1. Nov 22, 2004 Undergraduate Medical Education ONCOLOGY BLOCK

2. Nov 22, 2004 Project to Advance Clinical Education “Keeping PACE with the health care needs of our region” Medical School: 3 rd & 4 th year curriculaMedical School: 3 rd & 4 th year curricula New rotations, more ambulatory care, more disease-oriented / patient-oriented (not department-based)New rotations, more ambulatory care, more disease-oriented / patient-oriented (not department-based) New “Oncology Block” rotationNew “Oncology Block” rotation –Required in new 4 th year curriculum for all students –Not intended to duplicate material, but to expand it to the “next level” –Planned for 2006-2007 (pilot run next year?) Medical School: 3 rd & 4 th year curriculaMedical School: 3 rd & 4 th year curricula New rotations, more ambulatory care, more disease-oriented / patient-oriented (not department-based)New rotations, more ambulatory care, more disease-oriented / patient-oriented (not department-based) New “Oncology Block” rotationNew “Oncology Block” rotation –Required in new 4 th year curriculum for all students –Not intended to duplicate material, but to expand it to the “next level” –Planned for 2006-2007 (pilot run next year?)

3. Nov 22, 2004

4. Oncology Block: Outcomes Fundamentals of oncologyFundamentals of oncology –Tumor biology, carcinogenesis, epidemiology, tumor markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issues Multidisciplinary approach to prevention, diagnosis, treatment, support, & rehabilitationMultidisciplinary approach to prevention, diagnosis, treatment, support, & rehabilitation Natural history, diagnosis, and management of common cancers (breast, colon, lung)Natural history, diagnosis, and management of common cancers (breast, colon, lung) Conveying difficult newsConveying difficult news Fundamentals of oncologyFundamentals of oncology –Tumor biology, carcinogenesis, epidemiology, tumor markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issues Multidisciplinary approach to prevention, diagnosis, treatment, support, & rehabilitationMultidisciplinary approach to prevention, diagnosis, treatment, support, & rehabilitation Natural history, diagnosis, and management of common cancers (breast, colon, lung)Natural history, diagnosis, and management of common cancers (breast, colon, lung) Conveying difficult newsConveying difficult news

5. Nov 22, 2004 Oncology Block: Components Home BaseHome Base –Program-based; patient-oriented; multidisciplinary experience Core ActivitiesCore Activities –Didactic program, mock student tumor boards, POM/PBL/EBM sessions, journal club, etc. Mandatory ExperiencesMandatory Experiences –Mammography, XRT, Pain clinic, Hospice… Home BaseHome Base –Program-based; patient-oriented; multidisciplinary experience Core ActivitiesCore Activities –Didactic program, mock student tumor boards, POM/PBL/EBM sessions, journal club, etc. Mandatory ExperiencesMandatory Experiences –Mammography, XRT, Pain clinic, Hospice…

6. Nov 22, 2004 Home Base Eligible Programs: Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyEligible Programs: Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, Pathology Preceptors -- CRITICAL: to ensure comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLPreceptors -- CRITICAL: to ensure comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOL Patient-oriented total cancer care, involving all disciplines (surgery, med onc, rad onc, …)Patient-oriented total cancer care, involving all disciplines (surgery, med onc, rad onc, …) NOT 1 wk surgery, 1 wk med onc, 1 wk rad oncNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc Eligible Programs: Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyEligible Programs: Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, Pathology Preceptors -- CRITICAL: to ensure comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLPreceptors -- CRITICAL: to ensure comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOL Patient-oriented total cancer care, involving all disciplines (surgery, med onc, rad onc, …)Patient-oriented total cancer care, involving all disciplines (surgery, med onc, rad onc, …) NOT 1 wk surgery, 1 wk med onc, 1 wk rad oncNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc

7. Nov 22, 2004 Core Activities Didactic Program (~ 5 hrs)Didactic Program (~ 5 hrs) –Introduction to Total Cancer Care (~ 1/2 hr) –Diagnostic modalities (~ 3/4 hr) –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) –Diagnostic modalities (~ 3/4 hr) –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 ? )

