Doctors ill-prepared to offer radiation oncology: study

An alarming number of doctors leave medical school with a poor understanding of the benefits of radiation oncology, leading to worse outcomes for cancer patients who miss out on treatment, it has been claimed .

The authors of an Australian-first survey say that about 50% of oncology patients would benefit from radiation therapy for curative or palliative treatment but uptake rates in Australia sit at between 26% and 38%.

They say the low uptake is at least in part caused by doctors’ lack of knowledge about the benefits of radiation oncology. And they have pointed the finger at medical schools for failing to focus on the treatment in undergraduate and post-graduate education.

In their survey of curriculum content of 16 medical faculties in Australia and New Zealand, they found:

  • Almost all (94%) surveyed faculties had no formal radiation oncology curriculum.
  • At least half did not offer formal radiation oncology teaching to all medical students.
  • Up to 81% of medical students did not receive dedicated clinical exposure in radiation oncology.
  • Clinical exposure comprised under five days of the medical degree in 44% of courses.

The survey results are “alarming because large numbers of students may be graduating with very little knowledge of a primary cancer treatment modality, leading to underutilisation of radiotherapy and increased morbidity and mortality of patients,” according to Dr Luke Nicholls, a radiation oncology registrar at Princess Alexandra Hospital, Brisbane, and his co-authors in the Journal of Medical Imaging and Radiation Oncology.

“It is well established that a lack of oncology teaching translates into poor oncological knowledge and confidence among graduating doctors,” they write.

The authors point to a 2003 survey of 443 interns from Australian and New Zealand hospitals, which found 20% of respondents had never attended a clinic in medical oncology, radiation oncology or palliative care.

“This places graduating doctors and their future patients at a significant disadvantage, especially given the vast and increasing burden of cancer in the community.”

They also note that many medical faculties are updating their curriculum but with no plans to improve radiation oncology components. The authors argue that during this period of reform, advocates should be pushing for beefed up radiation oncology content in study programs.

“This study supports the need for formal advocacy to improve radiation oncology education in medical schools and will contribute to new national recommendations for radiation oncology curriculum development.”

Dr Apsara Windsor, the senior supervisor of the project and Director of Radiation Oncology, Central Coast Cancer Centre, NSW, said radiation therapy could be the preferred and/or most effective treatment option for many cancer patients.

“All cancer patients for whom radiation therapy might be an option should see a radiation oncologist to understand the pros and cons. Only then can they make fully informed decisions about treatment. All doctors having knowledge of the role of radiation therapy is vital in ensuring this occurs,” she said.

“In the meantime, I would urge Australian and New Zealand patients and health professionals keen to discover more about radiation therapy to visit the Targeting Cancer website (

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