Medical Education Reform Research Articles

Intervention of innovative reform in medical education on students’ anxiety disorders

BackgroundGeneralized Anxiety Disorder (GAD) is a common mental illness among adolescents, characterized by generalized and persistent anxiety, lack of clear targets, nervousness, and even involvement of the respiratory and digestive systems. Cognitive behavioral therapy has an improvement effect on anxiety disorders. This research was conducted to provide treatment interventions for students with anxiety disorders.Subjects and MethodsFirstly, 90 adolescent anxiety disorder patients aged 13-22 from a certain hospital were selected. Next, they were randomly divided into a control group and an observation group. The control group received routine drug treatment, while the observation group received cognitive behavioral therapy on this basis. The final treatment period was 16 weeks, with a round of treatment every 8 weeks. Statistical software SPSS23.0 was used for statistical description, and t-tests were used for measurement data.ResultsAfter a round of 8-week treatment, there was no statistically significant difference in the anxiety symptom scale scores between the two groups (P>0.05). After the second round, the Hamilton Anxiety Scale scores of the observation group were significantly lower than those of the control group (P<0.05); The difference in stress status scores at different times was significantly lower in the observation group than in the control group after the start of the second round (P<0.05). In short, cognitive behavioral therapy has a relieving effect on students’ anxiety disorders.ConclusionsDrug therapy is mostly targeted at adult patients. However for adolescent patients, it is necessary to gradually combine cognitive behavioral therapy to promote the relief of anxiety disorders in students.

Contract doctors' strike in Malaysia: A content analysis of the perception of medical fraternity and stakeholders on Facebook.

Contract appointment policy for newly graduated medical officers was implemented by the Ministry of Health Malaysia in 2016 to overcome the lack of permanent posts. Contract officers faced disadvantages in terms of salary, leave provision, and career prospects. A nationwide strike, Hartal Doktor Kontrak (HDK) was organised on 26th July 2021. Besides generating widespread public attention, HDK was also closely scrutinised by the medical fraternity and stakeholders. This content analysis aimed to explore how the medical fraternity and stakeholders viewed the strike as their perception would offer vital insights into the fundamental causes and viable solutions to the contract appointment policy. A qualitative content analysis of Facebook (FB) posts on the HDK strike was conducted from 1st June 2021 until 28th February 2022. A total of 182 FB posts were retrieved from stakeholders, medical fraternity groups, and medical key opinion personnel. Inductive coding was used in the thematic analysis to identify pertinent themes. Three main themes emerged: triggering factors, reactions to the strike, and outcomes of the strike. Factors that led to the strike included unequal treatment faced by contract officers, frustration with the government's lack of long-term solutions, and aggravation by the COVID-19 pandemic. In terms of reactions, there was a mixture of supportive and opposing voices. No substantial negative impact on the healthcare service resulted from the strike. Instead, it generated widespread attention that propelled the government into implementing solutions to prevent adverse short and long-term consequences. Various suggestions were proposed, including the reform of human resource planning and undergraduate medical education. The results highlight the importance of proactive systemic measures by the government to prevent further strikes that may jeopardise healthcare provision. In summary, social media was found to influence the progress and outcome of HDK, thus demonstrating the impact of media influence on similar issues.

Medicine in history and history in medicine: the inaugural Davis Coakley Memorial Lecture

Professor Davis Coakley (1946–2022) was an outstanding physician, historian, and leader of reform in medical services and education. This inaugural Davis Coakley Memorial Lecture, delivered in The Edward Worth Library at Dr Steevens’ Hospital, Dublin, Ireland, on 28 September 2023, focuses on ‘Medicine in History & History in Medicine’. It explores the position of the physician-historian in medical historiography, discusses Coakley’s extensive historical work (especially his many books about the history of medicine), and concludes with comments about one of Coakley’s great interests: the work of Sir William Wilde (1815–1876). Sir William was a prominent Victorian doctor, father of playwright Oscar, and remarkably prescient commentator on public health in Ireland. Sir William’s comments about patterns of epidemics are especially arresting and relevant today in the immediate wake of COVID-19. Coakley’s interest in Sir William echoed Coakley’s broader commitment to medical care, progressive education, and genuine scholarship that shed light on suffering, illness, healing, and recovery. The fields of both medicine and history are greatly enriched by Coakley’s life and work.

