Assessing Impact Of Inpatient Rotations On Resident Interest In Hematology-Oncology.
JOURNAL OF CLINICAL ONCOLOGY(2020)
摘要
11031 Background: Working as a hematologist-oncologist is rewarding yet challenging. As cancer cases increase, there is a growing need to recruit more oncologists. It has been hypothesized that earlier exposure to oncology may improve resident interest in the field. This is often achieved by rotations on inpatient oncology wards, which represents only a small subset of the clinical work typical in hematology-oncology. We looked to assess whether early exposure to an inpatient oncology rotation impacts pursuit of this career path. Methods: Categorical interns in Internal Medicine at the University of Florida during year 2017-2018 were surveyed anonymously before and after their inpatient oncology rotation. Confidential identifiers were used to pair surveys. Similar surveys were used in the cardiology and gastroenterology rotations to allow for comparison. The survey included descriptor words to choose when describing the field. These words were categorized as either positive or negative. Results: Thirty-three interns were surveyed. Seventeen surveys were able to be paired (52% response rate) in oncology. Cardiology had 15 paired survey responses and gastroenterology had 13 paired responses. Using a 4-point Likert scale, interest in hematology-oncology decreased overall from 3.12 to 2.82 (p = 0.059) while interest in pursuing a fellowship remained the same. Stress levels were increased slightly from 2.30 to 2.05 (p = 0.564). Cardiology also saw a decrease in interest in the field from 3.53 to 2.93 (p = 0.007) but also an increase in pursuing fellowship from 2.20 to 2.60 (p = 0.014) and decreased stress from 3.13 to 2.67 (p = 0.020). Gastroenterology saw a decrease in interest in the field as well from 3.46 to 2.92 (p = 0.020). Interest in pursuing a fellowship and stress levels were not significantly different for gastroenterology. Field descriptors including “challenging,” “scared,” and “excited” decreased the most while “confident,” “inspired,” and “motivated” increased the most when describing hematology-oncology. Conclusions: While interest in this field was negatively impacted, stress levels associated with the field decreased. Furthermore, field descriptors were generally more positive and optimistic in the post-rotation setting. Though not statistically significant, these findings suggest that interns see oncology as less stressful and feel more capable after inpatient exposure during intern year. As much of hematology-oncology practice is outpatient, increasing intern exposure in this area may further improve perception and recruitment to the field.
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