R1 Objectives
Oncology
The oncology rotation is six to seven weeks in length. The R1 provides coverage of the floors and admits oncology patients. The R1 second assists on appropriate cases. During this rotation the R1 takes overnight call at Highland Hospital and attends oncology clinic one to two times a week.
Medical Knowledge
- Develop a core knowledge of:
- Risk factors associated with gynecological malignancies
- Historical and physical findings associated with a gynecological malignancy
- Screening tests for gynecological malignancies
- Chemotherapeutic agents used to treat gynecological malignancies, the major side effects, and management of these side effects
- General radiation principles and the most common complications
- Management of the abnormal pap smear
- Vulvovaginal dysplasia
- Pain control in the patient with cancer
- Postoperative care
- Laser principles
- Pelvic anatomy
Patient Care
- Obtain a targeted history in patients with a suspected gynecological malignancy
- Order and interpret appropriate screening tests
- Order and interpret appropriate labs for patients receiving chemotherapy
- Evaluate patients for side effects from chemotherapy
- Prescribe treatment for common side problems such as nausea/vomiting and pain control
- Perform routine postoperative care
- Diagnose post-operative complications:
- Wound infection
- Ileus
- Bowel obstruction
- Fluid overload
- DVT and PE
- Describe the indications and components of bowel prep
- Perform colposcopy in the patient with vulvovaginal or cervical dysplasia
- Obtain informed consent for transfusions
Interpersonal and Communication Skills
- Counsel patients in regard to:
- Pain control options
- Postoperative expectations
- Transfusion of blood products
- Communicate effectively with other members of the team, nursing staff and ancillary services
- Work with consult services to provide comprehensive care
Professionalism
- Demonstrate sensitivity to a terminally ill patient and her family
- Demonstrate an understanding of the stages of grief and how it impacts a patient diagnosed with cancer.
- Demonstrate an understanding of patient’s different religious preference and understand how it impacts patient’s decisions and desires
Practice Based Learning
- Assist the team in counseling families regarding code status
- Understand the resources available in the chaplain’s office for families
- Work with social work to provide necessary services for patients after discharge
System Based Practice
- Describe how cancer screening can prevent malignancies
- Explore how outpatient chemotherapy versus inpatient chemotherapy impacts health care costs
Learning Resources
- The Resident Room has major gynecology textbooks and further oncology literature is available in the oncology office including slides
- The team rounds with the oncology attending on a daily basis for bedside teaching and directed patient care
- Residents attend Thursday morning Grand Rounds followed by protected teaching time from 9-11am.
- Each resident prepares a “E-Tumor Board”, a short case presentation for distribution to the residency and to post on the internet
Evaluations
- Faculty and resident colleagues are encouraged to provide direct verbal feedback so that resident performance can be commended or improved during the rotation.
- Residents are evaluated via a Web-based evaluation system at MyEvaluations.com at the end of each rotation using a standardized evaluation form given to supervising OB/GYN attendings and upper-level residents. Attending evaluations are available for immediate review by the resident once completed.
- Problems, which appear to be of a more urgent nature, will be brought immediately to the attention of the resident and residency program director for discussion
- Residents will receive a form at the end of each rotation via MyEvaluations.com soliciting feedback regarding the rotation, upper-level residents, and faculty. This information is shared anonymously and used for course/faculty improvement activities.
