Oncology

Residents work with the Park Nicollet oncology physicians on their inpatient service. The primary emphasis of the rotation is managing the multiple medical problems of oncology patients. This involves diagnosis and treatment of conditions related to malignancy, familiarity with issues related to chemotherapy treatment regimens, and management of complications related to treatment. Residents also become well acquainted with important issues related to cancer screening, cancer diagnosis, and managing end of life issues.

Oncology Rotation Teaching Module

Rotational Goal
Residents will gain an understanding about common malignancies encountered in primary care, the primary care management of common oncologic emergencies, principals of pain management and end of life care, and general medical care of the patients on the in-patient oncology service.

Rotational Objectives
By the end of the oncology rotation, residents will be able to demonstrate mastery in the diagnosis and treatment of cancer-related conditions as follows:  

(A) Patient Care
Through patient care experience gained as part of the oncology rotation, when further presented with a patient with cancer in the hospital, residents will be able to:

• Provide general medical care for inpatient oncology patients, managing common medical problems of cancer patients
• Demonstrate skills in pain management, including knowledge of equipotent doses between various forms and routes of narcotic administration
• Facilitate discussions about end of life issues and hospice

(B) Medical Knowledge
At the completion of the oncology rotation, residents will be able to demonstrate medical knowledge of common cancer-related diseases and “best practice treatment plans” suitable for the general practitioner, to include being able to:

• Describe the screening, diagnosis, and common treatment options for breast, lung, colon, and prostate cancer
• Describe appropriate diagnostic and treatment plans for common hematologic conditions, including anemia, leucopenia, and leukocytosis
• Describe appropriate management of common oncologic emergencies, including hypercalcemia, neutropenia with fever, and altered mental status
• Identify and manage issues of comorbid medical illnesses in cancer patients
• List the stages involved in the process of disease acceptance and coping in cancer patients

(C) Practice-based Learning and Improvement
At the completion of the oncology rotation, and subsequently in the family medicine clinic and inpatient setting, when presented with patients with or at risk for cancer, residents will be able to:

• Critically evaluate evidence basis for screening and treatment protocols published by various professional organizations
• Interpret and apply treatment guidelines for breast, prostate, colon, and cervical cancer screening, such as the US Preventive Services Task Force and the American Cancer Society guidelines
• In conjunction with the patient’s oncologist, modify patient treatment plans on an ongoing basis based on patient response to therapy.  In particular, re-address patient’s goals for treatment and end of life care in cancers which do not respond to treatment

(D) Interpersonal and Communication Skills
At the completion of the oncology rotation, and subsequently in the family practice clinic and inpatient setting, when presented with the cancer patient, residents will be able to:

• Use effective communication skills in family conferences and in patient interviews to facilitate compassionate, respectful, patient-centered decision-making
• Provide appropriate patient education on cancer screening, diagnosis and treatment as part of a management plan based upon the literacy level of patients and their families/care takers
• Coordinate care with patient and other team members for oncology, radiation oncology, surgery, hospice, and other care programs as appropriate

(E) Professionalism
During the oncology rotation, residents will exhibit characteristics of a professional health care provider by:

• Dressing appropriately based upon standards present for attending physicians in the clinic and/or inpatient setting associated with the oncology rotation
• Demonstrate sensitivity and responsiveness to cancer patients’ perception of illness and to the varied responses to cancer diagnosis from the patient and his/her loved ones; include these perceptions and patient preferences in formulation of management plan
• Substantively contributing to the learning community in the clinic/hospital associated with the oncology rotation, by attending and actively participating in educational and research presentations associated with the oncology rotation

(F) Systems-based Practice
At the completion of the oncology rotation, residents will be able to:

• Describe several ways in which the primary care provider and specialists can work as a healthcare team in providing effective treatment when presented with a patient with a diagnosis of cancer
• Use appropriate referral resources for medical oncology, radiation oncology, surgery, hospice, spiritual care, palliative care, pharmacy, and primary care
• Demonstrate understanding of the primary care physician’s role in cost effective screening, detection, and follow-up of patients with cancer diagnosis