Medical students get little exposure to cancer patients

Cancer care

By Michael Woodhead

1 May 2018

Most medical students have little or no meaningful exposure to patients with common cancers, a study from WA suggests.

Fewer than half of students saw patients with breast (45%) colorectal (41%) or lung cancer (32%) while on clinical placements, an analysis of patient encounters by 88 students at the University of Notre Dame Australia School of Medicine, Fremantle, has found.

Most of the encounters with cancer patients occurred during surgery placements or during a brief placement in palliative care, when they may have had only limited interaction with the patient, according to study author Darren Starmer, Head of Assessment at the university’s medical school.

Published in the Journal of Cancer Education, the study reviewed clinical placement logbooks covering 9430 patient encounters by medical students on the four-year postgraduate degree. It found that 8.8% of the patients seen had a diagnosis of cancer.

Students were most likely to encounter patients with lower GI cancers (18%) followed by haematological (10%), upper GI (10%) and respiratory (9%) cancers.

However most cancer patients were seen on surgical and ENT placements, when there may have been little opportunity for talking to or examining the patient. Relatively few cancer patients were seen on general medicine placements and hardly any were encountered during general practice placements.

Only 16% of students spent time in a cancer service unit, 2% in a haematology unit and none spent any time in a radiation oncology unit.

The review concludes that the lack of exposure to cancer patients and lack of time spent in cancer units is worrying, particularly for the students who go on to have medical careers in primary care or non-cancer specialities.

“Experiencing multidisciplinary patient management, observing the various treatment modalities and developing an understanding of modern cancer medicine are invaluable learning opportunities that will benefit both the student and their future patients,” it says.

Exposure to cancer patients during training is also important to dispel myths and misconceptions and to adequately prepare the attitudes of clinicians when caring for cancer patients.

“Regardless of their chosen career path, all doctors will encounter cancer patients, making it crucial that they possess the knowledge, skills and attitudes to provide high quality care,” it concludes.

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