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1.
Artigo em Inglês | MEDLINE | ID: mdl-32220567

RESUMO

BACKGROUND: Primary management of localized, intermediate-risk prostate cancer consists of radical prostatectomy (RP), radiotherapy (RT) with short-course androgen deprivation therapy (ADT), or RT alone. The purpose of this study was to determine if these treatment strategies have equivalent overall survival (OS) in patients < 55 years old with intermediate-risk prostate cancer. PATIENTS AND METHODS: We identified 35,134 patients in the National Cancer Data Base with localized intermediate-risk prostate cancer treated with RP, RT + ADT, or RT from 2004 to 2013. Ten-year OS rates were estimated by the Kaplan-Meier method. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were computed by multivariate Cox regression. RESULTS: A total of 29,920 patients (85.2%) underwent RP, 1393 (4.0%) RT + ADT, and 3821 (10.9%) RT. Median patient age was 51 years old, and median follow-up was 59.9 months. Ten-year OS was estimated to be 94.2% for RP, 80.7% for RT + ADT, and 85.2% for RT (P < .0001). On multivariate analysis, treatment with RT + ADT or RT was associated with significantly worse OS compared to treatment with RP (RT + ADT HR = 2.06, 95% CI 1.67-2.54, P < .0001; RT HR = 2.0, 95% CI 1.71-2.33, P < .0001). Patients who met all 3 of the intermediate-risk criteria showed worse OS compared to patients who met only one criterion (HR = 1.80; 95% CI, 1.32-2.44; P = .0002). CONCLUSION: RP is significantly more likely than RT + ADT or RT to be used as a primary treatment for young men with localized intermediate prostate cancer. RP was also associated with improved OS compared to RT + ADT and RT.

2.
Clin Breast Cancer ; 20(2): e200-e213, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32089454

RESUMO

BACKGROUND: Although systemic therapy is the standard treatment for metastatic breast cancer, the value of locoregional treatment (LRT) of the primary tumor and its impact on survival is controversial. This study evaluates survival outcomes in patients with metastatic breast cancer after receiving LRT (surgery and/or radiation therapy) of the primary tumor. MATERIALS AND METHODS: The National Cancer Database was used to identify 16,128 qualifying cases of metastatic breast cancer who received systemic therapy with or without LRT from 2004 to 2013. Treatment modality was divided into surgery (Sx), radiation therapy (RT), surgery followed by RT (Sx + RT), and no LRT. The median survival and 3-year actuarial survival rates (OS) were analyzed for each treatment group. On multivariate analyses, adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were computed using Cox regression modeling to adjust for patient and clinicopathologic characteristics. RESULTS: Overall, the median follow-up was 28.3 months, and the median survival for all patients was 37.2 months. With 9761 deaths reported, the estimated 3-year OS was 51.3%. The Sx + RT group (n = 2166) had the highest 3-year OS of 69.4%, followed by the Sx group (n = 4293) with 57.6%, the no LRT group (n = 8955) with 44.3%, and the RT group (n = 714) with 41.5% (P < .0001). On multivariate analysis, compared with the no LRT group, a decreased HR was noted in patients receiving Sx (adjusted HR, 0.68; 95% CI, 0.65-0.71; P < .0001) and Sx + RT (adjusted HR, 0.46; 95% CI, 0.43-0.49; P < .0001). CONCLUSION: LRT, especially surgery followed by RT, in addition to systemic therapy, was associated with improved survival in patients with metastatic breast cancer.

