Abstract：
Radiation therapy (RT) is a critical component of multidisciplinary cancer care, but has inconsistent curricular exposure. We characterize the radiation oncology (RO) content on the standardized undergraduate medical examinations by comparing its context and prevalence with other domains in oncology. National Board of Medical Examiners (NBME) self-assessments and sample questions for the United States Medical Licensing Exam (USMLE) Steps 1-3 and NBME clinical science shelf examinations were accessed (n = 3878). Questions were inductively analyzed for content pertaining to oncology and treatment modalities of RT, systemic therapy (ST), and surgical intervention (SI). Questions were coded using USMLE Physician Tasks/Competencies and thematic analysis. Descriptive statistics and analyses using the Kruskal-Wallis test are reported. A total of 337 questions (8.6%) within the USMLE and shelf exams included oncology content, with 101 questions (2.6%) referencing at least one cancer treatment modality (n = 35 RT, 45 ST, 57 SI). Treatment questions were more common on USMLE Step 2 CK (n = 35/101, 32%) compared to Step 1 (n = 23/101, 23%) and Step 3 (n = 8/101, 8%) (p < 0.001). RT was significantly less likely to be the correct answer (2/35, 6%) compared to ST (4/45, 9%) and SI (18/57, 32%) (p = 0.003). Therapeutic oncology questions are uncommon on the examination material, with an under-representation of radiation-related content, and contextual bias favoring surgical approaches. We advocate for greater RO involvement in the content creation of such examinations to help trainees better understand multidisciplinary cancer care.
摘要：
放射治疗（RT）是多学科癌症治疗的重要组成部分，但课程暴露不一致。我们通过将其背景和患病率与肿瘤学中的其他领域进行比较，来表征标准化本科医学检查中的放射肿瘤学（RO）内容。国家医学检查委员会（NBME）自我评估和美国医学许可考试（USMLE）步骤1-3和NBME临床科学架检查的样本问题被访问（n=3878）。对有关肿瘤学和RT治疗方式的问题进行了归纳分析，全身治疗（ST），和手术干预（SI）。使用USMLE医师任务/能力和主题分析对问题进行编码。报告了使用Kruskal-Wallis检验的描述性统计和分析。USMLE和货架考试中共337个问题（8.6％）包括肿瘤学内容，有101个问题（2.6%）参考至少一种癌症治疗方式（n=35RT，45ST,57SI)。与步骤1（n=23/101，23％）和步骤3（n=8/101，8％）相比，USMLE步骤2CK（n=35/101，32％）的治疗问题更常见（p<0.001）。与ST（4/45，9％）和SI（18/57，32％）相比（p=0.003），RT是正确答案的可能性明显较小（2/35，6％）。治疗肿瘤学问题在检查材料上并不常见，与辐射相关的内容代表性不足，和有利于手术方法的上下文偏见。我们主张RO更多地参与此类考试的内容创建，以帮助学员更好地了解多学科癌症护理。
