Introduction

Cancer accounts for almost one in every four deaths and is the second most common cause of death in the USA. However, formal exposure to oncology is limited during the traditional pre-clinical and clinical aspects of undergraduate medical education [5, 1, 12]. Recognizing the need for more structured oncology education for the physician workforce as a whole, medical schools have increased exposure through dedicated pre-clinical oncology modules as well as clinical rotations in medical oncology, surgical oncology, and radiation oncology [2, 7, 4, 16].

An extracurricular pre-clinical interest group in oncology can provide an avenue for students to identify and pursue experiences in oncology beyond the traditional medical school curriculum. Institutions with student interest groups in dermatology, surgery, family medicine, and internal medicine among others have shown that these groups foster early career interest, create mentorship relationships between faculty and students, and encourage student research in the field [9–11, 13]. At the Boston University School of Medicine (BUSM), the Student Oncology Society (SOS), a group organized by second-year medical students and led by a faculty radiation oncologist, has hosted events to generate interest in oncology since 2006.

The purpose of the SOS is not only to cater to the needs of medical students with a particular interest in oncology but also to inform students planning to enter other specialties, since many non-oncologists are often at the frontline of screening for cancer and managing cancer survivors. To our knowledge, this is the first documented effort to describe a medical student oncology interest group.

Methods

Structure of the SOS

The SOS is a student-run multidisciplinary interest group created to promote and develop interest in oncologic specialties. The student government-funded organization is led by three to four second-year medical students and a radiation oncology faculty mentor.

SOS Events

The SOS organizes physician panels, oncology case discussions, volunteering events, shadowing opportunities, and career seminars. The career pathways event typically hosts a panel of physicians, including medical oncologists, pediatric oncologists, surgical oncologists, radiation oncologists, and others oncology specialists from our institution. These physicians discuss their career path and describe their typical work day in addition to answering questions from students. By discussing their different roles in the care and management of cancer patients, the physicians highlight the importance of a multidisciplinary cancer team. In the spring, the SOS hosts a palliative care panel consisting of a palliative care physician, a geriatric nurse practitioner, a hospital chaplain, and a bereavement care social worker. At the end of each academic year, the society hosts a student panel of fourth-year medical students and residents who are interested in careers in oncology. The SOS also collaborates with other groups, such as the Radiology Interest Group, to host interactive case discussions that discuss the imaging and management of cancer patients.

During the annual hospital-wide cancer screening day, the SOS pairs students with physicians to provide free cancer screening and education for the community. Furthermore, students are encouraged to sign up to attend tumor board meetings, shadow individual physicians, and tour the radiation oncology department to obtain early experiential exposure to cancer care.

Study Population, Design, and Statistical Analysis of Student Survey

Students attended a recent lunchtime meeting on careers in oncology featuring a surgical oncologist, a gynecologic oncologist, a medical oncologist, and a radiation oncologist to discuss careers in medicine in February of 2014. A total of 35 students attended the event and 23 completed the survey questionnaire (response rate = 65.7 %). Of the 23 students, six (26 %) had attended a previous SOS event. Students were asked to complete a short, 10-question survey to evaluate their perception of oncology education at BUSM, their interest in oncology, and the usefulness of the current panel discussion. Question 1 asked if students had attended an SOS event in the past. Student responses for questions 2–10 followed a 5-point Likert scale, with a score of 3 indicating “uncertain.” The final question asked students what types of lunchtime sessions they would find most useful, with options including discussion about career paths of various physicians, multidisciplinary case study, student/resident panel on oncology, and other (please specify). All questions are listed in Table 1. The average (mean) and standard deviation were reported for each response.

Table 1 Survey questions
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Results

Summary statistics for questions 2–9 are reported in Table 2. All students reported that they were more interested in oncology now than they were before entering medical school, with average ratings of 3.74 before medical school and 4.48 now. A majority of the students (19, 83 %) reported they were either “somewhat interested” or “very interested” in oncology research. When asked about their perceived accessibility of student mentors, 15 students (65 %) reported that they were uncertain. Similarly, 14 (61 %) students reported that they were uncertain regarding the accessibility of faculty mentors. A minority of students reported that student mentors and faculty mentors were somewhat accessible or very accessible, with mean scores of 3.26 and 3.48, respectively, for each question. All students reported that they found the panel discussion event to be either “somewhat valuable” or “very valuable.”

Table 2 Student responses to survey questions
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Students who had attended previous SOS events reported a higher average interest in oncology, with a score of 4.83, as compared to a score of 4.35 among students who had not previously attended an event. Similarly, students’ perceived accessibility of faculty mentors was higher among those students who had attended previous events. Notably, the difference in the students’ interest in oncology before entering medical school was not significantly different between the two groups, at 3.67 and 3.76, respectively. Similarly, the difference in students’ interest in oncology research was not significantly significant, at 4.17 and 4.29, respectively.

At the end of the survey, students were asked, “What would be most valuable for a lunch meeting in the future?” Four (17 %) students chose “multidisciplinary case study,” nine (39 %) students chose “discussion about career paths of various physicians,” and four (17 %) chose “student/resident panel on oncology.” There was also the option of “other” where students could fill in their own ideas about future lunch topics. Those who chose “other” had ideas such as “information about clinical and hospital opportunities for students,” “information for BU students interested in pediatric oncology,” and “how to pursue oncology research and resources for students.”

Discussion

The primary goal of the SOS is to stimulate interest in oncology by exposing medical students to the field. The rise in interest in oncology among first-time attendees during the time of the survey as compared to before they entered medical school may reflect the results of the Oncology Education Initiative (OEI) at our institution [8, 2, 7]. The OEI has integrated oncology education throughout our medical school curriculum. During the pre-clinical curriculum, students learn via oncology cases during the first-year anatomy class and complete a dedicated pre-clinical oncology block led by a faculty radiation oncologist during the second year. During the clinical curriculum, all students receive a didactic lecture on radiation oncology during the required radiology block and approximately 50 % of students spend time in the radiation oncology clinic. Students can also complete rotations in medical oncology and surgical oncology during the core internal medicine and surgery blocks during the third year. Finally, students have the option of pursuing a range of clinical and research electives in oncological specialties during the fourth year.

The success of the SOS is reliant on its ability to create relationships between faculty and medical students. Early mentorship has been shown to have a significant impact on career selection, career success, research productivity, and student wellbeing across a variety of specialties [14, 3, 15]. Our findings show that students who had attended multiple SOS events perceived faculty mentors in oncology to be more accessible than students who had attended only a single SOS event. Typically, medical students have limited direct contact with oncologists until their clinical rotations, and the only contact during the pre-clinical years are during large, lecture hall-style lectures on oncology. SOS events featuring oncologists and SOS-sponsored shadowing experiences allow students to personally connect with physician-mentors. At our institution, of the 58 alumni who have participated in the radiation oncology mentorship initiative, 17 (29.3 %) pursued residency in radiation oncology and many more expressed interest in other oncological specialties [6].

Our study is limited by the fact that students who attended the SOS event and completed surveys were likely students with a baseline interest in oncology and not a representative sample of the medical school class as a whole. Furthermore, because we surveyed a single event, it is difficult to draw direct conclusions regarding the efficacy of SOS events as a whole. We also did not assess other avenues that students use to identify mentors in oncology.

Although this short report provides a model for other medical schools to begin their own student oncology interest groups, further rigorous evaluation of pre-clinical oncology education initiatives are necessary in order to document their long-term impact on medical education. In the future, we hope to expand clinical opportunities for first- and second-year medical students with a focus on identifying faculty mentors for interested medical students.