3.
J Community Health ; 45(3): 452-457, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31625050

RESUMO

Disparities in outcomes for vulnerable women is an ongoing problem. Homelessness and breast cancer treatment outcomes is understudied. This is a descriptive study exploring types of homelessness and treatment delays at an urban safety net hospital providing care to a vulnerable patient population.This study is a retrospective chart review of homeless female patients diagnosed with breast cancer between January 1, 2000 and December 31, 2014. Data for this study were acquired from the hospital cancer registry and electronic medical record. All demographic characteristics, time to treatment and factors related to delays to treatment were analyzed descriptively, reporting frequencies and proportions. The total number of individuals analyzed was 24. All except two subjects were delayed to treatment (≥ 30 days from diagnosis to treatment). Most women in this cohort were categorized as chronically homeless (46%) with the rest categorized as transitionally (29%) or episodically (12%) homeless. The majority of subjects (70%) were Black, non-Hispanic. All except one subject were publicly insured (71% Medicaid; 12% Medicare) or uninsured (8%). Regardless of type of homelessness, most subjects were either 30-60 or 60-90 days delayed. Those who were chronically homeless experienced significantly more delays to first treatment (56% of those who were delayed 30-60 days and 57% of those who were delayed 60-90 days; p value 0.006) than those who were episodically or transitionally homeless. Significant delays and barriers to breast cancer treatment exist among women experiencing homelessness. Further studies to improve breast cancer care for homeless women are warranted.

4.
J Cancer Educ ; 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31087258

RESUMO

The importance of mentorship in medicine and its impact on academic and professional development has been widely studied. However, mentorship for medical students in the field of radiation oncology is limited. Our radiation oncology department developed a formal medical student mentorship program in 2004. This program included both clinical and research mentoring pathways. Our study aims to gain feedback and perspective from former medical student participants who subsequently entered into a radiation oncology residency program. An anonymous survey was sent to 22 former students in the mentorship program from 2005 to 2016 who entered a radiation oncology residency program. The survey included Likert scales (1-5), multiple choice, strength category rankings, and free responses. Data was compiled and analyzed with Qualtrics data software. The survey response rate was 100%. Seventeen (77.3%) participants reported that the mentorship program strongly affected their career choice and a majority reported that their research experience strongly (45.5%) or moderately affected (31.8%) their career choice. Fourteen (63.6%) respondents reported that the mentorship program was very effective and 8 (36.4%) reported it as being effective. Eighteen (81.8%) respondents reported that mentorship was extremely important to their career. Students participating in the research pathway also reported improvement in valuable skills such as presentations, abstract writing, manuscript writing, statistical analysis, and coordination with colleagues. A total of 66.7% of attending radiation oncologists who previously participated in this program now practice in an academic setting. Our institution successfully developed a formalized mentorship program for medical students interested in radiation oncology. Participants in this program reported high levels of satisfaction and emphasized the importance of mentorship in the development of valuable research competencies and on their overall career path. This program can serve as a model for future mentorship initiative in medical school.

5.
J Cancer Educ ; 34(1): 56-58, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-28782081

RESUMO

Delivering a cohesive oncology curriculum to medical students is challenging due to oncology's multidisciplinary nature, predominantly outpatient clinical setting, and lack of data describing effective approaches to teaching it. We sought to better characterize approaches to oncology education at US medical schools by surveying third and fourth year medical students who serve on their institution's curriculum committee. We received responses from students at 19 schools (15.2% response rate). Key findings included the following: (1) an under-emphasis of cancer in the curriculum relative to other common diseases; (2) imbalanced involvement of different clinical subspecialists as educators; (3) infrequent requirements for students to rotate through non-surgical oncologic clerkships; and (4) students are less confident in their knowledge of cancer treatment compared to basic science/natural history or workup/diagnosis. Based on these findings, we provide several recommendations to achieve robust multidisciplinary curriculum design and implementation that better balances the clinical and classroom aspects of oncology education.


Assuntos
Currículo/normas , Educação de Graduação em Medicina/normas , Oncologia/educação , Neoplasias/prevenção & controle , Faculdades de Medicina/normas , Estudantes de Medicina/estatística & dados numéricos , Humanos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Estados Unidos
6.
Am J Surg ; 217(1): 175-179, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30086832

RESUMO

BACKGROUND: Student authorship (SA) in research utilizes the H-index (Hi), to measure scholarly impact. We analyzed SA rates over time in the Journal of the American College of Surgeons (JACS). METHODS: We compared Hi of corresponding authors (CA) for articles over time (2006, 2008, 2010, 2012, 2014), comparing those with (SA) and without (nSA) student authors. RESULTS: SA doubled over time (70-146; P = 0.02) as did first or second SA rates (21-44; P = 0.22). Mean and Median CA Hi were similar independent of SA involvement. The change in Hi for CAs in 2006, 2008 and 2010 to current Hi (2016) was similar for SA and nSA groups (2006: 22.4 vs. 20.7; 2008: 20.2 vs. 20.6; 2010: 19.2 vs. 18.3; all P > 0.05). CONCLUSIONS: The number of SA in JACS publications is increasing, without detriment to CA scholarly advancement. Involving students in surgical research should be encouraged.