Integrating physiology into the first two years of a new osteopathic medical school curriculum.

The integrated curriculum is a hot topic in curriculum reform in undergraduate medical education; however, there are varying definitions of the term, and resources guiding the integration of specific disciplines throughout the first 2years of undergraduate medical education in a learner-centered curriculum are limited. Our first class matriculated into our osteopathic medical school in 2017, and since then we have developed and implemented a learner-centered, integrated curriculum that begins on day one for our learners. This paper will discuss our experience with the development and implementation of the University of the Incarnate Word School of Osteopathic Medicine (UIWSOM) curriculum with specific emphasis on how we incorporate physiology into it.

Chinese medical students reflections on medical professionalism: A qualitative thematic analysis.

There is no common medical professionalism framework in China, mandating work to conceptualize professionalism from various perspectives. Studies on students viewpoints about medical professionalism are limited. Therefore, this study aimed to investigate how Chinese medical students perceive professionalism to provide a reference for future medical education reform and policy development. Fifty-four written reflections on medical professionalism were collected from first-year students of China 4 + 4 medical education program enrolled in 2020 to 2021 academic years. Essays were subjected to thematic analysis using NVivo 12. Three main themes emerged: inter-personal, intra-personal, and public professionalism. Students emphasized the importance of physician-patient relationships, proficiency of medical knowledge, and enthusiasm for promoting health-related issues. By contrast, teamwork and confidentiality were not considered essential aspects of professionalism. The medical professionalism framework articulated by students in China was roughly the same as in other countries. Where there were differences, these may have been due to the unique sociocultural environment. Future medical professionalism education should be adjusted according to students understanding of professionalism.

Does medical education reform change who is selected? A national cross-sectional survey from China

ObjectivesApproximately 10 years ago, China introduced an education plan to improve the overall quality of medical education and to better serve the population’s health needs. Many medical schools were then...

Competency-based medical curriculum: Exploring the preclinical medical teachers' pedagogical and technical readiness levels.

Background The medical curriculum for undergraduates was revised by the Medical Council of India in 2019, after 21 years. We did this study to determine teachers' pedagogical and technical readiness to implement the competency-based curriculum in medical colleges and determine factors that affect readiness, from their perspective. Methods We conducted a cross-sectional survey in the form of an online questionnaire. The qualitative data were coded numerically and were analysed using frequencies and proportions. Pearson Chi-square test was used to study the association among variables. Results The majority (85%) of respondents had attended a curriculum implementation training programme; 62.2% with experience <5 years, 56.1% with experience 5-10 years and a minority of 13.3% with >10 years' experience were ready to a 'great extent' to implement the new curriculum; 54.1% agreed to re-frame lectures and 64.9% possessed technological skills to suit the needs of a competency-based curriculum. About 77% agreed that it will provide a rich learning environment, inspire self-directed learning while 52% believed it will promote scientific thinking and provide better learning outcomes in the long run. Conclusion Medical teachers had a positive attitude towards implementation of the new curriculum. However, numerous factors such as low teacher-student ratio, textbooks designed according to the traditional curriculum, limited teachers' training and cumbersome paperwork may hinder its successful implementation. Updation of teachers' knowledge and skills through seminars/workshops is recommended to facilitate delivery of the new curriculum. Like any other ongoing reforms in medical education, competency-based curriculum is a work in process.

Multifunctional high-simulation 3D-printed hydrogel model manufacturing engineering for surgical training.

