Oncology DIO

Nov 22, 2004Nov 22, 2004

Undergraduate Medical EducationUndergraduate Medical EducationONCOLOGY BLOCKONCOLOGY BLOCK

Undergraduate Medical EducationUndergraduate Medical EducationONCOLOGY BLOCKONCOLOGY BLOCK

Nov 22, 2004Nov 22, 2004

PProject to roject to AAdvance dvance CClinical linical EEducationducation“Keeping PACE with the health care needs of our region”“Keeping PACE with the health care needs of our region”

PProject to roject to AAdvance dvance CClinical linical EEducationducation“Keeping PACE with the health care needs of our region”“Keeping PACE with the health care needs of our region”

• Medical School: Medical School: 33rdrd & 4 & 4thth year curricula year curricula• New rotations, more ambulatory care, more New rotations, more ambulatory care, more

disease-oriented / patient-oriented (not disease-oriented / patient-oriented (not department-based)department-based)

• New New “Oncology Block”“Oncology Block” rotation rotation– Required in new 4Required in new 4thth year curriculum for all students year curriculum for all students– Not intended to duplicate material, but to expand it to Not intended to duplicate material, but to expand it to

the “next level”the “next level”– Planned for 2006-2007 (pilot run next year?)Planned for 2006-2007 (pilot run next year?)

• Medical School: Medical School: 33rdrd & 4 & 4thth year curricula year curricula• New rotations, more ambulatory care, more New rotations, more ambulatory care, more

disease-oriented / patient-oriented (not disease-oriented / patient-oriented (not department-based)department-based)

• New New “Oncology Block”“Oncology Block” rotation rotation– Required in new 4Required in new 4thth year curriculum for all students year curriculum for all students– Not intended to duplicate material, but to expand it to Not intended to duplicate material, but to expand it to

the “next level”the “next level”– Planned for 2006-2007 (pilot run next year?)Planned for 2006-2007 (pilot run next year?)

Nov 22, 2004Nov 22, 2004

Total Cancer Care ApproachTotal Cancer Care Approach

DiagnosisDiagnosis

PrognosisPrognosis

TreatmentTreatment

Primary TherapyPrimary Therapy--MultimodalityMultimodality

Post TherapyPost Therapy--Surveillance Surveillance

--ConsolidationConsolidation

RelapsedRelapsedDiseaseDisease

Salvage TherapySalvage Therapy-Phase I program-Drug Discovery

Behavioral ResearchBehavioral Research& Palliative Care& Palliative Care

Behavioral Behavioral OncologyOncology

Cancer Control &Cancer Control &PreventionPrevention

Outreach to theOutreach to theCommunityCommunity

HealthHealthOutcomesOutcomes CancerCancer

PatientPatient

Cancer Cancer ControlControl

Risk FactorsRisk FactorsGeneticsGenetics

ScreeningScreeningPreventionPreventionNutritionNutritionLife StyleLife Style

Molecular OncologyMolecular OncologyFunctional GenomicsFunctional Genomics

Functional Functional GenomicsGenomicsImaging Imaging

Modalities:Modalities:NanotechnologyNanotechnology

Nov 22, 2004Nov 22, 2004

Oncology Block: OutcomesOncology Block: OutcomesOncology Block: OutcomesOncology Block: Outcomes

• Fundamentals of oncologyFundamentals of oncology– Tumor biology, carcinogenesis, epidemiology, tumor Tumor biology, carcinogenesis, epidemiology, tumor

markers, pathology, pharmacology, immunology, markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issuesissues, end-of-life issues

• Multidisciplinary approachMultidisciplinary approach to prevention, to prevention, diagnosis, treatment, support, & rehabilitationdiagnosis, treatment, support, & rehabilitation

• Natural history, diagnosis, and management of Natural history, diagnosis, and management of common cancers (breast, colon, lung)common cancers (breast, colon, lung)

• Conveying difficult newsConveying difficult news

• Fundamentals of oncologyFundamentals of oncology– Tumor biology, carcinogenesis, epidemiology, tumor Tumor biology, carcinogenesis, epidemiology, tumor

markers, pathology, pharmacology, immunology, markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issuesissues, end-of-life issues

• Multidisciplinary approachMultidisciplinary approach to prevention, to prevention, diagnosis, treatment, support, & rehabilitationdiagnosis, treatment, support, & rehabilitation

• Natural history, diagnosis, and management of Natural history, diagnosis, and management of common cancers (breast, colon, lung)common cancers (breast, colon, lung)

• Conveying difficult newsConveying difficult news

Nov 22, 2004Nov 22, 2004

Oncology Block: ComponentsOncology Block: ComponentsOncology Block: ComponentsOncology Block: Components

• Home BaseHome Base– Program-based; patient-oriented; Program-based; patient-oriented;

multidisciplinary experiencemultidisciplinary experience

• Core ActivitiesCore Activities– Didactic program, mock student tumor Didactic program, mock student tumor

boards, POM/PBL/EBM sessions, journal boards, POM/PBL/EBM sessions, journal club, club, etc.etc.