Assuntos
Autoria , Pesquisa Biomédica , Cirurgia Geral/educação , Estudantes de Medicina , Humanos
7.
J Am Coll Radiol ; 15(11): 1527, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30392613
8.
Adv Radiat Oncol ; 3(2): 181-189, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29904743

RESUMO

Objectives: Understanding the drivers of delays from diagnosis to treatment can elucidate how to reduce the time to treatment (TTT) in patients with prostate cancer. In addition, the available treatments depending on the stage of cancer can vary widely for many reasons. This study investigated the relationship of TTT and treatment choice with sociodemographic factors in patients with prostate cancer who underwent external beam radiation therapy (RT), radical prostatectomy (RP), androgen deprivation therapy (ADT), or active surveillance (AS) at a safety-net academic medical center. Methods and materials: A retrospective review was performed on 1088 patients who were diagnosed with nonmetastatic prostate cancer between January 2005 and December 2013. Demographic data as well as data on TTT, initial treatment choice, American Joint Committee on Cancer stage, and National Comprehensive Cancer Network risk categories were collected. Analyses of variance and multivariable logistic regression models were performed to analyze the relationship of these factors with treatment choice and TTT. Results: Age, race, and marital status were significantly related to treatment choice. Patients who were nonwhite and older than 60 years were less likely to undergo RP. Black patients were 3.8 times more likely to undergo RT compared with white patients. The median TTT was 75 days. Longer time delays were significant in patients of older age, nonwhite race/ethnicity, non-English speakers, those with noncommercial insurance, and those with non-married status. The average TTT of high-risk patients was 25 days longer than that of low-risk patients. Patients who underwent RT had an average TTT that was 34 days longer than that of RP patients. Conclusions: The treatment choice and TTT of patients with prostate cancer are affected by demographic factors such as age, race, marital status, and insurance, as well as clinical factors including stage and risk category of disease.

9.
Int J Radiat Oncol Biol Phys ; 101(5): 1029-1038, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29859794

RESUMO

PURPOSE: To assess the optimal structure of an introductory curriculum (IC) for radiation oncology residents, including the perceived utility of a 2-day off-site "boot camp," and evaluate the success of a pilot introductory radiation oncology curriculum (IROC) based on these initial data. METHODS AND MATERIALS: In the first phase, anonymous, web-based surveys were sent to US radiation oncology program directors and residents. Likert-type scores (1, not at all; 5, extremely) are reported as the median and interquartile range. Using the phase 1 results, IROC was developed, piloted, and evaluated. RESULTS: Of the 89 program directors and 697 residents, 47 (53%) and 165 (24%) responded, respectively. Of the 89 program directors, 37 (79%) reported offering a formal IC. However, only 83 residents (50%) reported having a formal IC. Program directors reported resident preparation for clinical training as "moderate" (median 3, interquartile range 2-3) on entering residency and "moderate" (median 3, interquartile range 3-4) after IC completion (P = .03). However, residents only believed they were "slightly" prepared (median 2, interquartile range 1-2) on entering residency and "moderately" (median 3, interquartile range 2-3) prepared after IC completion (P < .01). Program directors believed an off-site boot camp would be of "moderate" utility (median 3, interquartile range 3-4) with participation limited by funding (57%). Residents without an IC reported that having an IC would be "quite" beneficial (median 4, interquartile range 3-5). Residents preferred instruction before the clinical training (49%) and over 1 week (40%). Both program directors and residents rated lectures on radiation emergencies and simulation highly. Using these data, IROC was developed and piloted with incoming residents at 4 institutions. After IROC, residents reported improvement in overall preparedness for clinical training (before: median 1, interquartile range 1-2; vs after: median 3, interquartile range 2-3; P < .01) and among specific practice domains. CONCLUSIONS: Beginning radiation oncology residents frequently lack structured introductory curricula but desire instruction before the clinical training with a focus on practical aspects (emergency management, contouring). Program directors recognize the value of both off-site and on-site boot camps. An on-site IC could mitigate funding barriers. A standardized IC, IROC, piloted at 4 programs, showed promising outcomes.


