Designing a solid tumor oncology curriculum for medical residents: A single-institution needs assessment.

Abstract

e21011 Background: Patients with solid tumor malignancies comprise a large portion of inpatient medicine admissions at many academic institutions; however, structured solid tumor oncology education for internal medicine (IM) residents is variable. At our institution, IM residents do not rotate through inpatient solid tumor oncology services, limiting formal exposure to cancer-specific management principles. We conducted a needs assessment to assess resident exposure to hospitalized solid tumor patients, oncology-specific teaching, and comfort managing common inpatient oncology conditions. Methods: We developed an anonymous survey to assess IM resident experiences in the University of Pennsylvania Health System (UPHS) caring for hospitalized patients with solid tumor malignancies, then distributed the survey via email from November 12, 2025 to January 23, 2026. Survey domains included demographic data, perceived frequency of formal teaching, clinical setting and frequency of inpatient solid oncology care, and comfort managing solid oncology topics. Comfort was assessed using a 5-point Likert scale (1, “very uncomfortable” to 5, “very comfortable”). Open-ended questions captured qualitative feedback. Results: A total of 18 categorical IM residents at UPHS completed the survey (response rate = 21%) including PGY-1 (n = 2), PGY-2 (n = 6), and PGY-3 (n = 10) respondents. All reported caring for hospitalized patients with solid tumors. Most residents (n = 15; 83%) reported providing care on four or more inpatient services including general medicine, medical ICU, pulmonology, and gastroenterology rotations. However, most residents (n = 16; 89%) reported “never” or “infrequently” receiving solid oncology teaching. Residents reported lowest comfort managing oncologic emergencies, namely "superior vena cava syndrome” (mean comfort score 2.33) and “cord compression” (mean 3.11), as well as “cancer-treatment toxicity” (mean 3.11). Greater clinical exposure generally correlated with higher reported comfort, though persistent gaps remained for “cord compression” and “malignant bowel obstruction”. In qualitative responses, residents expressed strong interest in formal education on initial diagnosis and inpatient work-up of new malignancy (n = 6), including treatment intent and inpatient diagnostic testing. Residents preferred online mobile-friendly resources (n = 16; 89%) over printable materials (n = 6; 33%) and video content (n = 6; 33%). Conclusions: Internal medicine residents frequently provide inpatient care to patients with solid tumors across non-oncology rotations, yet most report limited formal oncology teaching and low comfort managing oncologic emergencies and treatment complications. These findings will inform the development of targeted, mobile-friendly educational resources to improve resident preparedness in caring for hospitalized oncology patients.