- Email: [email protected]
Integrity of the Radiation Oncology National Resident Matching Program: Applicant Perspectives
S602
International Journal of Radiation Oncology Biology Physics
appropriateness of RT, and common RT toxicities. The surveys were validated using cognitive interviews (24 in total; among MSs, PCPs, ROs) at seven medical schools with affiliated academic hospitals in the US. Respondents at each institution were identified using email directories and registrars. Surveys with one-time use links were emailed to respondents. A concordance of >90% among RO attendings in an answer for each question was necessary to then compare responses among MS1s, MS4s, and PCPs for that question. Results: The overall response rate for MS1s, MS4s, PCPs, and ROs was 26%; n: 315 + 435 + 42 + 17 Z 812/3145. With respect to RO job descriptions, non-RO respondents felt that to become an RO, one must complete a radiology residency (% MS1s: 54, %MS4s: 16, %PCPs: 39); that ROs stage patients (55, 67, 60), and push a button to deliver RT daily (24, 23, 21). They could define IMRT (48, 55, 50). With respect to appropriateness of RT, respondents selected that RT was generally used for palliation, not for cure (21, 10, 22); that RT was almost never used in pediatric cancers because of a risk of second cancer formation (30, 24, 20); and, that protons were superior to photons in the treatment of prostate cancer (88, 73, 73). Respondents believed that RT may be used as part of the standard initial management of superior vena cava syndrome (29, 56, 83), spinal cord compression from cancer (50, 75, 86), pancreatic cancer (73, 53, 46), and arteriovenous malformations (35, 44, 43). With respect to common RT toxicities, respondents believed that frequent side effects from prostate IMRT were skin redness or tanning (68, 75, 60), risk of infection due to bone marrow suppression (44, 24, 11), second cancer formation (43, 48, 19), and hair loss on the head (33, 9, 0). They believed that the rate of secondary cancer formation after RT was > 2% per year (58, 36, 20); that patients emit radiation after receiving external beam RT (42, 49, 31); and that patients can “feel/ sense” external beam RT (24, 19, 26). Conclusions: Although MS knowledge of general RT principles improves from 1st to 4th year, a large knowledge gap exists between MSs, current PCPs, and ROs. Some basic misconceptions regarding the benefits and harms of RT persist among a minority of PCPs. Initiatives to better educate physicians regarding core RT principles should be considered. Author Disclosure: N.G. Zaorsky: None. T.A. Shaikh: None. E.A. Handorf: None. G. Eastwick: None. A. Hesney: None. E.D. Scher: None. R.T. Jones: None. T.N. Showalter: None. V. Avkshtol: None. H.W. Berhane: None. S.R. Rice: None. J.E. Meyer: None.
answered that they use ROW more often than printed text and 28% use both resources equally. When asked about the quality of ROW, respondents reported favorably with 24% “Good”, 48% “Very Good” and 24% “Excellent”. Despite being highly rated and utilized, 96% said they have not contributed to ROW within the past year. Interestingly, 63% said they would be interested in contributing. Barriers to contributing include; not feeling contribution would be meaningful (52%), concern about accuracy (41%) and not knowing how to contribute (34%). Major motivators to contribute to ROW included contribution to a book fund, recognition by Program Director and inclusion on the WikiBooks editors’ list. There was significant support for enhancing credibility of the content with the addition of editorials contributed by leaders in Radiation Oncology (85%), as well as expert rating of the importance of the references found on ROW (86%). Conclusions: The Radiation Oncology WikiBooks is a highly utilized and rated educational tool for radiation oncology trainees. However, there are significant barriers to ongoing contribution that undermines the capacity for this resource to remain current, accurate and of the highest quality. It is reasonable to encourage leaders in radiation oncology residency training to embrace an organized effort to promote contribution from both experts and trainees, so ROW continues as a dynamic educational resource. Author Disclosure: C. Curkendoll: A. Employee; Tufts Medical Center. K. Huber: A. Employee; Tufts Medical Center.
