Impact of a Radiation Oncology Elective on the Careers of Young Physicians: Update on a Prospective Cohort Study

Received Jan 27, 2013. Accepted for publication Feb 2, 2013Cancer is the second leading cause of death in the United Statesand Western Europe. Approximately 60% of cancer patientsreceive radiation therapy. Although European medical schoolshave signiﬁcantly improved oncologic training in the past decade(1), the United States has not, and radiation oncology is particu-larly underrepresented in US medical curricula (2). As survivor-ship from cancer continues to increase, medical practitionersthroughout the world will need to know the basics of radiationtherapy and its role in the multimodal management of cancers,outcomes, and toxicities.In July 2010, Jefferson Medical College of Thomas JeffersonUniversity began offering a 3-week clinical rotation in radiationoncology. The rotation was structured on Accreditation Councilfor Graduate Medical Education core competencies (3), interna-tional oncologic training recommendations (4), and previouslyreported methods shown to be successful in teaching radiationoncology, including didactic lectures, hands-on contouringsessions, student presentations, clinical time with patients andphysicians, and examinations (5, 6).The rotation improved studentknowledge of radiation oncology, including aspects of clinicaloncology, radiobiology, and medical physics, and was appreciatedby students and faculty (7). In 2012, young physicians were sentfollow-up surveys and examinations to (1) evaluate the long-lasting impact of the rotation on young physicians’ careers; (2)assess memory retention; (3) identify ideal methods of teachingradiation oncology; and (4) make a recommendation regarding theintegration of a radiation oncology rotation in medical curricula.Of the 56 students who initially took the rotation, 41 respondedto the survey (response rate, 73%). The median follow-up timewas approximately 1.5 years. Most students enrolled in the rota-tion planned to go into primary care. All respondents considereda career in academics. Sixty-four percent of respondents plannedon seeing oncologic patients frequently or very frequently in theircareer. The long-term effects of the rotation (Fig. 1A) spanned allAccreditation Council for Graduate Medical Education corecompetencies, including patient care, medical knowledge,practice-based learning and improvement, interpersonal andcommunication skills, professionalism, and systems-based prac-tice (3). Additional beneﬁts included knowing when to consultradiation oncologists, learning about advanced technology, iden-tifying radiation therapy emergencies, and taking care of cancerpatients (mean weighted Likerts, >4.5/5). Young physiciansrecommended teaching their peers about radiation oncologythrough an optional rotation (4.4) and did not believe it affectedother graduate medical training (1.6). On examinations (Fig. 1B),the prerotation, immediate postrotation, and survey results inclinical oncology were 58%, 83%, 64%; radiobiology, 21%, 44%,60%; and radiophysics, 62%, 94%, 83%.We conclude that a clinical rotation in radiation oncology haspositive effects on the careers of young physicians, independent ofcareer plan. After taking the rotation, young physicians were moreprepared to treat cancer patients and consult radiation oncologistsfor appropriate conditions. Moreover, previous studies have shownbeneﬁts of teaching medical professionals end-of-life situation