Advanced bionic organ models with vivid biological structures and wetness and softness are essential for medical-surgical training. Still, there are many challenges in the preparation process, such as matching mechanical properties, good feedback on surgical instruments, reproducibility of specific surgical scenarios, and distinguishability between structural levels. In this paper, we achieved tissuemimicking dual-network (DN) hydrogels with customizable stiffness by adjusting the composition of the hydrogel matrix and the immersion time of the ionic solution to match different biological soft tissues precisely. Combined with advanced threedimensional (3D) printing fabrication techniques, various performance-tunable bionic hydrogel organ models with structural complexity and fidelity, including kidney, liver, pancreas, and vascular tissues, were perfectly fabricated. The simulation and applicability of the model were also simulated for the forced change of the suture needle in the puncture and suture of a single tissue and between different tissues, the cutting of substantive organs by ultrasonic scalpel, the coagulation and hemostasis of blood vessels, the visualization of the internal structure under ultrasound, and the microwave ablation of liver tumors. By constructing advanced biomimetic organ models based on hydrogel with specific and tunable properties, the development of surgical training, medical device testing, and medical education reform will be significantly promoted.

Investigating Students' Perceptions towards Artificial Intelligence in Medical Education.

Implementing a reform in medical education requires students' awareness regarding the importance of artificial intelligence (AI) in modern medical practice. The objective of this study was to investigate students' perceptions of AI in medical education. A cross-sectional survey was conducted from June 2021 to November 2021 using an online questionnaire to collect data from medical students in the Faculty of Medicine at Kuwait University, Kuwait. The response rate for the survey was 51%, with a sample size of 352. Most students (349 (99.1%)) agreed that AI would play an important role in healthcare. More than half of the students (213 (60.5%)) understood the basic principles of AI, and (329 (93.4%)) students showed comfort with AI terminology. Many students (329 (83.5%)) believed that learning about AI would benefit their careers, and (289 (82.1%)) believed that medical students should receive AI teaching or training. The study revealed that most students had positive perceptions of AI. Undoubtedly, the role of AI in the future of medicine will be significant, and AI-based medical practice is required. There was a strong consensus that AI will not replace doctors but will drastically transform healthcare practices.

Medical Faculty Perspectives Toward Cadaveric Dissection as a Learning Tool for Anatomy Education: A Survey Study in India.

Cadaveric dissection, as a learning tool, has been a part of Indian medical education. Worldwide, with reforms in medical education and the introduction of new learning modalities, cadaveric dissection has been complemented with other modalities such as living anatomy and virtual anatomy. This study aims to collect the feedback of faculty members regarding the role of dissection in the present context of medical education. The method of the study involved a 32-item questionnaire to collect responses; they were collected using the 5-point Likert scale along with two open-ended questions. In general, the closed questions covered these sections: learning styles, interpersonal skills, teaching and learning, dissection, and other learning modes. The principal component analysis was used to explore the multivariate relationships among the items' perceptions. The multivariate regression analysis was conducted between the construct and the latent variable to develop the structural equation model. Four themes, PC1 (learning ability with structural orientation), PC2 (interpersonal skill), PC3 (multimedia-virtual tool), and PC5 (associated factors) had positive relation and were treated as a latent variable motivation for dissection, and theme 4 (PC4, safety) had a negative correlation and was treated as a latent variable repulsion for dissection. It was found that the dissection room is an important place for learning clinical and personal skills, along with empathy, in anatomy education. Safety issues and implementation of stress-coping activities during the induction phase are required. There is also a need to use mixed-method approaches that integratetechnology-enhanced learning such as virtual anatomy, living anatomy, and radiologicalanatomy with cadaveric dissection.

