Medical Oncology Training Programs Research Articles

Implementing changes to a residency program curriculum before competency-based medical education: a survey of Canadian medical oncology program directors.

Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature. We surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme. Prior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches. Transitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.

Implementation of Competency-Based Medical Education in a Canadian Medical Oncology Training Program: a First Year Retrospective Review.

As part of a university-wide initiative, competency-based medical education (CBME) was implemented in the Medical Oncology training program at Queen's University in July 2017. Stages, entrustable professional activities (EPAs), and required training experiences established by the Royal College of Physicians and Surgeons of Canada (RCPSC) national subspecialty committee were adopted. Entrada (Elentra), the electronic portfolio developed at Queen's University, was used for assessment collection. Between July 2017 and December 2018, participating faculty members completed 157 assessments. Eighty-nine percent were EPA assessments with a median of 16 assessments per faculty member (range 1-40). Ninety-five percent of assessments included written "Comments" or "Next steps" with 56% of all assessments including specific or actionable feedback. Discussions between the program director, residents, program administrator, CBME education consultant, and CBME lead led to the identification of 9 lessons learned during implementation. These centered on (1) faculty and resident development and engagement; (2) sharing the work of CBME; (3) collaboration and communication; (4) global assessment; (5) assessment plan challenges; (6) burden of CBME; (7) limitations of e-portfolio; (8) importance of early tracking of resident progress; and (9) culture change. This article describes the experience of the authors and considers strategies that may be helpful to programs implementing CBME in their teaching and learning environment.

Implementation of competency-based medical education in a Canadian medical oncology training program: Lessons from our first year.

10514 Background: As part of a university wide initiative, CBME was implemented in our MO training program in July 2017. Stages, Entrustable Professional Activity (EPA) assessments and Required Training Experiences established by the Royal College of Physicians and Surgeons of Canada were adopted. MedTech Central, the electronic portfolio developed at our university was used for assessment collection. We share here observations and experiences from our first year of implementation. Methods: Assessment metrics were obtained through MEdTech. Ethics was granted by Queen’s University as part of an ongoing research study on feedback. Lessons learned were compiled from discussions between the Program Director, Residents, Program Administrator, CBME Education Consultant and CBME lead. Results: A total of 195 assessments were completed July 2017-November 2018. 81% were EPA assessments and the remainder multisource feedback, rubrics and field notes. The median number of assessments per faculty was 17 (0-42). 52% of assessments included written “Comments” or “Next steps”. A median of 6 assessments per faculty member included specific or actionable feedback. Lessons learned centered on: 1) Faculty and Resident development and engagement (critical before, during and after implementation); 2) Value of sharing work of CBME (CBME Education Consultant, CBME Lead, Academic Advisors, Competence Committee); 3) Importance of effective communication strategy with stakeholders 4) Importance of collaboration with other training programs at institutional and national levels; 5) Culture change (a slow process); 6) Resident concerns regarding lack of global assessment; 7) Assessment plan challenges (How many observations required?); 8) Burden of CBME (Resident driven assessments or a better balance?) ; 9) Limitations of e-portfolio (How to live track and by whom?); 10) Costs 11) Value of continuous quality assurance and improvement. Conclusions: Our first year of implementation was successful in introducing CBME concepts, work based assessments and e-portfolios. Ongoing work is needed, including increasing the number of assessments and quality of feedback.

Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015

To quantify and determine the relationship between oncology departmental/division heads and private industry vis-à-vis potential financial conflict of interests (FCOIs) as publicly reported by the Centers for Medicare and Medicaid Services Open Payments database. We extracted the names of the chairs/chiefs in medical oncology (MO) and chairs of radiation oncology (RO) for 81 different institutions with both RO and MO training programs as reported by the Association of American Medical Colleges. For each leader, the amount of consulting fees and research payments received in 2015 was determined. Logistic modeling was used to assess associations between the 2 endpoints of receiving a consulting fee and receiving a research payment with various institution-specific and practitioner-specific variables included as covariates: specialty, sex, National Cancer Institute designation, PhD status, and geographic region. The majority of leaders in MO were reported to have received consulting fees or research payments (69.5%) compared with a minority of RO chairs (27.2%). Among those receiving payments, the average (range) consulting fee was $13,413 ($200-$70,423) for MO leaders and $6463 ($837-$16,205) for RO chairs; the average research payment for MO leaders receiving payments was $240,446 ($156-$1,234,762) and $295,089 ($160-$1,219,564) for RO chairs. On multivariable regression when the endpoint was receipt of a research payment, those receiving a consulting fee (odds ratio [OR]: 5.34; 95% confidence interval [CI]: 2.22-13.65) and MO leaders (OR: 5.54; 95% CI: 2.62-12.18) were more likely to receive research payments. Examination of the receipt of consulting fees as the endpoint showed that those receiving a research payment (OR: 5.41; 95% CI: 2.23-13.99) and MO leaders (OR: 3.06; 95% CI: 1.21-8.13) were more likely to receive a consulting fee. Leaders in academic oncology receive consulting or research payments from industry. Relationships between oncology leaders and industry can be beneficial, but guidance is needed to develop consistent institutional policies to manage FCOIs.

