Assessing Oncology Content in the Canadian Internal Medicine Competence by Design Residency Curriculum

Cancer is the leading cause of death in Canada, and care for cancer patients is becoming increasingly complex. Oncology education, particularly for internal medicine trainees, has been shown to be lacking in both a Canadian and global context. In Canada, residency training is now delivered through a competence-based medical education system. Trainees achieve competency by completing "tasks" called Entrustable Professional Activities (EPAs). Using document analysis, 27 EPAs encompassing 401 observations were identified in the general internal medicine residency curriculum. These were mapped to 17 subspecialties. Cardiology and general medicine EPAs comprised the highest proportions at 12% and 10% respectively. However, oncology-related objectives comprised only 6% of all EPAs, ranking 9^th in representation among the subspecialties. We believe updated efforts are needed to improve oncology education within internal medicine training given increasing public health needs. Creating a national curriculum with standardized learning objectives that may complement the Competence by Design (CBD) curriculum could satisfy this educational need.