Oncology Education for Canadian Internal Medicine Residents: The Value of Participating in a Medical Oncology Elective Rotation

Abstract

Background: Despite the high incidence and burden of cancer in Canadians, medical oncology (MO) rotations are not mandatory in most Canadian internal medicine (IM) residency training programs. Methods: All IM residents scheduled for a MO rotation at 4 Canadian teaching cancer centres between 1 January 2013 and 31 December 2015 were invited to complete an online survey before and after their rotation. The survey was designed to evaluate perceptions of oncology, comfort in managing cancer patients, and basic oncology knowledge. Results: The survey was completed by 68 IM residents pre-rotation and by 48 (71%) post-rotation. Cancer-related learning was acquired mostly from MO physicians in clinic (35%). Self-directed learning, didactic teaching, and resident or fellow teaching accounted for 31%, 26%, and 10% respectively of learning acquisition. Comfort level in dealing with cancer patients and patients at end of life improved to 4.0/5 from 3.2/5 (p < 0.001) and to 4.0/5 from 3.6/5 (p = 0.003) respectively. Mean knowledge assessment score improved to 83% post-rotation from 76% pre-rotation (p = 0.003), with the greatest increase observed in general knowledge of common malignancies. The 3 topics ranked as most important to learn during a MO rotation were oncologic emergencies, common complications of treatment, and approach to diagnosis of cancer. Conclusions: A rotation in MO improves the perceptions of IM residents about oncology and their comfort level in dealing with cancer patients and patients at end of life. Overall cancer knowledge is also improved. Given those benefits, IM residency programs should encourage most of their residents to complete a MO rotation.