ASSESSING MEDICAL-STUDENTS AND SURGERY RESIDENTS CLINICAL COMPETENCE IN PROBLEM-SOLVING IN SURGICAL ONCOLOGY

Background: We sought to determine the competence of medical students and surgery residents in evaluating clinical problems (using both real and simulated patients) in surgical oncology. Methods: Forty-five thi rd-year medical students, 23 first postgraduate year (PGY-1) residents , and seven second postgraduate year (PGY-2) residents were presented with the same four clinical problems (breast evaluation, prostate nodu le, colon cancer, and mole evaluation). The two resident groups were p resented with two additional patients (breast cancer options and thyro id mass). Results: Mean performance scores for the problems were gener ally poor (32-72%); most students and residents failed almost all of t he problems. Level of training was of some importance; the overall mea n scores of the PGY-2 residents were superior to those of the medical students and the PGY-1 residents (p = 0.049). However, in many areas o f information gathering, diagnosis, and management, training level app eared to have no impact. Numerous important performance deficits were identified in all groups. Conclusion: Medical students and surgery res idents are not receiving adequate training in diagnosing and treating important problems in surgical oncology.