Narrative Expertise in Oncology: An Integrated Training Model to Advance the Field

Despite growing evidence that narrative expertise may benefit cancer care professionals and the field, few hematology-oncology trainees pursue graduate degrees in the humanities. For those trainees with a particular interest in humanism in medicine, we advocate for integration of a Master of Fine Arts (MFA) degree concurrent with fellowship training. This pathway enables trainees to gain advanced skills in narrative competence, informing research and scholarly activities during fellowship and building a foundation for future careers that promote humanism in the field of hematology-oncology across clinical practice, education, research, and advocacy. Narrative competence describes the ability to create space for and elevate the voices of patients, families, and clinicians, which includes active listening, reflecting, sharing, and being moved by stories. In this paper, we review evidence suggesting that frequent exposure to suffering can threaten career longevity for cancer care clinicians, and we highlight narrative competence as an approach to mitigate moral distress, improve well-being, and bolster resilience for our workforce. The influence of narrative competence extends beyond patient care, with meaningful ramifications for advancing research, education, and advocacy efforts across the field. We encourage institutions with hematology-oncology fellowship programs that have capacity to support graduate studies to include the MFA as an option for trainees who aim to become thought leaders and experts in narrative competence. The MFA serves as a strategic mechanism to invest in growing the next generation of hematologist-oncologists with expertise in narrative competence to advance the field.