Assuntos
Currículo , Educação de Pós-Graduação em Medicina , Determinação de Necessidades de Cuidados de Saúde , Radioterapia (Especialidade)/educação , Competência Clínica , Humanos , Internet , Internato e Residência , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Estados Unidos
10.
Int J Radiat Oncol Biol Phys ; 101(4): 779-783, 2018 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-29748099

RESUMO

PURPOSE: To evaluate the rate of non-doctoral student authors publishing in an academic journal over time and to analyze the effects student authors have on the scholarly impact of corresponding authors (CAs) by comparing their respective H-index (Hi). METHODS AND MATERIALS: A database was created of authors who published articles in the International Journal of Radiation Oncology, Biology, Physics in 2006, 2010, and 2014 that included CA, degree, and student author designations. Corresponding authors' His were obtained from Scopus (scopus.com). Student authorship rates were compared between the sampled years. The data were divided into 2 groups: CAs publishing with student authors (SA) and those without (nSA). The CAs' median and mean His with standard deviation and a 95% confidence interval were compared between SA and nSA. RESULTS: A total of 1728 published articles were identified with 1477 unique CAs. The percentage of published articles with student authors increased from 44.4% in 2006, to 52.9% in 2010, to 55.9% in 2014 (P = .0003). In overall analysis, mean Hi was higher for SA as compared with nSA (24.3 vs 22.9), although this did not achieve statistical significance (P = .094). Mean Hi (standard deviation) in 2006, 2010, and 2014 was 27.9 (16.6), 23.6 (16.7), and 18.5 (14.6), respectively. Mean Hi was significantly higher for SA compared with nSA in the years 2006 (29.5 vs 26.6, P = .048) and 2010 (24.9 vs 21.9, P = .038) but not in 2014 (18.5 vs 18.4, P = .963). CONCLUSION: Student authorship rates in the International Journal of Radiation Oncology, Biology, Physics are increasing. The data suggest that student participation in research may benefit both corresponding and student authors. Creating and expanding research programs to integrate research into medical education may enhance students' experience and encourage interest in radiation oncology.


Assuntos
Autoria , Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Radioterapia (Especialidade)/estatística & dados numéricos , Comunicação Acadêmica/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Pesquisa Biomédica/educação , Bases de Dados Bibliográficas , Humanos , Radioterapia (Especialidade)/educação , Comunicação Acadêmica/normas
13.
Artigo em Inglês | MEDLINE | ID: mdl-30775692

RESUMO

This paper presents the design evolution, fabrication, and testing of a novel patient and organ-specific, 3D printed phantom for external beam radiation therapy of prostate cancer. In contrast to those found in current practice, this phantom can be used to plan and validate treatment tailored to an individual patient. It contains a model of the prostate gland with a dominant intraprostatic lesion, seminal vesicles, urethra, ejaculatory duct, neurovascular bundles, rectal wall, and penile bulb generated from a series of combined T2-weighted/dynamic contrast-enhanced magnetic resonance images. The iterative process for designing the phantom based on user interaction and evaluation is described. Using the CyberKnife System at Boston Medical Center a treatment plan was successfully created and delivered. Dosage delivery results were validated through gamma index calculations based on radiochromic film measurements which yielded a 99.8% passing rate. This phantom is a demonstration of a methodology for incorporating high-contrast magnetic resonance imaging into computed-tomography-based radiotherapy treatment planning; moreover, it can be used to perform quality assurance.

