Background and acknowledgments
Educating medical students about cancer
By Martin HN Tattersall
Professor of Cancer Medicine, University of Sydney
Australian medical student education is changing. The procedures for medical student selection are being reformed in several medical schools and in some medical schools only graduate students are eligible for entry. Medical school curricula are also changing, with an increased use of problem-based learning and self-directed learning. These changes are a response to a vast increase in medical knowledge, and major change in patient expectations of the medical profession.
In addition, new disciplines have claimed curriculum time eg. molecular biology and genetics, organ imaging, health economics, clinical epidemiology and preventive health, and some diseases have become more important in the community such as cancer and HIV. The rise of consumer lobby groups is also beginning to impact on medical curricula and education.
In part via this mechanism, the House of Representatives Inquiry into the management of breast cancer identified the need to improve the training of medical students: “The Committee recommends that medical schools as a matter of urgency, examine their curricula with a view to initiating courses which will enable their (under)graduates to access information about the diagnosis, management and treatment of cancer, with particular reference to breast cancer”.
A survey of cancer education for Australian medical students in 1986 resulted in the Australian Cancer Society developing guidelines for an “ideal” cancer curriculum, circulated to all Australian medical schools in 1989. The International Union Against Cancer, a non-governmental independent association of more than 290 member organisations in more than 90 countries, published a monograph on cancer education for medical students in 1994. The monograph describes global concerns about the status of medical student education about cancer and provides a series of model curricula.
A survey of cancer curricula in Australian and New Zealand medical schools was undertaken in 1997. The survey instrument was based on the 1989 curriculum recommendations of the Australian Cancer Society. The main outcome measures were the presence and composition of cancer curriculum planning and assessment groups, and the course content and clinical exposure as they relate to cancer. The survey revealed that most medical schools now have cancer-planning groups, but the range of clinical experience of cancer patients varies considerably.
The changes in teaching methods and curriculum changes at several Australian medical schools provide an opportunity to reform and enhance cancer education of medical students. The Ideal Oncology Curriculum should be useful to those medical schools currently revising their cancer education curriculum. The task of monitoring the impact of changes in student selection, curriculum and educational methods remains, but repeating the surveys of medical schools and graduating medical students seems logical.
The Australian Cancer Society Statement of 1988 stated: “In all Australian medical schools a compulsory course in oncology should be established, this topic should be examinable, and the presence of an appropriate course should be a requirement for an accreditation review.”
It seems change has been slow and erratic. The total burden of cancer on the community and the health care professions is increasing, as is the cost per case and the overall cost. The curriculum developed by the Oncology Education Committee provides a template for improved medical student cancer education in Australia and New Zealand.
The Oncology Education Committee (OEC) wishes to thank the National Health and Medical Research Council and the National Breast Cancer Centre for permission to use their concept of a Curriculum for Australian Medical Education in Oncology (CAMEO) to provide the framework for early drafts of this document. We acknowledge the role of the CAMEO National Advisory Committee in the development of the CAMEO curriculum concept.
Members of the OEC developed the core concepts of this document in April 1998, and its subsequent progress was guided by the OEC Executive. The committee undertook extensive consultation with academic, professional and consumer bodies both locally and internationally, and wishes to thank the 68 organisations and individuals whose comments and suggestions have significantly improved this curriculum.
Educational input was provided by Dr Rob Simons of The Cancer Council NSW Professional Education and Training Unit, and detailed project work was undertaken by Mr Richard Thode. The revision of the Ideal Oncology Curriculum has been undertaken by members of the OEC. Without their dedication and commitment, this project would not have been possible.
- Lawson KA, Armstrong RM, Van der Weyden MB. A sea change in Australian medical education. Med J Aust 1998 [cited 2014 May 29];169: 653-658 Available from: https://www.mja.com.au/journal/1998/169/11/medical-education.
- House of Representatives Standing Committee on Community Affairs. Report on the management and treatment of breast cancer in Australia. Canberra: AGPS; 1995 Mar 6 [cited 2014 May 29]. Report No.: Parl Paper Number: 23. Available from: http://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?rl=reports/1995/1995_pp23.pdf.
- Tattersall MH, Langlands AO, Simpson JS, Forbes JF. Undergraduate education about cancer: a survey in Australian medical schools. Eur J Cancer 1988 [cited 2014 May 29];24(3):467-471 Available from: http://europepmc.org/abstract/MED/3383948.
- Robinson E, Sherman CD, Love RR (eds). Cancer education for undergraduate medical students: curricula from around the world. In: Robinson E. Undergraduate education around the world. Geneva: International Union Against Cancer (UICC); 1994 [cited 2014 May 29]. p. 1-9.
- Barton MB, Simons RG. A survey of cancer curricula in Australian and New Zealand medical schools in 1997. Oncology Education Committee of the Australian Cancer Society. Med J Aust 1999 Mar 1;170(5):225-7 Available from: http://www.ncbi.nlm.nih.gov/pubmed/10092922.