General Objectives
- The following EPAs pertain to clinical rotations during the first year of training:
- Foundation EPA #3: “Assessing patients and integrating clinical information in the evaluation of disease processes”
- The following conditions must be met:
- Direct observation and/or case review by supervisor and can consist of direct observation of history; direct observation of communication with patients; case discussion or chart review
- Collect at least 10 observations of achievement
- At least 2 of each type of observation listed above
- At least 2 each for medicine, surgery, oncology, and pediatrics
- For the PGY1 AP resident completing EPAs during their Radiation Oncology rotation, ensure you select “oncology” for this EPA.
At least 1 assessment from a staff supervisor in each setting
- Core EPA #18A: “Participating in direct patient care activities that highlight clinicopathological correlation”
- Part A: Clinical setting
- Direct observation and/or case discussion by supervisor, this may include clinicians, pathologists, or senior trainees (TTP residents, fellows) in clinical or pathology disciplines
- Setting: cancer clinic; colposcopy clinic; endoscopy clinic; dermatology clinic; genetics counselling; other
- Collect 3 observations of achievement
At least 2 different clinical settings
The PGY1 Anatomical Pathology resident is expected to:
Principal Objectives
- To further develop clinical skills, ability to analyze common problems in radiation oncology in the ambulatory setting and will gain experience managing the care of inpatients with cancer
Medical Expert Role
- Demonstrate the ability to perform a focused history and physical exam and an appropriate diagnostic impression to be formulated with the differential diagnosis in patients with oncologic disease.
- Present cases in a clear, concise, integrated, and problem-based manner.
- Understand and appreciate the clinical presentation of patients with various malignancies (egs. gynecological, breast, head and neck, respiratory, genitourinary, gastrointestinal, germ cell tumors, etc.) in order to guide to diagnosis, staging, treatment and follow-up of tumors.
- Sufficient time should be spent in clinics with staff radiation oncologists, in order to gain exposure to how the radiation oncologist utilizes information from the pathologist to guide their treatment plan.
- Perform histories and physicals, diagnostic evaluations and staging appropriate to specific malignancies.
- Understand clinical consequences/side effects of radiation therapy and how these relate to pathological changes secondary to radiation therapy
- Learn about and develop a basic understanding of the various treatment modalities utilized by radiation oncologists (eg. Various radiation therapy regimens for different types of carcinomas, etc) and when radiation therapy is in fact appropriate
- Learn some basic principles of radiation therapy, side effects, and management of side effects (acute and chronic toxicities associated)
- Develop an understanding of when disease is incurable, and gain exposure to palliative treatment and its social and ethical implications.
Communicator Role
- Effectively advocate and relay patient problems and works out possible solutions with other members of the health care team.
- Develop rapport and healthy therapeutic alliance with patients and family members.
- Clearly, consistently and accurately communicate the patient diagnosis, management plan, and prognosis with the patient and relevant family members and decision makers.
- Demonstrate facility regarding issues of informed consent, breaking bad news, capacity to consent, disclosure of adverse events, and end of life discussions.
- Continuously and consistently represent the voice of the patient in health care team discussions (patient advocate).
Collaborator Role
- Describe the role and function of each member of the multi-disciplinary team.
- Recognize and integrate into case management of other health care providers including surgeons, medical oncologists, dieticians, palliative care workers, necrosis, psychiatrists and social workers.
- Participate in multidisciplinary rounds as appropriate.
- Develop an understanding of when disease is incurable, and gain exposure to palliative treatment and its social and ethical implications.
- Participate in family meetings as appropriate.
- Work collaboratively with primary care physicians to ensure continuity of care upon discharge.
- Maintain collegial and healthy relationships with all consulting services.
- Foster respect for and appreciation of the importance of communication with allied health care workers and referring physicians in the care of the patients.
- Recognize source of conflict between different health care professionals.
- Dictation of succinct and informative discharge summaries.
Manager Role
- Formulate an appropriate investigative approach (utilizing the questioning approach to the care care) addressing quality of life and cost-benefit ratios.
- Understand the indications as well as the limitations and complications of various radiological investigations of common oncology problems.
- Learn how to effectively “complete tasks” in a timely and complete manner within the hospital.
- Describe the community and outpatient resources available to care for the cancer patient (eg. homecare, chemotherapy courses, convalescent care, rehabilitation centers, long term care facilities).
- Manage time while on the ward, balancing learning, patient care, and personal health, whilst recognizing personal limits.
Scholar Role
- Present assigned learning topics to the team as appropriate.
- Use patient encounters as a stimulus to further reading and review of the current literature.
- Record personal learning objectives during the rotation and take responsibility for self- managing your own learning objectives documented at the beginning of the rotation.
- Seek ongoing feedback from teachers and modify learning objectives as necessary.
Professional Role
- Take positive steps to maintain a healthy and positive attitude in yourself and to promote it in others.
- Demonstrate appropriate relationships with patients, family members, and setting limits where appropriate.
- Showing integrity and honesty and a high level of responsibility towards patient care.
- Demonstrate appropriate relationships with all staff physicians and consultants.
- Show up on time and attend all appropriate learning sessions and rounds.
- Complete all necessary evaluations on time.
- Adhere to hospital rules and accepted standards of dress while working.
Health Advocate
- Recognized the role played by physicians in the healthcare system.
- Appreciate patient autonomy and the religious, ethnic, and psychosocial factors which influence the doctor-patient relationship and to take such factors into account when pursuing problems, informed consent and understanding patient decisions.
Updated April, 2022