14.
J Cancer Educ ; 33(6): 1176-1180, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-28488259

RESUMO

Medical students at our institution all take a pre-clinical oncology course as well as a clinical radiation oncology didactic session during their clinical curriculum. The objective of this analysis is to demonstrate the impact of the radiation oncology didactic on medical student knowledge of core oncology concepts. All students received a standardized didactic lecture introducing students to core concepts of general oncology and radiation. We administered an 18-question pretest and a posttest examining student knowledge between 2012 and 2015. Changes in student responses between pre-test and post-tests were analyzed to evaluate the effectiveness of the didactic session. Over the course of three years, 319 (64.4%) of 495 students who completed the Radiology block completed both the pre-test and post-test. The average student test grade improved from 62.0% on the pretest to 69.6% on the posttest (p < 0.001). By category, students increased their score from 81.4% to 89.8% (p < 0.001) in general oncology, from 59.9% to 69.9% (p < 0.001) in breast oncology, from 43.0% to 51.0% (p < 0.001) in prostate oncology, and from 71.3% to 75.7% (p = 0.003) in radiation oncology. Students showed increases in knowledge across general oncology, prostate oncology, breast oncology, and radiation oncology.


Assuntos
Competência Clínica , Avaliação Educacional , Radioterapia (Especialidade)/educação , Estudantes de Medicina , Currículo , Feminino , Humanos , Masculino , Radio-Oncologistas
15.
Int J Womens Health ; 9: 887-896, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29255374

RESUMO

Purpose and objective: The aim of this study was to examine the impact of patient demographics, tumor characteristics, and treatment type on time to treatment (TTT) in patients with breast cancer treated at a safety net medical center with a diverse patient population. Patients and methods: A total of 1,130 patients were diagnosed and treated for breast cancer between 2004 and 2014 at our institution. We retrospectively collected data on patient age at diagnosis, race/ethnicity, primary language spoken, marital status, insurance coverage, American Joint Committee on Cancer (AJCC) stage, hormone receptor status, and treatment dates. TTT was determined from the date of breast cancer biopsy to treatment start date. Nonparametric Mann-Whitney U-test (or Kruskal-Wallis test when appropriate) and multivariable quantile regression models were employed to assess for significant differences in TTT associated with each factor. Results: Longer median TTT was noted for Black (P=0.002) and single (P=0.002) patients. AJCC stage IV patients had shorter TTT (27.5 days) compared to earlier AJCC patients (36, 35, 37, 37 days for stage 0, I, II, III, respectively), P=0.028. Age, primary language spoken, insurance coverage, and hormone receptor status had no significant impact on TTT. On multivariate analysis, race/ethnicity remained the only significant factor with Black reporting longer TTT, P=0.025. However, race was not a significant factor for time from first to second treatment. More Black patients were noted to be single (P<0.0001) and received chemotherapy as first treatment (P=0.008) compared to White, Hispanic, or other race/ethnicity patients. Conclusion: In this retrospective analysis, Black patients had longer TTT, were more likely to receive chemotherapy as first treatment, and have a single marital status. These patient factors will help identify vulnerable patients and guide further research to understand the barriers to care and the impact of treatment delays on outcomes.

16.
Eur Radiol ; 27(11): 4797-4803, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28526892

RESUMO

OBJECTIVES: To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors. METHODS: This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration. RESULTS: Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration. CONCLUSIONS: Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration. KEY POINTS: • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.


Assuntos
Biópsia com Agulha de Grande Calibre/instrumentação , Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Mamografia , Biópsia com Agulha de Grande Calibre/métodos , Mama/patologia , Densidade da Mama , Neoplasias da Mama/patologia , Feminino , Humanos , Imageamento Tridimensional , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
J Appl Clin Med Phys ; 18(3): 37-43, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28407345

RESUMO

PURPOSE: In SBRT for prostate cancer, higher fractional dose to the rectum is a major toxicity concern due to using smaller PTV margin and hypofractionation. We investigate the dosimetric impact on rectum using endorectal balloon (ERB) in prostate SBRT. MATERIALS AND METHODS: Twenty prostate cancer patients were included in a retrospective study, ten with ERB and 10 without ERB. Optimized SBRT plans were generated on CyberKnife MultiPlan for 5 × 7.25 Gy to PTV under RTOG-0938 protocol for early-stage prostate cancer. For the rectum and the anterior half rectum, mean dose and percentage of volumes receiving 50%, 80%, 90%, and 100% prescription dose were compared. RESULTS: Using ERB, mean dose to the rectum was 62 cGy (P = 0.001) lower per fraction, and 50 cGy (P = 0.024) lower per fraction for the anterior half rectum. The average V50% , V80% , V90% , and V100% were lower by 9.9% (P = 0.001), 5.3% (P = 0.0002), 3.4% (P = 0.0002), and 1.2% (P = 0.005) for the rectum, and lower by 10.4% (P = 0.009), 8.3% (P = 0.0004), 5.4% (P = 0.0003), and 2.1% (P = 0.003) for the anterior half rectum. CONCLUSIONS: Significant reductions of dose to the rectum using ERB were observed. This may lead to improvement of the rectal toxicity profiles in prostate SBRT.