Development, implementation, and results of a simulation-based hands-on brachytherapy workshop for medical students

PurposeThe new Medical Licensing Regulations 2025 (Ärztliche Approbationsordnung, ÄApprO) require the development of competence-oriented teaching formats. In addition, there is a great need for high-quality teaching in the field of radiation oncology, which manifests itself already during medical school. For this reason, we developed a simulation-based, hands-on medical education format to teach competency in performing accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy for early breast cancer. In addition, we designed realistic breast models suitable for teaching both palpation of the female breast and implantation of brachytherapy catheters.MethodsFrom June 2021 to July 2022, 70 medical students took part in the hands-on brachytherapy workshop. After a propaedeutic introduction, the participants simulated the implantation of single-lead catheters under supervision using the silicone-based breast models. Correct catheter placement was subsequently assessed by CT scans. Participants rated their skills before and after the workshop on a six-point Likert scale in a standardized questionnaire.ResultsParticipants significantly improved their knowledge-based and practical skills on APBI in all items as assessed by a standardized questionnaire (mean sum score 42.4 before and 16.0 after the course, p < 0.001). The majority of respondents fully agreed that the workshop increased their interest in brachytherapy (mean 1.15, standard deviation [SD] 0.40 on the six-point Likert scale). The silicone-based breast model was found to be suitable for achieving the previously defined learning objectives (1.19, SD 0.47). The learning atmosphere and didactic quality were rated particularly well (mean 1.07, SD 0.26 and 1.13, SD 0.3 on the six-point Likert scale).ConclusionThe simulation-based medical education course for multicatheter brachytherapy can improve self-assessed technical competence. Residency programs should provide resources for this essential component of radiation oncology. This course is exemplary for the development of innovative practical and competence-based teaching formats to meet the current reforms in medical education.

MARTYN MATVIYOVYCH TEREHOVSKYI (1740-1796) AND IMPROVEMENT OF TEACHING IN THE HIGHER MEDICAL SCHOOL

Objective: to summarize the main facts of M. M. Terekhovskyi’s biography based on a critical analysis of publications and, at the same time, to highlight his contribution to the improvement of teaching in higher medical school. Materials and methods. Published materials were used as historical sources. The historical method was the main research method in the article. Results. We performed an analysis of the literature about prof. Terekhovskyi. For the first time, his role in the reforms of higher medical education in the late 18th – early 19th centuries was clarified. The first critical analysis of the literature about M. M. Terekhovskyi, published over more than a century and a half, made it possible to identify erroneous statements and typos. It was found that the first publication about him appeared in 1845, that is, half a century after his death. It was a brief biographical note in the dictionary of Metropolitan Eugene. It was proved that the main and most complete life description of Professor Terekhovskyi was his biography written by Ya. A. Chistovich (1883), which was based on archival materials and supplemented with archival findings by M. K. Borodii (1984). The fundamental study of his contribution to science was represented by the work of S. L. Sobol (1948, 1963). It was shown that the charter of 1792 of the higher medical school (academy), which Professor Terehovskyi took part in, served as the basis for the staff of the St. Petersburg Medical and Surgical Academy in 1808. The charter of 1792 for the first time included Medical Police (Politia Medica), which was later transformed into Social Hygiene and Public Health, as one of the teaching subjects in the higher medical school. Then it was enshrined in the charter of 1806, which was written by the founder of this science, J. P. Frank. The study made it possible to identify gaps in the biography of M. M. Terekhovskyi. Thus, the date and month of his birth are still unknown; it is not clear who his mother was, whether he had his own family (wife, children), and whether he received a scholarship from Princess Ye. D. Golitsyna. With this regard, further archival searches are needed to confirm Professor Terekhovsky’s authorship of the handwritten essay «Opinion on the correction of medical sciences.»

