Patient management including referral and multidisciplinary management

From Oncology for Medical Students
Ideal oncology curriculum > Patient management including referral and multidisciplinary management

Objective 3.1

At graduation, the student should be able to:

a) demonstrate awareness of clinical practice guidelines, where available, for appropriate referral patterns -- understand the need for evidence based medicine
b) identify effective means of communication to enhance the clinical management of patients with cancer
c) demonstrate an understanding of the need to recognise, address and manage psychological distress in the patient
d) recognise the importance of coordinated care in optimising overall management of patients
e) recognise their own clinical limitations and understand that help from those with better specialist knowledge can be sought
f) demonstrate an ability to seek help at an appropriate level of urgency, using appropriate methods of communication, from appropriate sources
g) demonstrate an attitude of accepting responsibility for ensuring continuity of care for patients over the long-term, and at all hours
h) describe the integration of treatment modalities
i) survey treatment options available to the patient, including a knowledge of unproven/experimental therapies, as distinct from alternative therapies
j) demonstrate an understanding of the range of medical and non-medical health professionals involved in cancer care
k) demonstrate an understanding of the effective use of a multidisciplinary management team.

Prerequisite knowledge

  • Basic understanding of how the health care system works

Representative questions that suggest the required depth of knowledge

1. Write a referral letter from a general practitioner to a specialist about a patient who you suspect has a lung cancer (develop hypothetical case data). Include all the information you consider relevant for the specialist to manage the case in conjunction with the patient’s GP (yourself).

Essential in answer:

  • History taking
  • Examination
  • Succinct communication and relevance

2. You have referred Mrs Briggs, a 47 year old woman, to a general surgeon who you went to university with because she has a suspicious lump in her left breast. Mrs Briggs asks you about the multidisciplinary clinic that she has read about in the National Health and Medical Research Council consumer guide. How do you respond?

Essential in answer:

  • Knowledge of multidisciplinary management of cancer
  • Knowledge of specialist v non-specialist management of cancer
  • Ability to review management in light of evidence

3. Write a submission to a hospital administration justifying the establishment of a multidisciplinary breast clinic in your large teaching hospital.

Essential in answer:

  • Knowledge of the different disciplines that contribute to successful cancer management
  • Knowledge of models that integrate disciplines
  • Understanding of cost-benefits