2994 Use of WikiBooks in Radiation Oncology Education C. Curkendoll and K. Huber; Tufts Medical Center, Boston, MA Purpose/Objective(s): Graduate medical educators must take into consideration how advances in technology impact patterns of resource utilization in order to best allocate support. With this in mind, it is important to know how radiation oncology trainees access educational information most efficiently. Radiation Oncology WikiBooks (ROW) was created by residents in training using the WikiBook open-access platform for organizing key educational material. The purpose of this study is to characterize the utilization of ROW and access the frequency of contribution by our trainees, as well as identify barriers and incentives for ongoing contribution. Materials/Methods: We surveyed current radiation oncology residents, applicants, and recent graduates of Accreditation Council for Graduate Medical Education accredited programs regarding their use of ROW. This cohort was asked to complete an anonymous questionnaire consisting of 17 questions. The questionnaire asked subjects about their experiences and feedback regarding their use of ROW. This study received ethics approval from our institution’s IRB. Results: Of the 104 subjects, 39% were medical students, 19% were PGY1 residents, 38% were PGY2 to PGY5 radiation oncology residents and 3% were recent graduates. Just more than half of residents report that their program provides a book fund. ROW is utilized by 97% of the respondents with 16% reporting using ROW almost every day. In addition, 38%
2995 Integrity of the Radiation Oncology National Resident Matching Program: Applicant Perspectives A. Kusano1 and C.R. Thomas2; 1University of Washington School of Medicine Seattle, WA, 2Oregon Health & Science University, Portland, OR Purpose/Objective(s): The National Resident Matching Program (NRMP) outlines a strict code of conduct for residency programs and applicants. The specific aim of this study is to examine the experiences of radiation oncology applicants and to evaluate the prevalence of behaviors that may be in conflict with established ethical standards. Materials/Methods: An IRB approved, anonymous, online survey was sent to all 2013 applicants to a single radiation oncology residency program within a NCI-Designated Cancer Center. Questionnaire items included demographics, qualitative survey of observed behaviors and opinions about the radiation oncology interview and matching process. Descriptive statistics are presented with chi-square tests performed where appropriate. Results: Questionnaires were completed by 87 of 171 applicants (51% response rate). Thirty-one percent of respondents were female. Applicants completed a median of 2 away rotations and attended a median of 12 interviews. Of respondents, 90% reported being asked at least one question in conflict with the NRMP code of conduct. The most common potentially illegal questions pertained to where else an applicant was interviewing (87%), marital/relationship status (60%), how an applicant would rank a program (28%), and having children or plans to have children (22%). Less commonly, applicants were offered incentives (8%), asked about religion (5%) and offered a position outside of the Match (1%). Seventeen percent reported being told their rank position or that they were “ranked to match” prior to Match day with 27% of these individuals indicating this information affected their ranking of programs. No significant difference in prevalence of potentially illegal questions or behaviors was observed by gender. Ethical dilemmas were common with 52% reporting unsolicited post-interview contact by programs and 36% feeling pressured to give assurances. When asked where else they were interviewing, 64% stated that this made them uncomfortable. Sixty-nine percent felt they could improve their rank position by having faculty contact programs on their behalf. Half of respondents felt applicants often make dishonest or misleading assurances with one-third reporting that desired Match outcome could be improved by deliberately misleading programs. Conclusions: Radiation oncology applicants report a high prevalence of behaviors that conflict with written NRMP policies. While this analysis is
Volume 90 Number 1S Supplement 2014 unable to discern contextual factors of these topic discussions, those involved in residency selection should be reminded of ethical expectations. Post-interview communication should be discouraged in order to enhance fairness and support the professional development of future radiation oncologists. Author Disclosure: A. Kusano: None. C.R. Thomas: None.
