Cancer survivorship training: a pilot study examining the educational gap in primary care medicine residency programs.

BACKGROUND: Cancer survivors need high-quality follow-up care that addresses long-term problems related to cancer and their treatment. With growing numbers of cancer patients transitioning from oncological treatment to survivorship care, primary care physicians (PCPs) will play a major role in the delivery of survivorship care.

OBJECTIVE: This pilot study was undertaken to provide initial insights into internal medicine (IM) and family medicine (FM) residents' educational experience, training, and preparedness for practice as healthcare providers of adult cancer survivors (ACS).

DESIGN: This study utilizes an anonymous cross-sectional, electronic survey of a sample of US IM and FM residents.

PARTICIPANTS: A total of 77 residents in their PGY-3 year of training responded to the survey, including 53 IM (69%) and 24 FM (31%) residents.

RESULTS: The majority (97%) of respondents performed as PCPs for ACS during their training, and 81% expected to take care of such patients in the future. However, only a minority reported feeling very comfortable in this role or very confident of identifying cancer recurrence and potential long-term effects of cancer treatment (13%, 21%, and 15%, respectively). Formal education in survivorship care was reported by 27% of residents and was modestly associated with knowledge responses. High clinical exposure (defined as having ≥10 opportunities to perform as the PCP for ACS) was significantly associated with self-reported knowledge, comfort level, and self-confidence in being able to evaluate and manage potential long-term effects of cancer treatment and their symptoms.

CONCLUSIONS: Our results suggest there is a substantial disconnect between resident's educational experience, training, and self-reported preparedness for practice in cancer survivorship in both IM and FM training specialties.

IMPLICATIONS FOR CANCER SURVIVORS: Inadequate training in cancer survivorship represents a barrier to providing adequate cancer follow-up. Inexperience or unawareness of essential survivorship issues could lead to mistakes which affect survivors' health and timely assessment of long-term cancer-associated morbidity. As PCPs will play a key role in the delivery of survivorship care, effective educational opportunities and achievement of competencies in adult cancer survivorship care by primary care trainees are needed.