Choosing oncology: A cross-sectional study of Caribbean medical students’ fourth-year elective rotation preferences.

Abstract

e21035 Background: The rising global burden of cancer underscores the need to attract medical students to oncology. Caribbean medical schools play a pivotal role in training future physicians who often pursue residency opportunities in America, thereby influencing the global oncology workforce. However, little is known about factors influencing fourth-year Caribbean medical students’ interest in choosing oncology during their elective rotations. This gap in understanding their preferences and motivations may hinder effective recruitment strategies to bolster the future oncologist workforce. Methods: An anonymous 20 question, skip logic, survey was distributed online to 4 th year medical students of 4 Caribbean schools. The survey included Likert-style questions, closed ended responses, as well as free-response text. Questions about student’s likelihood of pursing an oncology rotation (n = 2), overall confidence for success (n = 4), general views about oncology rotations (n = 5), anticipated emotional challenges (n = 4), alignment with desired career specialty (n = 2), and factors that would change current choices (n = 3) were asked. Chi-square tests to compare the proportion of students with strong interest (Likert ≥4) in an oncology rotation across intended specialties (e.g., internal medicine vs. surgical fields vs. others). For Likert-scale questions such as emotional burden and confidence, Mann-Whitney U was used to compare mean/median scores between students with strong interest (≥4) versus lower interest ( < 4). Results: Of the 112 respondents, 28% indicated strong interest (Likert ≥4) in pursuing an oncology rotation; 9.8% had completed or scheduled one. A Chi-square test demonstrated that students intending to enter internal medicine were more likely to show strong interest (36%) compared to those pursuing surgical fields (14%), p = 0.031. Students intending to enter general medicine were more likely to show interest (36%) than those pursuing surgery (14%). Reported barriers included limited oncology exposure (58%), fear of emotional burden (72%), and uncertainty about mentorship (38%). Free‐text responses emphasized personal cancer experiences (n = 66), concerns about medical students’ role in oncology settings (n = 37), and lack of knowledge of cancer drugs (n = 32). Mann-Whitney U tests indicate that students reporting greater fear of emotional burden scored significantly lower on interest in pursuing an oncology rotation (p = 0.045). Conclusions: Key barriers to oncology rotations included limited exposure, emotional toll, and uncertain mentorship, with heightened emotional burden linked to lower interest. However, most respondents indicated that better research and clinical opportunities could increase interest. Strengthening oncology curriculum, mentorship, and research support may help increase oncology elective enrollment.