Medical Student Exposure to Cancer Patients Whilst on Clinical Placement: a Retrospective Analyses of Clinical Log Books

Breast cancer: presentation, investigation and management

Breast cancer is the most common global malignancy and the leading cause of cancer deaths. Despite this, undergraduate and postgraduate exposure to breast cancer is limited, impacting on the ability of clinicians to accurately recognise, assess and refer appropriate patients. This article provides a comprehensive review of the pathology, epidemiology, clinical presentation, referral pathways and management of breast cancer in the UK. It also describes how to conduct a thorough clinical breast examination.

A paediatric logbook: Millstone or milestone?

Logbooks are ubiquitous in undergraduate and postgraduate medical education. Here, two alumni who are in the early phase of their career, reflect on their experience in their undergraduate paediatric term and how this was shaped by their mandatory paediatric logbook.

Student Exposure to Cancer Patients: an Analysis of Clinical Logbooks and Focus Groups in Clinical Year Medical Students

Despite cancer being the leading cause of mortality, cancer education and patient exposure are lacking in many medical schools. The aim of this study was to evaluate the nature of cancer patient exposure, relative to the clinical setting for medical students on placement and to explore their experiences. Participants were asked to maintain a logbook of cancer patient encounters and were invited to attend a structured focus group upon completion of the academic year. Eleven students submitted logbooks (rr = 6.15%) and eight participated in the focus groups (4.47%). A total of 247 cancer patient encounters were recorded. Third-year students primarily saw cancer patients in surgery (18.62%) and general practice (8.50%), whilst final year students saw cancer patients most frequently in palliative care (35.22%) and ENT surgery (13.77%). Students highlighted that the quality of their interactions with cancer patients varied significantly between clinical settings. Outpatient clinics and surgical in-patients had the lowest level of interaction, with students having a predominantly observatory role. Repeated themes of uncertainty and awkwardness regarding history, examination and discussing death and dying were outcomes of the thematic analysis. Exposure to cancer patients remains highly variable and opportunistic. Students voiced concerns for preparedness to practice and many found it worrisome that they will likely examine a primary cancer when they have graduated, without having done so during their training. Our study suggests that a more structured approach to teaching and clinical exposure to cancer patients is required.