PSY3–1 - Medical Oncology Training Programs At the University of Texas MD Anderson Cancer Center Need for Clinical Cancer Biologists to Advance the Field of Medical Oncology

PSY3–1 - Medical Oncology Training Programs At the University of Texas MD Anderson Cancer Center Need for Clinical Cancer Biologists to Advance the Field of Medical Oncology

PSY2-KEYNOTE SPEECH - Medical Oncology Training Programs in the United States

ABSTRACT Specific training in the field of medical oncology is available to physicians who have completed their residency training in general internal medicine. The objective of medical oncology fellowships is to train general internists to become well-rounded medical oncologists who can deal with many different types of cancer using multi-modality approaches. At the completion of the fellowship program, these physicians are expected to be board-eligible for medical oncology and board certified in internal medicine. We expect that many graduates of fellowship programs will work in community settings rather than at academic institutions. Nevertheless, given the rapid pace at which the medical knowledge base is expanding, part of the fellowship training process involves teaching fellows how to conduct, evaluate, and interpret advances in biomedical science, with the goal of applying that knowledge in their practices. Fellowships also offer the opportunity for direct experience in cancer prevention, treatment, and palliative care; particular attention is given to the psychosocial and medical effects of cancer and its treatment on quality of life. Medical oncology fellowships are generally offered in combination with fellowship training in hematology. The fellowship period usually lasts for 3 years. The major advancement of science in the field of medical onclogy requires a team medicine and a team science approach. Therefore, the requirement to etablish yourself as a medical oncologist is not simply about obtainging knowledge skill set but to have a strong communication or leadership skills.

New look at the old management of unknown primary

Journal of Surgical OncologyVolume 98, Issue 2 p. 71-72 Guest Editorial New look at the old management of unknown primary Scot Dowden MD, Corresponding Author Scot Dowden MD [email protected] Tom Baker Cancer Centre, University of Calgary, Alberta, Canada Medical Oncologist; Clinical Assistant Professor, Medicine and Oncology; Assistant Chair, Gastrointestinal Tumour Group; Director, Medical Oncology Training Program.1331—29th Street NW, Calgary, Alberta, Canada T2N 4N2; Fax: 403-283-1651.===Search for more papers by this authorWalter Miller D.O., Walter Miller D.O. Department of Surgical Oncology, Tom Baker Cancer Centre, Alberta, Canada Surgery Oncology Fellow.Search for more papers by this author Scot Dowden MD, Corresponding Author Scot Dowden MD [email protected] Tom Baker Cancer Centre, University of Calgary, Alberta, Canada Medical Oncologist; Clinical Assistant Professor, Medicine and Oncology; Assistant Chair, Gastrointestinal Tumour Group; Director, Medical Oncology Training Program.1331—29th Street NW, Calgary, Alberta, Canada T2N 4N2; Fax: 403-283-1651.===Search for more papers by this authorWalter Miller D.O., Walter Miller D.O. Department of Surgical Oncology, Tom Baker Cancer Centre, Alberta, Canada Surgery Oncology Fellow.Search for more papers by this author First published: 11 July 2008 https://doi.org/10.1002/jso.20995Citations: 1 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume98, Issue21 August 2008Pages 71-72 RelatedInformation

Caring for the Elderly Cancer Patient: Training the Next Generation of Oncologists

Caring for the Elderly Cancer Patient: Training the Next Generation of Oncologists

The use of the internet for medical information and a needs assessment for a web based educational resource: A survey of Canadian medical oncology trainees and training program directors

17022 Background: Medical Oncology trainees develop their skills and knowledge through formal educational sessions, independent learning and clinical rotations. The internet serves as a source of up to date information and a potential educatinal resource. Despite the existence of many websites with oncology related information, there has not been a comprehensive assessment of how medical oncology trainees and program directors use the internet to meet educational objectivs. Method: In the first phase of developing a new educational website (OncologyEducation.com), we surveyed medical oncology trainees and program directors from training programs across Canada to assess how they accessed the internet to determine the elements they considered essential for a trainee-oriented site. Results: 12 out of 13 Canadian medical oncology training programs participated in our survey. A total of 12 program directors and 23 trainees responsed to our survey for a 74.5% response rate. 71.4% of respondents spend up to 10 hours per week on the internet for work related reasons. Pubmed and UptoDate were the most frequently visited sites. Respondents reported using the internet for email (97.1%), answering clinical questions (88.6%), accessing practice guidelines (80%), and literature updates (71.4%). Respondents expressed a need for an educational website stressing the following content: (1) Key updates by disease sites (2) Access to pivotal journal articles (3) Access to upcoming conferences/information (4) Links to other medical sites/medical oncology sites (5) Fellowship Opportunities. Conclusion: The internet is an important resource for supplementing the training of medical oncology trainees. The development of an educational website based on the needs assessed in this survey is warranted. Upon development of the website it will be evaluated for effectiveness and impact on oncology training and clinical practice. No significant financial relationships to disclose.

