Competencies for practicing medical oncology with common sense: A global curricula review.

Abstract

9018 Background: The Common Sense Oncology (CSO) movement advocates for high-quality, patient-centered cancer care by emphasizing evidence-based, patient-relevant outcomes and equitable access to care through improved evidence generation, interpretation, and communication. A key part of CSO’s mission is training oncologists to incorporate these principles into their practice. Therefore, this study aimed to evaluate how competencies in global postgraduate medical oncology curricula align with CSO principles. Methods: We conducted a document analysis of publicly available postgraduate medical and clinical oncology curricula. Curricula were identified through: (1) searches in Education Source, EMBASE, and PubMed using the terms 'oncology', 'curriculum', and 'competency-based'; (2) a grey literature search; and (3) requests to medical education experts. Curricula in English, Spanish, Italian, Portuguese, or Hebrew were included to ensure regional representation, while accounting for the research team’s language proficiency. Competencies were categorized into eight domains aligned with CSO principles, including critical appraisal, cost and value of cancer care, communication about outcomes and treatment risks, equity in accessing cancer care, ethical principles, and integration of psychosocial oncology, survivorship, and palliative care. Two team members reviewed each curriculum, resolving discrepancies collaboratively, with unresolved cases adjudicated by the first or senior author. Results: We analyzed 16 curricula (Australia/New Zealand, Brazil, Canada, the European Union, India, Ireland, Italy, Japan, Mexico, Nigeria, Pakistan, Spain, the United Kingdom, the United States, and the ESMO/ASCO joint curriculum). Ten (63%) were from high-income regions, and six (37%) were from low/ middle-income countries (LMIC). The most frequently identified domains were critical appraisal (94% of curricula), communication (94%), palliative care (94%), and cost/value of care (88%). Less frequent domains were equity in accessing cancer care (56%), ethical principles (56%), and survivorship care (63%). Four (25%) curricula, all from high-income regions, covered all CSO-relevant domains, while three (19%) addressed four or fewer. Competencies related to equity and ethics were found in 70% of high-income curricula but only in 33% of LMIC. Conclusions: Competencies reflecting CSO principles were identified in global oncology curricula, with emphasis on critical appraisal, communication, palliative care, and psychosocial oncology. Competencies related to equity, ethical principles and survivorship care were less frequently observed. Notable gaps were observed between high-income countries and LMIC, though language limitations may have influenced our findings. Our results will inform the development of a globally relevant competency framework for common sense in oncology.