• Mandatory ExperiencesMandatory Experiences– Mammography, XRT, Pain clinic, Hospice…Mammography, XRT, Pain clinic, Hospice…

• Home BaseHome Base– Program-based; patient-oriented; Program-based; patient-oriented;

multidisciplinary experiencemultidisciplinary experience

• Core ActivitiesCore Activities– Didactic program, mock student tumor Didactic program, mock student tumor

boards, POM/PBL/EBM sessions, journal boards, POM/PBL/EBM sessions, journal club, club, etc.etc.

• Mandatory ExperiencesMandatory Experiences– Mammography, XRT, Pain clinic, Hospice…Mammography, XRT, Pain clinic, Hospice…

Nov 22, 2004Nov 22, 2004

Home BaseHome BaseHome BaseHome Base

• Eligible Programs:Eligible Programs: Breast, GI, GU, Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyCare, Senior Adult Oncology, Pathology

• Preceptors -- CRITICAL: Preceptors -- CRITICAL: to ensure to ensure comprehensive exposure -- screening, dx, comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLimaging, path, Rx, f/u, prevention, QOL

• Patient-oriented total cancer care, Patient-oriented total cancer care, involving involving all disciplines (surgery, med onc, rad onc, …)all disciplines (surgery, med onc, rad onc, …)

• NOTNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc 1 wk surgery, 1 wk med onc, 1 wk rad onc

• Eligible Programs:Eligible Programs: Breast, GI, GU, Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyCare, Senior Adult Oncology, Pathology

• Preceptors -- CRITICAL: Preceptors -- CRITICAL: to ensure to ensure comprehensive exposure -- screening, dx, comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLimaging, path, Rx, f/u, prevention, QOL

• Patient-oriented total cancer care, Patient-oriented total cancer care, involving involving all disciplines (surgery, med onc, rad onc, …)all disciplines (surgery, med onc, rad onc, …)

• NOTNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc 1 wk surgery, 1 wk med onc, 1 wk rad onc

Nov 22, 2004Nov 22, 2004

Core ActivitiesCore ActivitiesCore ActivitiesCore Activities

• Didactic Program (~ 5 hrs)Didactic Program (~ 5 hrs)– Introduction to Total Cancer Care (~ 1/2 hr)Introduction to Total Cancer Care (~ 1/2 hr)– Diagnostic modalities (~ 3/4 hr)Diagnostic modalities (~ 3/4 hr)– Cancer Sciences (~ 3 + hrs ? )Cancer Sciences (~ 3 + hrs ? )

• Carcinogenesis / Molecular oncology (RJ ? )Carcinogenesis / Molecular oncology (RJ ? )• Tumor immunology / Cancer vaccines (SD ? )Tumor immunology / Cancer vaccines (SD ? )• Drug discovery (SS ? )Drug discovery (SS ? )• Experimental therapeutics (DS ? )Experimental therapeutics (DS ? )• Risk assessment, detection, intervention (AG ?)Risk assessment, detection, intervention (AG ?)• Health outcomes (PJ ? )Health outcomes (PJ ? )• Cancer prevention & control (TS ? )Cancer prevention & control (TS ? )

• Didactic Program (~ 5 hrs)Didactic Program (~ 5 hrs)– Introduction to Total Cancer Care (~ 1/2 hr)Introduction to Total Cancer Care (~ 1/2 hr)– Diagnostic modalities (~ 3/4 hr)Diagnostic modalities (~ 3/4 hr)– Cancer Sciences (~ 3 + hrs ? )Cancer Sciences (~ 3 + hrs ? )

• Carcinogenesis / Molecular oncology (RJ ? )Carcinogenesis / Molecular oncology (RJ ? )• Tumor immunology / Cancer vaccines (SD ? )Tumor immunology / Cancer vaccines (SD ? )• Drug discovery (SS ? )Drug discovery (SS ? )• Experimental therapeutics (DS ? )Experimental therapeutics (DS ? )• Risk assessment, detection, intervention (AG ?)Risk assessment, detection, intervention (AG ?)• Health outcomes (PJ ? )Health outcomes (PJ ? )• Cancer prevention & control (TS ? )Cancer prevention & control (TS ? )