8. Nov 22, 2004 Core Activities Conveying difficult news (2 hrs)Conveying difficult news (2 hrs) –Video-taped role playing; discussion; analysis –Topics: A new cancer diagnosisA new cancer diagnosis Staging and prognostic informationStaging and prognostic information Treatment optionsTreatment options QOL issues (e.g. mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)QOL issues (e.g. mastectomy, colostomy, 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; analysis –Topics: A new cancer diagnosisA new cancer diagnosis Staging and prognostic informationStaging and prognostic information Treatment optionsTreatment options QOL issues (e.g. mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)QOL issues (e.g. mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE) End-of-life issues and hospiceEnd-of-life issues and hospice

9. Nov 22, 2004 Core Activities Journal Club (2 hrs)Journal Club (2 hrs) –Surg, Med Onc, Rad Onc, Rad, Path, Statistician, Basic Scientist –Students present; faculty assist w review –Demonstrate the role of EBM and critical review of the literature (statistical methods, study design, data analysis) –Pick hot or controversial topics (e.g. HRT) Journal Club (2 hrs)Journal Club (2 hrs) –Surg, Med Onc, Rad Onc, Rad, Path, Statistician, Basic Scientist –Students present; faculty assist w review –Demonstrate the role of EBM and critical review of the literature (statistical methods, study design, data analysis) –Pick hot or controversial topics (e.g. HRT)

10. Nov 22, 2004 Core Activities 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, Leukemia/Lymphoma, GI, Thoracic, Breast –Surgery, Med Onc, Rad Onc, Radiology, Pathology, Basic Scientist (?), other (e.g. speech pathologist etc) –Only 4-6 cases (real or simulated) selected to discuss diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, etc) –One 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, Leukemia/Lymphoma, GI, Thoracic, Breast –Surgery, Med Onc, Rad Onc, Radiology, Pathology, Basic Scientist (?), other (e.g. speech pathologist etc) –Only 4-6 cases (real or simulated) selected to discuss diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, etc) –One patient chosen for student role-playing

11. Nov 22, 2004 Core Activities POM/PBL/EBM Sessions (1.5 hrs x 4)POM/PBL/EBM Sessions (1.5 hrs x 4) –Topics: Breast cancer, Lung cancer, Colorectal cancer, Pain Management / Palliative Care / Hospice –Case histories and specific objectives provided to students at the beginning of the rotation –Access to “experts” throughout the rotation –Students present at the end of the rotation –Content experts provide feedback, supplement the information, and “wrap-up” the session –Bibliographies 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: Breast cancer, Lung cancer, Colorectal cancer, Pain Management / Palliative Care / Hospice –Case histories and specific objectives provided to students at the beginning of the rotation –Access to “experts” throughout the rotation –Students present at the end of the rotation –Content experts provide feedback, supplement the information, and “wrap-up” the session –Bibliographies will be available on the web

12. Nov 22, 2004 Mandatory Experiences Students must pick 5 of the following: Screening at Lifetime (incl seeing a mammogram being done, and doing 3 CBE’s under supervision)Screening at Lifetime (incl seeing a mammogram being done, and doing 3 CBE’s under supervision) Genetic Counselling - one consultationGenetic Counselling - one consultation Radiation Treatment (incl simulation, marking of fields, designing shields, tattooing…)Radiation Treatment (incl simulation, marking of fields, designing shields, tattooing…) Oncologic emergencies and medical complications of cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)Oncologic emergencies and medical complications of cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s) Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia) Hospice in the communityHospice in the community Students must pick 5 of the following: Screening at Lifetime (incl seeing a mammogram being done, and doing 3 CBE’s under supervision)Screening at Lifetime (incl seeing a mammogram being done, and doing 3 CBE’s under supervision) Genetic Counselling - one consultationGenetic Counselling - one consultation Radiation Treatment (incl simulation, marking of fields, designing shields, tattooing…)Radiation Treatment (incl simulation, marking of fields, designing shields, tattooing…) Oncologic emergencies and medical complications of cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)Oncologic emergencies and medical complications of cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s) Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia) Hospice in the communityHospice in the community

13. Nov 22, 2004 AcknowledgmentsAcknowledgments Paul Wallach, Associate Dean, Curriculum and Medical EducationPaul Wallach, Associate Dean, Curriculum and Medical Education PACE committee membersPACE committee members Oncology Block committee membersOncology Block committee members Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV) Paul Wallach, Associate Dean, Curriculum and Medical EducationPaul Wallach, Associate Dean, Curriculum and Medical Education PACE committee membersPACE committee members Oncology Block committee membersOncology Block committee members Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)

14. Nov 22, 2004 H. Lee Moffitt Cancer Center