Mahoney Mary T, Linkowski Lauren C, Wu Trudy C, Chen Jie Jane, Neilsen Beth K, Thompson Petria S, Mix Michael D, Sura Karna T, Mattes Malcolm D
Transitional Year Residency Program, Garnet Health Medical Center, 707 East Main St, Middletown, NY, 10940, USA.
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
J Cancer Educ. 2025 Feb;40(1):79-87. doi: 10.1007/s13187-024-02475-0. Epub 2024 Jul 13.
Radiation therapy (RT) is a critical component of multidisciplinary cancer care, but has inconsistent curricular exposure. We characterize the radiation oncology (RO) content on the standardized undergraduate medical examinations by comparing its context and prevalence with other domains in oncology. National Board of Medical Examiners (NBME) self-assessments and sample questions for the United States Medical Licensing Exam (USMLE) Steps 1-3 and NBME clinical science shelf examinations were accessed (n = 3878). Questions were inductively analyzed for content pertaining to oncology and treatment modalities of RT, systemic therapy (ST), and surgical intervention (SI). Questions were coded using USMLE Physician Tasks/Competencies and thematic analysis. Descriptive statistics and analyses using the Kruskal-Wallis test are reported. A total of 337 questions (8.6%) within the USMLE and shelf exams included oncology content, with 101 questions (2.6%) referencing at least one cancer treatment modality (n = 35 RT, 45 ST, 57 SI). Treatment questions were more common on USMLE Step 2 CK (n = 35/101, 32%) compared to Step 1 (n = 23/101, 23%) and Step 3 (n = 8/101, 8%) (p < 0.001). RT was significantly less likely to be the correct answer (2/35, 6%) compared to ST (4/45, 9%) and SI (18/57, 32%) (p = 0.003). Therapeutic oncology questions are uncommon on the examination material, with an under-representation of radiation-related content, and contextual bias favoring surgical approaches. We advocate for greater RO involvement in the content creation of such examinations to help trainees better understand multidisciplinary cancer care.
放射治疗（RT）是多学科癌症治疗的关键组成部分，但在课程中的接触情况并不一致。我们通过将放射肿瘤学（RO）内容与肿瘤学其他领域的背景和患病率进行比较，来描述标准化本科医学考试中的放射肿瘤学内容。获取了美国国家医学考试委员会（NBME）针对美国医师执照考试（USMLE）第1 - 3步的自我评估和样题，以及NBME临床科学结业考试（n = 3878）。对与肿瘤学以及RT、全身治疗（ST）和手术干预（SI）的治疗方式相关的内容进行归纳分析。使用USMLE医师任务/能力和主题分析对问题进行编码。报告描述性统计数据以及使用克鲁斯卡尔 - 沃利斯检验的分析结果。USMLE和结业考试中共有337道题（8.6%）包含肿瘤学内容，其中101道题（2.6%）提及至少一种癌症治疗方式（n = 35道RT题、45道ST题、57道SI题）。与USMLE第1步（n = 23/101，23%）和第3步（n = 8/101，8%）相比，治疗相关问题在USMLE第2步临床知识（CK）中更为常见（n = 35/101，32%）（p < 0.001）。与ST（4/45，9%）和SI（18/57，32%）相比，RT作为正确答案的可能性显著更低（2/35，6%）（p = 0.003）。治疗肿瘤学问题在考试材料中并不常见，与放射相关的内容占比不足，且存在偏向手术方法的背景偏差。我们主张RO更多地参与此类考试的内容创建，以帮助学员更好地理解多学科癌症治疗。