2996 Student Oncology Society: A Radiation OncologisteLed Approach to Exploring Careers in Oncology for Medical Students S. Byler, A. Agarwal, and A. Hirsch; Boston University School of Medicine, Boston, MA Purpose/Objective(s): Formal exposure to careers in oncology is limited during the traditional pre-clinical and clinical aspects of undergraduate medical education. Fostering students’ interest and participation in learning about various specialties through student interest groups has been well documented. At our institution, the Student Oncology Society (SOS), led by medical students interested in oncology and currently sponsored by a faculty radiation oncologist, has hosted events to help foster interest in oncology since 2006. The purpose of this descriptive analysis is to document the results of this initiative. Materials/Methods: The SOS is a student-run multidisciplinary interest group to promote and develop interest in oncology specialties, provide networking opportunities with physicians for research or shadowing experiences, discuss the different career pathways in oncology, and encourage early student involvement in cancer care. The programming features physicians from fields such surgical oncology, medical oncology, radiation oncology, and gynecology. We describe the programming that we have held through this group since its inception in 2006. Results: The SOS offers free lunchtime events for medical students. The first event of the year is typically a panel of physicians, including a medical oncologist, a surgical oncologist, and a radiation oncologist from our institution. These physicians share many of the same patients and are able to highlight the importance of an oncology team and their different roles in the progression of cancer care. The SOS also hosts a student/resident panel of fourth year medical students and residents who are interested in careers in oncology. In the spring, the SOS hosts a palliative care panel consisting of a hospice/palliative care physician, a geriatric nurse practitioner, a hospital chaplain, and a bereavement care social worker. Finally, the SOS hosts a cancer-screening day, which pairs students with physicians to provide free cancer screening and education for the community. SOS collaborates with other groups, such as the Radiology Interest Group, to host interactive case discussions that highlight diagnosis and management using specific patient cases. Growing student curiosity in radiation oncology via the SOS has sponsored the incorporation of radiation oncology seminars targeted at medical students at our institution. Conclusions: By giving students an opportunity to learn about the different fields of oncology, the SOS is able to cultivate an early interest and understanding about the multidisciplinary approach to cancer care. For students who are unsure about their career paths, a multidisciplinary interest group allows for exploration of different career pathways, including radiation oncology. Author Disclosure: S. Byler: None. A. Agarwal: None. A. Hirsch: None.
2997 Evaluating the Impact of a Canadian Anatomy and Radiology Contouring (ARC) Boot Camp for Radiation Oncology Residents J.K. Jaswal,1 L. D’Souza,2 M. Johnson,2 K. Willmore,2 K. Tay,3 M. Landis,3 Z. Kassam,4 A. Nichols,3 E. Leung,1 D.P. D’Souza,1 T.L. Sexton,1 and D.A. Palma1; 1London Regional Cancer Program, London, ON, Canada, 2University of Western Ontario, London, ON, Canada, 3London Health Sciences Centre - Victoria Hospital, London, ON, Canada, 4St. Joseph’s Health Care, London, ON, Canada Purpose/Objective(s): Radiation therapy treatment planning, in the modern era, has an increased focus on three-dimensional planning. Recent
Poster Viewing Abstracts S603 studies suggest a need for improved resident instruction in this area. The purpose of this study was to evaluate the effectiveness of a 2.5-day, intensive curriculum (“boot camp”) designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary team of clinical educators. Materials/Methods: The boot camp was modeled after a prior singleinstitution pilot study and a national needs assessment survey. The boot camp consisted of joint didactic lectures incorporating radiation and surgical oncologists and radiologists, with hands-on contouring instruction. Interactive small group seminars with clinical anatomists were held using cadaveric prosections and correlative axial radiographs to enhance 2D-3D spatial relationships. Educational outcomes were evaluated with pre- and post-testing, including 30 multiple-choice knowledge questions and timed contouring sessions of 18 structures (evaluated relative to a gold standard using Dice similarity metrics). Analyses of pre- vs post-test scores were done using non-parametric paired testing. Results: 29 residents from 10 universities participated including 9 postgraduate year (PGY) 3s, 12 PGY 4s and 7 PGY 5s. A majority of the students had done at least one rotation in each clinical site. 27%, 67% and 20% of residents stated that they currently receive formal instruction in anatomy, radiology and contouring, respectively. There was a significant improvement in knowledge scores (pre-test mean 60% vs post-test mean 80%, p<0.001). Across all contoured structures there was an improvement in students’ average dice score (median improvement 0.20, p <0.001). For individual contoured structures, dice improvements were evident in 10 structures contoured, with a trend (p<0.1) for three additional structures. Students self-reported improved ability to interpret radiographs and contour OARs in all clinical sites (head & neck, thorax, abdomen, male/female pelvis p<0.001). In the post-boot camp questionnaire, 92% found the multidisciplinary format effective for their learning, 93% found the boot camp more effective than other educational sessions at their own institutions, and 100% stated that they would recommend this course to others. Conclusions: The ARC boot camp is an effective strategy for improving radiation oncology residents’ knowledge of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring. Author Disclosure: J.K. Jaswal: None. L. D’Souza: None. M. Johnson: None. K. Willmore: None. K. Tay: None. M. Landis: None. Z. Kassam: None. A. Nichols: None. E. Leung: None. D.P. D’Souza: None. T.L. Sexton: None. D.A. Palma: None.