Assuntos
Neoplasias da Próstata/radioterapia , Radiocirurgia/instrumentação , Radiocirurgia/métodos , Reto/efeitos da radiação , Humanos , Masculino , Neoplasias da Próstata/patologia , Doses de Radiação , Lesões por Radiação/prevenção & controle , Radiometria , Estudos Retrospectivos
18.
J Cancer Educ ; 32(1): 31-34, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-26341219

RESUMO

The purpose of this descriptive analysis is to describe a formal method to foster interest in oncology among medical students through a Student Oncology Society (SOS). The SOS is a student-run multidisciplinary interest group that offers oncology-related events to interested medical students at the Boston University School of Medicine (BUSM). We employed a student survey to document the impact of the SOS on student interest in careers in oncology and students' perceived accessibility of mentors in oncology at our institution. All 35 students who attended the event reported that they found the discussion panels "valuable" or "somewhat valuable." A minority of students reported that student and faculty were "somewhat accessible" or "very accessible." At the end of the survey, 37 % of the students reported that a discussion of career paths of various physicians or a student/resident panel on oncology would be beneficial. By giving students an opportunity to learn about the different medical and surgical specialties within oncology, the SOS is able to cultivate early interest and understanding of the field of oncology among pre-clinical medical students. Further work must be done to connect medical students to faculty mentors in oncology. Although this short report provides a model for other medical schools to begin their own student oncology interest groups, further rigorous evaluation of pre-clinical oncology education initiatives are necessary in order to document their long-term impact on medical education.


Assuntos
Escolha da Profissão , Educação Médica , Oncologia/educação , Mentores/psicologia , Estudantes de Medicina/psicologia , Humanos , Aprendizagem , Sociedades Médicas , Inquéritos e Questionários
20.
J Cancer Educ ; 31(4): 679-686, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26123764

RESUMO

Cancer is the second leading cause of death in the USA, but there is minimal data on how oncology is taught to medical students. The purpose of this study is to characterize oncology education at US medical schools. An electronic survey was sent between December 2014 and February 2015 to a convenience sample of medical students who either attended the American Society for Radiation Oncology annual meeting or serve as delegates to the American Association of Medical Colleges. Information on various aspects of oncology instruction at participants' medical schools was collected. Seventy-six responses from students in 28 states were received. Among the six most common causes of death in the USA, cancer reportedly received the fourth most curricular time. During the first, second, and third years of medical school, participants most commonly reported 6-10, 16-20, and 6-10 h of oncology teaching, respectively. Participants were less confident in their understanding of cancer treatment than workup/diagnosis or basic science/natural history of cancer (p < 0.01). During the preclinical years, pathologists, scientists/Ph.D.'s, and medical oncologists reportedly performed the majority of teaching, whereas during the clinical clerkships, medical and surgical oncologists reportedly performed the majority of teaching. Radiation oncologists were significantly less involved during both periods (p < 0.01). Most schools did not require any oncology-oriented clerkship. During each mandatory rotation, <20 % of patients had a primary diagnosis of cancer. Oncology education is often underemphasized and fragmented with wide variability in content and structure between medical schools, suggesting a need for reform.


Assuntos
Estágio Clínico/normas , Competência Clínica/normas , Currículo/normas , Educação de Graduação em Medicina/organização & administração , Oncologia/educação , Neoplasias/prevenção & controle , Educação de Graduação em Medicina/normas , Humanos , Estudantes de Medicina , Inquéritos e Questionários
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