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Undergraduate Medical Oncology

At the University of Alberta, the Faculty of Medicine and Dentistry divides undergraduate medical education into preclinical and clinical years.  The preclinical years are the first two years of education and there is a dedicated Oncology Block at the end of the second year.  The course, known as DMED525, is four weeks long and is a comprehensive course that covers the principles of diagnostics, therapeutics, and end of life care for patients with malignant hematologic illnesses as well as solid tumours.  In addition, there is integration with psychosocial and spiritual issues associated with cancer patients and the cancer treatment experience as it affects the patient and their family.
 
The course is administered by the Faculty of Medicine and Dentistry (Undergraduate Medical Education UME) department.  The course is structured to deliver its content in accordance with guidelines set out by UME with respect to hours spent in didactic lecture versus other learning activities.  At present, the course delivers its content through the use of lectures, Discovery Learning activities, teaching OSCE's, clinical skills training, clinical placements (optional) and patient-based experiential learning.  Faculty from all divisions of the Department of Oncology actively contribute to the course through teaching, facilitating Discovery Learning, and allowing students to shadow them for clinical placements.
 
Content covered in the course is extensive.  Students learn about various modalities for diagnosing cancer and once diagnosed, what prognostic and predictive factors impact on treatment decisions.  Basics of radiation therapy and drug therapy (hormones, chemotherapy, biologics) are covered as well as discussions related to the principles of therapy (curative versus palliative) and toxicities and side effects that might be anticipated.  Benign hematology is reviewed and serves as an introduction to malignant hematology.  Students learn the basics about acute myeloid and lymphoid leukemias, multiple myeloma, lymphoma, and myeloproliferative disorders.  Solid tumour teaching focuses on breast, lung, GI (focus on colorectal), and GU (focus on prostate and testis) cancers.  Topics not covered during this block (i.e. gynecological malignancies) are covered in other preclinical blocks and are not revisited so as to reduce redundancy.  Interwoven with the clinical oncology teaching, patient centered care activities are also taught and discussed.  This includes how to break bad news, dealing with changes in body image, psychosocial impact on the family during cancer treatment, and grief and mourning.  Palliative care topics are also discussed, including pain management, delirium, dyspnea, and bowel complications.
 
The course is evaluated through formal examinations that include multiple choice and written questions, an OSCE examination to evaluate the students' ability to break bad news and there are also work at home questions that are graded.
 
During the clinical years, students also have the option of requesting a medical or radiation oncology elective or an elective in palliative care.  These rotations are not mandatory but student interest is generally good and at any given time there are usually medical students rotating through the Cross Cancer Institute in these various disciplines.