Cancer knowledge and skills of interns in Australia and New Zealand in 2001: comparison with 1990, and between course types

Over the past decade, four Australian medical schools (Flinders University, the University of Queensland, the University of Sydney, and the University of Melbourne) have introduced four-year medical courses accessible only to graduates. Introducing these graduate medical programs (GMPs) required review and reform of the curricula. Five or six-year undergraduate courses continue in other Australian and New Zealand medical schools, although there have been varying degrees of curriculum reform. Shorter courses may have less range and depth of content. Any such trend would run counter to efforts to increase teaching on cancer, which is a major and increasing health problem in both countries. Past surveys of medical students’ oncology knowledge and skills have not indicated a high standard of training in this area. This survey of interns was conducted in early 2001 with a questionnaire based on one for an earlier study. The aims were: To compare the cancer knowledge and skills of interns in 2001 who graduated from GMP courses with those from non-GMP courses; and To compare the cancer knowledge and skills of interns in 2001 with those who completed the survey in 1990.

ObjectiveTo compare the cancer knowledge and skills of interns in 2001 who graduated from graduate medical program (GMP) courses with those from non-GMP courses, and to compare the cancer knowledge and skills of interns in 2001 with those who completed a similar survey in 1990.

DesignQuestionnaire survey of recently graduated interns in a random sample of Australian and New Zealand hospitals. The questionnaire was designed to allow direct comparison with the 1990 survey, and was guided by the Australian Cancer Society’s Ideal Oncology Curriculum for Medical Schools.

Results443 interns completed the survey (response rate, 62%; 42 were excluded, leaving 401 surveys for analysis: 118 from GMP courses and 283 from non-GMP courses). Interns from GMP courses felt more competent than those from non-GMP courses at discussing death (P = 0.02), breaking bad news (P = 0.04) and advising on smoking cessation (P = 0.02), but less competent at preparing a patient for a hazardous procedure (P = 0.02). More GMP interns would refer a breast cancer patient to a multidisciplinary clinic (83% versus 70%; P = 0.03). Knowledge about cancer risks and prognosis was significantly less in GMP interns, but GMP interns rated their clinical skills, such as taking a Pap smear, higher than non-GMP interns. The GMP and non-GMP groups did not differ in their exposure to cancer patients, but compared with 1990 interns recent graduates had less exposure to patients with cancer.

ConclusionsGMP curricula appear to have successfully introduced new course material and new methods of teaching, but have not always succeeded in producing doctors with better knowledge about cancer. Recent graduates have less exposure to cancer patients than those who trained 10 years ago.

(Source: Medical Journal of Australia; Michael B Barton, Martin H Tattersall, Phyllis N Butow, Sally Crossing, Konrad Jamrozik, Bin Jalaludin, Christopher H Atkinson and Sharon E Miles; MJA 2003 178 (6): 285-289)