Nov 22, 2004Nov 22, 2004


• Conveying difficult news (2 hrs)Conveying difficult news (2 hrs)– Video-taped role playing; discussion; analysisVideo-taped role playing; discussion; analysis– Topics:Topics:

• A new cancer diagnosisA new cancer diagnosis

• Staging and prognostic informationStaging and prognostic information

• Treatment optionsTreatment options

• QOL issues (QOL issues (e.g.e.g. mastectomy, colostomy, mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)tracheostomy, infertility, amputation, ED, LE)

• End-of-life issues and hospiceEnd-of-life issues and hospice

• Conveying difficult news (2 hrs)Conveying difficult news (2 hrs)– Video-taped role playing; discussion; analysisVideo-taped role playing; discussion; analysis– Topics:Topics:

• A new cancer diagnosisA new cancer diagnosis

• Staging and prognostic informationStaging and prognostic information

• Treatment optionsTreatment options

• QOL issues (QOL issues (e.g.e.g. mastectomy, colostomy, mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)tracheostomy, infertility, amputation, ED, LE)

• End-of-life issues and hospiceEnd-of-life issues and hospice

Nov 22, 2004Nov 22, 2004


• Journal Club (2 hrs)Journal Club (2 hrs)– Surg, Med Onc, Rad Onc, Rad, Path, Surg, Med Onc, Rad Onc, Rad, Path,

Statistician, Basic ScientistStatistician, Basic Scientist– Students present; faculty assist w reviewStudents present; faculty assist w review– Demonstrate the role of EBM and critical Demonstrate the role of EBM and critical

review of the literature (statistical methods, review of the literature (statistical methods, study design, data analysis)study design, data analysis)

– Pick hot or controversial topics (Pick hot or controversial topics (e.g.e.g. HRT) HRT)

• Journal Club (2 hrs)Journal Club (2 hrs)– Surg, Med Onc, Rad Onc, Rad, Path, Surg, Med Onc, Rad Onc, Rad, Path,

Statistician, Basic ScientistStatistician, Basic Scientist– Students present; faculty assist w reviewStudents present; faculty assist w review– Demonstrate the role of EBM and critical Demonstrate the role of EBM and critical

review of the literature (statistical methods, review of the literature (statistical methods, study design, data analysis)study design, data analysis)

– Pick hot or controversial topics (Pick hot or controversial topics (e.g.e.g. HRT) HRT)

Nov 22, 2004Nov 22, 2004


• Mock Student Tumor Boards (1.5 hrs x 10)Mock Student Tumor Boards (1.5 hrs x 10)– GU, Melanoma, H&N, GYN, Sarc, Neuro, GU, Melanoma, H&N, GYN, Sarc, Neuro,

Leukemia/Lymphoma, GI, Thoracic, BreastLeukemia/Lymphoma, GI, Thoracic, Breast– Surgery, Med Onc, Rad Onc, Radiology, Pathology, Surgery, Med Onc, Rad Onc, Radiology, Pathology,

Basic Scientist (?), other (Basic Scientist (?), other (e.g.e.g. speech pathologist speech pathologist etcetc))– Only 4-6 cases (real or simulated) selected to discuss Only 4-6 cases (real or simulated) selected to discuss

diagnosis and treatment from a multidisciplinary point diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, clinical trials, etcetc))

– One patient chosen for student role-playingOne patient chosen for student role-playing

• Mock Student Tumor Boards (1.5 hrs x 10)Mock Student Tumor Boards (1.5 hrs x 10)– GU, Melanoma, H&N, GYN, Sarc, Neuro, GU, Melanoma, H&N, GYN, Sarc, Neuro,

Leukemia/Lymphoma, GI, Thoracic, BreastLeukemia/Lymphoma, GI, Thoracic, Breast– Surgery, Med Onc, Rad Onc, Radiology, Pathology, Surgery, Med Onc, Rad Onc, Radiology, Pathology,

Basic Scientist (?), other (Basic Scientist (?), other (e.g.e.g. speech pathologist speech pathologist etcetc))– Only 4-6 cases (real or simulated) selected to discuss Only 4-6 cases (real or simulated) selected to discuss

diagnosis and treatment from a multidisciplinary point diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, clinical trials, etcetc))