Reflection on the reform of college medical education in the new period

Reflection on the reform of college medical education in the new period

The Sudanese Medical Education in the Light of Flexner Report

Medical education as a profession is a legitimate offspring of Flexner’s report in 1910. It strived to excel in preparing future doctors and increasing the competency of medical practitioners. We provide a scientific critique of Flexner’s report, displaying its merits and shortcomings and shedding a spotlight on Sudan’s medical education milestones and its current strive for excellence and innovation in curricula designing, accreditation, graduate competencies, staff professional development, and quality improvement. Since the publication of this inspiring study, a global effort has been launched to improve the quality of health system policies and health professions’ competency through education. All stakeholders now seek fundamental reform in medical education in Sudan to improve its quality and trustworthiness. Based on this study, our impost does not necessarily propose following its footsteps but instead evaluates its stimulating role in planning and intervention.

How the Quadruple Aim Widens the Lens on the Transition to Residency.

How the Quadruple Aim Widens the Lens on the Transition to Residency.

Blind spots in medical education: how can we envision new possibilities?

As human beings, we all have blind spots. Most obvious are our visual blind spots, such as where the optic nerve meets the retina and our inability to see behind us. It can be more difficult to acknowledge our other types of blind spots, like unexamined beliefs, assumptions, or biases. While each individual has blind spots, groups can share blind spots that limit change and innovation or even systematically disadvantage certain other groups. In this article, we provide adefinition of blind spots in medical education, and offer examples, including unfamiliarity with the evidence and theory informing medical education, lack of evidence supporting well-accepted and influential practices, significant absences in our scholarly literature, and the failure to engage patients in curriculum development and reform. We argue that actively helping each other see blind spots may allow us to avoid pitfalls and take advantage of new opportunities for advancing medical education scholarship and practice. When we expand our collective field of vision, we can also envision more "adjacent possibilities," future states near enough to be considered but not so distant as to be unimaginable. For medical education to attend to its blind spots, there needs to be increased participation among all stakeholders and acommitment to acknowledging blind spots even when that may cause discomfort. Ultimately, the better we can see blind spots and imagine new possibilities, the more we will be able to adapt, innovate, and reform medical education to prepare and sustain aphysician workforce that serves society's needs.

Undergraduate Medical Education Reform in Viet Nam for a Primary Health Care Workforce.

Strong primary health care (PHC) systems require a robust PHC workforce. Traditionally, medical education takes place in academic medical centres that favour subspecialty care rather than PHC settings. This may undervalue primary care as a career and contribute to a shortage of PHC workers. However, designing undergraduate medical education curricula that incorporate early experiences in clinical care delivery at PHC sites remains a challenge, including in many low- and middle-income countries (LMICs). This paper describes how a collaboration between Harvard Medical School and five medical schools in Vietnam, and in-country collaborations among the Vietnamese medical schools, facilitated curricular innovation and co-creation of coursework relevant to PHC through the development of a Practice of Medicine (POM) course. The collaboration implemented a technical assistance strategy consisting of in-person workshops, focused virtual consultations, on-site 'office hours', site visits and observations to each of the five medical universities, and immersion trips to support the creation and implementation of the POM course. A pilot program was started at a single site and then scaled nationally using local customisation, experience, and expertise utilising a train-the-trainers approach. As a result, five new POM courses have been developed by five Vietnamese institutions. Fifty Vietnamese faculty received training to lead the POM course development, and 228 community-based preceptors have been trained to teach students at PHC sites. A total of 52 new PHC and community-based clinical training sites have been added, and 3,615 students have completed or are currently going through a POM course. This experience can serve as a model for future academic collaborations to support the development of a robust PHC workforce for the 21st century.

Value-Based Cancer Care: How are We Training Future Radiation Oncologists on the Quality/Cost Equation?

