RONU-4003 - General Oncology Curriculum

RONU-4003 - General Oncology Curriculum

Elective Title: General Oncology Curriculum
Course Number: RONU-4003
Elective Type: clinical Duration/Weeks: 2 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Intended for 3rd year medical students for Clerkship purposes only. C-form required, send form to Melissa Greenwald (
Responsible Faculty Director: Sandra Hatch, MD Periods Offered: 5A, 6AB, 7A, 9AB, 10AB, 12AB excluding holiday period 8 
Coordinator: Melissa Greenwald Other Faculty: Drs. Gwyn Richardson; Lois Ramondetta; Maurice Willis; Bagi Jana; Avi Markowitz; Rohit Venkatesan; Tejo Musunuru; Nabiha Aziz; Todd Swanson; Lee Wiederhold; PA; Chelsea Cochrane; Katy Keeling; & Kaitlyn Schaefer; NP-Lauren Perez & Lili Chen
Location to Report on First Day:
Department of Radiation Oncology, 1st floor of John McCullough Bldg.

To develop a general knowledge of malignancies and oncologic care, including evaluation, diagnosis and treatment with a variety of modalities such as surgery, chemotherapy and radiation treatment. In addition, exposure to hematologic cancers and unknown primary malignancies will also be provided.

Patient Care Objectives:
1. Perform appropriate histories and physicals in patients with cancers including performing appropriate disease specific physical examinations.
2. Obtain family cancer histories and identify patients who may have genetic risk for cancer.
3. Develop a problem list and differential diagnosis for cancer or treatment related problems.
4. Identify appropriate diagnostic studies for initial cancer staging, evaluation of treatment response and long-term surveillance.
5. Evaluate patients with common chemotherapeutic and radiation toxicities.
6. Evaluate common oncologic symptoms and effects.
and delayed toxicities.

The General Oncology Curriculum includes:
General Medical Oncology: 1. Observe consults: nutrition, chaplain, 2. Observe bone marrow aspiration if available services, social services, 3. Participate in Fellows Clinic, 4. Observe end of life, best supportive care discussions, 5. Attend tumor boards
Gynecologic Oncology: 1. Observe new patient H&P, 2. Observe pap smear, 3. Observe colposcopy, vulvar bx, endometrial bx, 4. Observe end of life, best supportive care discussions, 5. Attend tumor boards
Radiation Oncology: 1. Observe PET scan, 2. Observe implants (gyn onc patients) if available, 3. Observe simulation, planning and treatment, 4. Observe procedures: SRS, SBRT, nasopharyngeal scope, 5. Observe end of life, best supportive care discussions, 6. Attend tumor boards and peer review
Attend resident lectures on Thursdays as time permits
Ambulatory Treatment Center (ATC): 1. Observe nursing in ATC , 2. Observe chemotherapy infusions, 3. How to calculate chemotherapy dosing, 4. Exposure to Beacon

Description of course activities
The medical student will spend 2 weeks in the MD Anderson at UTMB Oncology department receiving a broad exposure to multiple types of malignancies and treatment modalities. The student will divide time with attendings in medical oncology, hematology, gynecologic oncology, radiation oncology, as well as with leadership in the ambulatory treatment center (ATC). These units are located on the 3rd floor of the UHC and 1st floor of the McCullough Bldg. All rotations will be in Galveston. Major Common Malignancies: breast, head and neck, colorectal, lung cancers Hematologic Malignancies: leukemia, lymphoma, myeloma Gynecologic Malignancies: cervical, ovarian, uterine cancers.

Type of students who would benefit from the course
Those considering a career in Oncology or in support of oncology patients

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00 5:00
Tuesday 8:00 5:00
Wednesday 8:00 5:00
Thursday 8:00 5:00
Friday 8:00 5:00

 Average number of patients seen per week: 50+
 Call Schedule: None

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty and Residents
  B. Frequency / Duration of Presentation(s)?
    At least one oral presentation per week during rotation
  C. Format - What guidelines are set for the student's presentation?
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
  B. Format - What guidelines are set for the student's written work?
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.