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From Cancer Patient to Cancer Survivor: Lost in Transition
and risk assessment (Personal communication, L. Wilkerson, David Geffen School of Medicine at University of California–Los Angeles, January 13, 2005). A survey on survivorship knowledge and experience has been designed as a needs assessment or program evaluation tool. The survivorship curriculum and materials will be available through the UCLA Cancer Education Project’s website (UCLA, 2005a) and the Health Education Assets Library (HEAL), an online, peer-reviewed health education repository (HEAL, 2005). As survivorship curricula and materials are developed, they can also be shared between medical schools through the MedEd Portal, a new online repository of education materials maintained by AAMC (2005b).
Graduate Medical Education
The curricula followed in graduate medical education is determined under the auspices of the American Council of Graduate Medical Education. According to a review of the curriculum for medical oncology, some of the 28 content areas listed are related to survivorship (e.g., knowledge of drug toxicity, rehabilitation, and psychosocial aspects of clinical management of the cancer patient), but no specific mention of cancer survivorship is made (Winn, 2002). The specific items to be included in the oncology fellowship training curriculum are not within the purview of the American Board of Internal Medicine and Accreditation Council for Graduate Medical Education. ASCO has assumed the task of creating a “Competence Comprising Curriculum” for medical oncology subspecialty training in 14 key areas, including supportive care and survivorship (Muss et al., 2005; ASCO, 2005a). For the primary care disciplines of internal medicine and family medicine, a review of curriculum guidelines found a lack of mention of cancer survivorship.
A review of selected general oncology and disease-specific medical textbooks found only one text that addressed cancer survivorship specifically (i.e., Diseases of the Breast, Harris et al., 2004) (Winn, 2000). Most of the other textbooks had certain survivorship issues represented, but there was relatively little discussion of practical clinical management issues. Several standard primary care and internal medicine textbooks were reviewed from the perspective of whether a primary care physician wishing to learn about the management of cancer survivors could readily obtain an overview of the entire area. The texts were not comprehensive or detailed enough in their coverage to serve as primary sources of information for the clinician seeking to effectively manage these patients. Available texts may, however, serve a purpose in highlighting some of the major problem areas of cancer survivorship and alerting the caregiver of the need to consult additional sources for more comprehensive information.