<h3>Purpose/Objective(s)</h3> The cost of a cancer diagnosis has increasingly caused financially harm to many Americans. Calls have been made by the American Medical Association and others to educate physicians on value and affordability with the goal to improve patient care and contribute to systemic change. This study sought to evaluate how future physicians are educated on cost and value-based principles during their undergraduate medical education. As a terminal oncology residency, radiation oncologists were the focus. <h3>Materials/Methods</h3> An anonymous 18-question survey was developed by the study team to assess undergraduate medical education experiences on cost, quality, and value. A list of recently graduated (2016-2021) physicians was generated from residency applications; emails and Twitter handles were identified via publicly available data and contacted August 2021- February 2022 to complete the survey. <h3>Results</h3> Of 279 contacted, 62 (22.2% response rate) completed the survey. The graduation year breakdown was: 2016 (27.4%), 2017 (4.8%), 2018 (24.2%), 2019 (19.4%), 2020 (14.5%), and 2021 (9.7%). Respondents trained in the Northeast (32.3%), South (29.0%), Midwest (29.0%), and West (9.7%). Less than half had had a lecture on value in healthcare (46.8%, n=29) or costs (32.3%, n=20); only 16.1% (n=10) had a class on value, and for most of those (60%, n=6) it was elective. 98.4% (n=61) had previously met a patient unable to afford healthcare however only 9.7% (n=6) had a good idea of the charged/billed prices and even less (6.5%, n=4) had a good idea of the out-of-pocket costs for standard tests, procedures, and medications. Two-thirds (64.5%, n=40) indicated that the value or cost of a test, procedure, or medication was rarely or never discussed at the point of care. 48.4% (n=30) hadn't heard of the "Choosing Wisely" guidelines during medical school although 82.3% (n=51) were are least vaguely familiar with the concept of "financial toxicity". Most physicians (90.3%, n=56) felt their education about value, affordability, and cost was marginal or insufficient. The vast majority indicated they thought these topics are important for their patients (96.8%, n=60). <h3>Conclusion</h3> Most recent graduates training in radiation oncology have suboptimal education on cost, affordability, and value during medical school despite widespread interest. Few had had a class on these vital topics and most indicated that costs and value were rarely discussed when ordering tests or medications. These educational gaps likely contribute to their present vague understanding of either billed or out of pocket costs. Given rising health care costs, systemic reform of medical education will be required to educate the next generation of oncologists on the importance of value-based cancer care.

The medical education systems in China and Thailand: A comparative study.

Background and AimsBoth China and Thailand attach great importance to education and are committed to high educational standards on an international level. Our study is to compare the medical education reforms that have occurred in China and Thailand to further improve the medical education system in China.MethodsThrough a search of official documents and prior studies, as well as consultation with Thai students studying in China, we gathered data regarding the evolution of the medical education systems in China and Thailand. The aggregate materials are incorporated into the summary and analysis.ResultsOver 200 journals and literature were analyzed retrospectively. Thailand's medical education reforms encompass Western strategies without neglecting domestic cultural factors and priorities, and a standardized and medical education system has been established. Chinese medical education reform has yielded remarkable results, though further improvements remain necessary.ConclusionReforms of Thailand's medical education system offer important experiences and lessons for China, that the development of medical education needs to absorb the merits of others and also needs to have its own national characteristics. The key to medical education reform in China lies in the establishment of a system that is dedicated to science, while also serving its primary purpose of training high‐level medical talent that can meet the needs of Chinese society.

Value-Based Cancer Care: What are the opportunities to improve training for future Radiation Oncologists on the Quality/Cost Equation?

