Medical education on inpatient medical oncology service before and after oncology hospitalist program

At Smilow Cancer Hospital, internal medicine-boarded oncology hospitalists assumed primary team attending responsibilities on an adult inpatient medical oncology academic service beginning in 2021. Medical oncology faculty transitioned from primary team attending to consulting physicians but remained engaged in daily morning teaching and twice-weekly formal afternoon didactics. The aim of this study was to compare the educational experiences of internal medicine residents before and after implementation of the oncology hospitalist program.

Yale School of Medicine internal medicine residents receive MedHub surveys following the inpatient oncology rotation. Surveys completed before July 2021 were compared to those after July 2022, when oncology hospitalists were fully integrated into both of the medical oncology teaching services. Surveys asked residents to: (1) score their rotation experience on a 5-point Likert scale (Poor = 1, Good = 2, Very Good = 3, Fair = 4, Excellent = 5) and (2) delineate major positives and negatives noted on their rotation using a free-text field. Answers were compared across timepoints using parametric tests.

118 participants completed the survey pre-implementation, and 84 completed the survey post-implementation. Residents completing the survey post-implementation reported greater general satisfaction (p = 0.005), greater balance between education and clinical demands (p = 0.019), improved resident education (p = 0.027), and greater hospitalist support (p < 0.001). There was greater operational challenges post-implementation (p = 0.003).

Previously-published literature has reported oncology hospitalist programs to have good hospital outcomes, with satisfaction and acceptance by oncologists. This article adds to the literature, suggesting that residents also experience improved clinical experience and support as well as a greater balance between clinical and educational demands. Further work can build upon the hospitalist model and explore oncology-specific education and mentorship to supplement the existing educational experience.