– One patient chosen for student role-playingOne patient chosen for student role-playing

Nov 22, 2004Nov 22, 2004


• POM/PBL/EBM Sessions (1.5 hrs x 4)POM/PBL/EBM Sessions (1.5 hrs x 4)– Topics:Topics: Breast cancer, Lung cancer, Colorectal Breast cancer, Lung cancer, Colorectal

cancer, Pain Management / Palliative Care / Hospicecancer, Pain Management / Palliative Care / Hospice– Case histories and specific objectives provided to Case histories and specific objectives provided to

students at the beginning of the rotationstudents at the beginning of the rotation– Access to “experts” throughout the rotationAccess to “experts” throughout the rotation– Students present at the end of the rotationStudents present at the end of the rotation– Content experts provide feedback, supplement the Content experts provide feedback, supplement the

information, and “wrap-up” the sessioninformation, and “wrap-up” the session– Bibliographies will be available on the webBibliographies will be available on the web

• POM/PBL/EBM Sessions (1.5 hrs x 4)POM/PBL/EBM Sessions (1.5 hrs x 4)– Topics:Topics: Breast cancer, Lung cancer, Colorectal Breast cancer, Lung cancer, Colorectal

cancer, Pain Management / Palliative Care / Hospicecancer, Pain Management / Palliative Care / Hospice– Case histories and specific objectives provided to Case histories and specific objectives provided to

students at the beginning of the rotationstudents at the beginning of the rotation– Access to “experts” throughout the rotationAccess to “experts” throughout the rotation– Students present at the end of the rotationStudents present at the end of the rotation– Content experts provide feedback, supplement the Content experts provide feedback, supplement the

information, and “wrap-up” the sessioninformation, and “wrap-up” the session– Bibliographies will be available on the webBibliographies will be available on the web

Nov 22, 2004Nov 22, 2004

Mandatory ExperiencesMandatory ExperiencesMandatory ExperiencesMandatory Experiences

Students must pick 5 of the following:Students must pick 5 of the following:• Screening at Lifetime (incl seeing a mammogram Screening at Lifetime (incl seeing a mammogram

being done, and doing 3 CBE’s under supervision)being done, and doing 3 CBE’s under supervision)• Genetic Counselling - one consultationGenetic Counselling - one consultation• Radiation Treatment (incl simulation, marking of Radiation Treatment (incl simulation, marking of

fields, designing shields, tattooing…)fields, designing shields, tattooing…)• Oncologic emergencies and medical complications of Oncologic emergencies and medical complications of

cancer and cancer Rx (recommend one full day with cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)one of the PTA/IHM MD’s)

• Palliative care and pain control (recommend one full Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)day in the Pain Clinic +/- interventional anaesthesia)

• Hospice in the communityHospice in the community

Students must pick 5 of the following:Students must pick 5 of the following:• Screening at Lifetime (incl seeing a mammogram Screening at Lifetime (incl seeing a mammogram

being done, and doing 3 CBE’s under supervision)being done, and doing 3 CBE’s under supervision)• Genetic Counselling - one consultationGenetic Counselling - one consultation• Radiation Treatment (incl simulation, marking of Radiation Treatment (incl simulation, marking of

fields, designing shields, tattooing…)fields, designing shields, tattooing…)• Oncologic emergencies and medical complications of Oncologic emergencies and medical complications of

cancer and cancer Rx (recommend one full day with cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)one of the PTA/IHM MD’s)

• Palliative care and pain control (recommend one full Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)day in the Pain Clinic +/- interventional anaesthesia)

• Hospice in the communityHospice in the community

Nov 22, 2004Nov 22, 2004

AcknowledgmentsAcknowledgmentsAcknowledgmentsAcknowledgments

• Paul Wallach, Paul Wallach, Associate Dean, Curriculum Associate Dean, Curriculum and Medical Educationand Medical Education

• PACE committee membersPACE committee members• Oncology Block committee membersOncology Block committee members

• Special thanks to Yash Patil (ENT) and Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Jennifer Sparks (MSIV)

• Paul Wallach, Paul Wallach, Associate Dean, Curriculum Associate Dean, Curriculum and Medical Educationand Medical Education

• PACE committee membersPACE committee members• Oncology Block committee membersOncology Block committee members

• Special thanks to Yash Patil (ENT) and Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Jennifer Sparks (MSIV)

Nov 22, 2004Nov 22, 2004

H. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer Center

Documents

Oncology DIO