Sep 23, 2010
By Fadi Braiteh, MD, CPI
Comprehensive Cancer Centers of Nevada
|Fadi Braiteh, MD, CPI|
October 2010 Issue: In our days of accelerated discoveries, light-speed communication, and rapidly changing technology, the world of physicians is overloaded with arrays of new data and the spread of new information. Much of it is often distracting, leaving us to wonder what is “really best” to serve our patients. This is mostly true in the world of hematology/oncology—a field of hundreds of diseases, their makeup redefined in the age of cancer biology and personalized medicine. Keeping up with this rapidly progressing field is a proven stressor for both seasoned veteran oncologists and those in training.
Numerous key papers are published each year in the highest impact factor journals—unfortunately with subtle differences in the results of overall survival, disease-free survival, progression-free survival, quality- of-life scores, and response rates. Furthermore, preliminary positive studies fail to retain proof of benefits once the final study is analyzed. It is quite impossible to keep up with the list of newly published clinical trials and their acronyms.
Turning to ASCO’s “training companion”
Because of the abundance of information available to oncologists, I have looked to ASCO to help me make meaning of all these data. In order to prepare for the Medical Oncology Board Exam, my key study tool was ASCO-SEP®. This comprehensive yet concise resource, now in its second edition, presents a current understanding of the full range of cancer diseases, divided into 22 chapters with interactive self-assessment practice questions. I advise taking full advantage of this resource as a training companion rather than a last-minute tool. I also recommend that you review the published papers in the reference sections for further detailed reading.
Collaborating with other fellows
My peer fellows and I at M. D. Anderson Cancer Center, in Houston, Texas, established a weekly one-hour board review conference for the second- and third-year trainees. The fellows purchased ASCO-SEP and used it as a backbone preparation tool for the certification examination. A chief fellow would choose a chapter to prepare a week in advance and invite a faculty member with expertise in that field to guide and oversee the discussion.
At the weekly conference, one of the fellows would present a summary of the established standard of care in light of evidence-based medicine and also briefly discuss the seminar papers related to the topic (as presented in the ASCO-SEP reference sections). Each fellow would then discuss a self-assessment question, analyze the different alternative answers, providing details and rationale. The faculty leader would add further details and clarify controversies, teasing out the practice variants that are not evidence-based. This step is particularly important since oncology is a field with many practice variants that lack any proven superiority. Over the year, all 22 chapters of ASCO-SEP pertinent to oncology are covered, alternating with weeks to cover hematology topics. In my experience, ASCO-SEP is a practical tool to prepare for the Board examination, serving as a skeleton to identify and fill in knowledge gaps.
Attending a review course
The exam preparation period can be completed by attending one of the national Board review courses. The course I attended provided a comprehensive overview of topics in hematology and oncology. The course was invaluable when it comes to information that rarely is needed for everyday practice but still appears on the examination. And yes, by the time you take and pass the Medical Oncology Board Examination, it isn’t long before you have to re-certify for Internal Medicine and enroll in Medical Oncology Maintenance of Certification...you are never off the hook!