapy and who may present with long-term treatment-related toxicities

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