Medical oncology and geriatric medicine: is it time for fellowship integration?

Although training programs exist in both medical oncology and geriatrics (approved by the American Board of Internal Medicine), neither is adequate to ensure an appropriate supply of physicians to assume a leadership role in the treatment of the increasing number of geriatric patients who have or will develop a malignancy. A proposal for offering a 3-4 year program leading to dual certification is under consideration. A careful review of both the medical oncology training program and added qualifications in geriatrics has identified key components of each that can serve as a basis for a combined program. Such a program can encourage research into behavior modification of existing biases in referring geriatric oncology patients for treatment as well as a better understanding of the biology of aging, addressing in particular the pharmacology of anticancer agents in this unique population. It is anticipated that pilot projects will be undertaken to develop common pathways for developing combined programs in medical oncology and geriatrics. The second phase will include recruitment of selected candidates who are interested in an academic career in geriatric oncology. A need for additional academic-based geriatric oncologists has been identified that can address the anticipated increase in the incidence and presence of cancer in an aging population. Such a cadre of specialists will be in an excellent position to recommend changes in the current (mostly negative) approach to the management of cancer in patients age > 65 years.

Developing a postgraduate medical oncology training program in Taipei, Taiwan, Republic of China.

Because cancer is the number one cause of mortality in Taiwan, a governmental decision was made to develop an experiment in medical oncology education using a United States-style training program in medical oncology in three Taipei, Taiwan, university hospitals. In the past, trainees from developing countries came to the United States or other foreign countries to receive specialty training. In doing so, the training did not necessarily prepare the individuals with skills to treat the indigenous cancers, nor did they work with other related specialists or support staff such as nursing and pharmacy, so important to providing good cancer care. This program involved 13 fellows with significant laboratory experience working with American faculty on-site. The major benefits of this model for oncology training are that the trainees developed important interdisciplinary relationships with local staff at each of the hospitals; they were involved in the treatment of the major cancer diseases of Taiwan such as nasopharyngeal, hepatocellular, and cervical cancers as well as breast, lung, and colon cancers; and they completed a certification process involving written and oral tests by two senior American oncologist examiners. Oncology services have been established at each of the hospitals and most of the fellows have expressed an interest or made arrangements to come to the United States to get additional research experience.

1987-1988 medical oncology training programs

A continuing survey of Medical Oncology training programs was conducted. In 148 programs, there were 841 trainees. This was an increase in the number of trainees recorded in a 1984 survey (767), with a substantial increase in third-year trainees. Since trainees in combined oncology/hematology programs intend to take the Medical Oncology certifying examination, a continuing output of medical oncologists can be expected.

Evaluation of clinical competence in medical oncology training programs.

The American Board of Internal Medicine (ABIM) has asked that directors of medical oncology training programs establish systems to evaluate, document, and substantiate the clinical competence of subspecialty trainees who seek certification. The Board defines the certificable medical oncologist at the completion of training as being competent to provide comprehensive and specialized medical care based on a high standard of demonstrated component skills. These skills clearly exceed those demonstrated by the certified internist. The goal of this expanded evaluation program is to ensure that the public and the profession can identify, through certification, physicians capable of providing a high standard of medical care.

Medical oncology manpower supply.

An explosion in the number of trained medical oncologists has led to concern that an overproduction will occur. A survey of 154 medical oncology training programs revealed 767 current trainees--316 first year, 307 second year, and 144 third year. Seventeen programs contained 301 persons (38.5%). After the 1985 certifying examination, 3,659 oncologists were certified. With approximately 750 eligible candidates for each examination, and assuming a 75% pass rate, by 1989 there will be 4,779 certified medical oncologists. By 1990, there will be no deficiency of clinical medical oncologists, but there appears to be a lack of academic oncologists. In order to assure the quality goals of oncology, and in an attempt to meet an adequate supply of medical oncologists, a position statement has been published by the American Society of Clinical Oncology. To avoid an overproduction of medical oncologists, an ongoing assessment of the number needed is warranted.