The medical oncology curriculum covers five domains including basic sciences, public health, professional qualities, basic principles of the management of cancer and specific cancers of the body. The fifth domain requires knowledge in the management of all cancers, specifically assessing, managing and treating cancers in specific areas of the body. The majority of clinical training in this domain is routinely performed in an outpatient setting with experience from new patient clinical encounters (NPCE). We aimed to assess whether NPCE over two years addresses this part of the medical oncology curriculum.
Basic clinical information and management from all NPCE seen from February 2014 to February 2016 in the medical oncology outpatient’s department over three sites in QLD, Australia was collected prospectively. The diagnosis and management of patients were recorded.
In total 290 patients were seen across three sites; Site A (N=96) over 6 months, Site B (N=72) over 6 months and Site C (N=122) over 12 months. The median age was 64 (range 21-93) years. Common sites of solid organ malignancies included breast (N=70), gastrointestinal (N=74), pulmonary (N=31), prostate (N=23), head & neck (N=20), genitourinary (N= 16) and gynaecological (N=15). Other sites included melanoma (N=8), central nervous system (N=5), neuro-endocrine (N=9), anal canal (N=4), sarcoma (N=1) and others (N=14). The intent of treatment was curative in 164 patients. Prescribed drug treatment included chemotherapy (N=151) and targeted agents including endocrine management (N=49).
Our experience has shown that a medical oncology trainee in Queensland has exposure to a variety of clinical encounters and management approaches in multiple tumour streams. To assess, manage and treat cancers, NPCE are a great learning opportunity. Areas of improvement include further exposure to sarcoma. A three-year clinical training programme could address this and consolidate our training with a greater ability to make treatment decisions.