Purpose A cancer diagnosis can lead to lasting financial problems for many Americans. The American Medical Association has called for a greater focus on value and affordability education to increase awareness of burdens on both patients and the healthcare system. This study evaluated how future physicians were educated on cost and value-based principles during their undergraduate medical education. Radiation Oncologists were the focus given their oncology specific residency. Methods An anonymous 18-question survey was developed by the study team to assess undergraduate medical education experiences on cost, quality, and value. A list of recently graduated (2016-2012) physicians was generated from residency applications; emails and Twitter handles were identified via publicly available data and contacted August 2021- February 2022 to complete the survey. Results Of 279 contacted, 67 (24.0% response rate) completed the survey. Participants graduated in 2016 (25.4%), 2017 (6.0%), 2018 (25.4%), 2019 (17.9%), 2020 (14.9%), and 2021 (10.4%); they trained in the Northeast (34.3%), South (26.9%), Midwest (29.9%), and West (9.0%). Less than half had a lecture on value (49.3%, n=33) or costs (32.8%, n=22). Only 19.4% (n=13) had an entire class on value. About half had heard value mentioned "occasionally" (55.2%, n=37) during their time on the wards and less than a third (28.4%, n=19) heard about it "frequently". Similarly, half had heard about costs "occasionally" (52.2%, n=35) and less than a quarter (17.9%, n=12) had heard it mentioned "frequently". Less than half had a lecture on health insurance (46.3%, n=31); about a third had heard it mentioned "occasionally" (38.8%, n=26) on the wards while less than a tenth (7.5%, n=5) had hear it mentioned "frequently". A third had NO education on improving affordability for patients (34.8%, n=23) although about a half had been taught to discuss the $4 list and/or pill splitting (47.0%, n=31). Less than a tenth (9.0%, n=6) had a "good idea" of the charged/billed prices and even less (6.0%, n=4) knew the out-of-pocket costs for standard tests, procedures, and medications. Most (89.6%, n=60) felt their education about value, affordability, and cost was marginal or insufficient. Discussion Most recent graduates entering radiation oncology have not received adequate education on cost, affordability, and value. This education gap leads to the vast majority stating ignorance to the cost burdens on patients. Given rising healthcare costs, systemic reform of medical education will be required to educate the next generation of oncologists on the importance of value-based cancer care. A cancer diagnosis can lead to lasting financial problems for many Americans. The American Medical Association has called for a greater focus on value and affordability education to increase awareness of burdens on both patients and the healthcare system. This study evaluated how future physicians were educated on cost and value-based principles during their undergraduate medical education. Radiation Oncologists were the focus given their oncology specific residency. An anonymous 18-question survey was developed by the study team to assess undergraduate medical education experiences on cost, quality, and value. A list of recently graduated (2016-2012) physicians was generated from residency applications; emails and Twitter handles were identified via publicly available data and contacted August 2021- February 2022 to complete the survey. Of 279 contacted, 67 (24.0% response rate) completed the survey. Participants graduated in 2016 (25.4%), 2017 (6.0%), 2018 (25.4%), 2019 (17.9%), 2020 (14.9%), and 2021 (10.4%); they trained in the Northeast (34.3%), South (26.9%), Midwest (29.9%), and West (9.0%). Less than half had a lecture on value (49.3%, n=33) or costs (32.8%, n=22). Only 19.4% (n=13) had an entire class on value. About half had heard value mentioned "occasionally" (55.2%, n=37) during their time on the wards and less than a third (28.4%, n=19) heard about it "frequently". Similarly, half had heard about costs "occasionally" (52.2%, n=35) and less than a quarter (17.9%, n=12) had heard it mentioned "frequently". Less than half had a lecture on health insurance (46.3%, n=31); about a third had heard it mentioned "occasionally" (38.8%, n=26) on the wards while less than a tenth (7.5%, n=5) had hear it mentioned "frequently". A third had NO education on improving affordability for patients (34.8%, n=23) although about a half had been taught to discuss the $4 list and/or pill splitting (47.0%, n=31). Less than a tenth (9.0%, n=6) had a "good idea" of the charged/billed prices and even less (6.0%, n=4) knew the out-of-pocket costs for standard tests, procedures, and medications. Most (89.6%, n=60) felt their education about value, affordability, and cost was marginal or insufficient. Most recent graduates entering radiation oncology have not received adequate education on cost, affordability, and value. This education gap leads to the vast majority stating ignorance to the cost burdens on patients. Given rising healthcare costs, systemic reform of medical education will be required to educate the next generation of oncologists on the importance of value-based cancer care.