2998 Radiation Oncology in Resource-Poor Settings: Challenges and Opportunities for Humanitarian or Collaborative Cancer Care, Research, and Education W. Ngwa,1,2 M. Moreau,2 and L. Asana3; 1Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 2 University of Massachusetts Lowell, Lowell, MA, 3African Renaissance Ambassador, Orlando, FL Purpose/Objective(s): In response to a world in which cancer is a growing global health challenge, leaders in cancer policy from the USA and 14 economically diverse countries recently concluded that successful campaigns to control cancers with existing methods and to improve current strategies will increasingly depend on concerted multinational collaborations. Given the growing burden of cancer this amounts to increased urgency for more collaborative global health action, as well as support for greater effectiveness of already existing initiatives involving partners from different nations, diverse economic and cultural backgrounds. The WHO 2014 cancer report also shows a substantially higher cancer burden in resource-poor countries in Africa, which are sadly the least capable of dealing with cancer alone. This work investigates the challenges of Radiation Oncology (RadOnc) in resource-poor settings and highlights the existing models and new opportunities for humanitarian or collaborative cancer Care Research and Education (CaRE).
International Journal of Radiation Oncology Biology Physics
appropriateness of RT, and common RT toxicities. The surveys were validated using cognitive interviews (24 in total; among MSs, PCPs, ROs) at seven medical schools with affiliated academic hospitals in the US. Respondents at each institution were identified using email directories and registrars. Surveys with one-time use links were emailed to respondents. A concordance of >90% among RO attendings in an answer for each question was necessary to then compare responses among MS1s, MS4s, and PCPs for that question. Results: The overall response rate for MS1s, MS4s, PCPs, and ROs was 26%; n: 315 + 435 + 42 + 17 Z 812/3145. With respect to RO job descriptions, non-RO respondents felt that to become an RO, one must complete a radiology residency (% MS1s: 54, %MS4s: 16, %PCPs: 39); that ROs stage patients (55, 67, 60), and push a button to deliver RT daily (24, 23, 21). They could define IMRT (48, 55, 50). With respect to appropriateness of RT, respondents selected that RT was generally used for palliation, not for cure (21, 10, 22); that RT was almost never used in pediatric cancers because of a risk of second cancer formation (30, 24, 20); and, that protons were superior to photons in the treatment of prostate cancer (88, 73, 73). Respondents believed that RT may be used as part of the standard initial management of superior vena cava syndrome (29, 56, 83), spinal cord compression from cancer (50, 75, 86), pancreatic cancer (73, 53, 46), and arteriovenous malformations (35, 44, 43). With respect to common RT toxicities, respondents believed that frequent side effects from prostate IMRT were skin redness or tanning (68, 75, 60), risk of infection due to bone marrow suppression (44, 24, 11), second cancer formation (43, 48, 19), and hair loss on the head (33, 9, 0). They believed that the rate of secondary cancer formation after RT was > 2% per year (58, 36, 20); that patients emit radiation after receiving external beam RT (42, 49, 31); and that patients can “feel/ sense” external beam RT (24, 19, 26). Conclusions: Although MS knowledge of general RT principles improves from 1st to 4th year, a large knowledge gap exists between MSs, current PCPs, and ROs. Some basic misconceptions regarding the benefits and harms of RT persist among a minority of PCPs. Initiatives to better educate physicians regarding core RT principles should be considered. Author Disclosure: N.G. Zaorsky: None. T.A. Shaikh: None. E.A. Handorf: None. G. Eastwick: None. A. Hesney: None. E.D. Scher: None. R.T. Jones: None. T.N. Showalter: None. V. Avkshtol: None. H.W. Berhane: None. S.R. Rice: None. J.E. Meyer: None.
answered that they use ROW more often than printed text and 28% use both resources equally. When asked about the quality of ROW, respondents reported favorably with 24% “Good”, 48% “Very Good” and 24% “Excellent”. Despite being highly rated and utilized, 96% said they have not contributed to ROW within the past year. Interestingly, 63% said they would be interested in contributing. Barriers to contributing include; not feeling contribution would be meaningful (52%), concern about accuracy (41%) and not knowing how to contribute (34%). Major motivators to contribute to ROW included contribution to a book fund, recognition by Program Director and inclusion on the WikiBooks editors’ list. There was significant support for enhancing credibility of the content with the addition of editorials contributed by leaders in Radiation Oncology (85%), as well as expert rating of the importance of the references found on ROW (86%). Conclusions: The Radiation Oncology WikiBooks is a highly utilized and rated educational tool for radiation oncology trainees. However, there are significant barriers to ongoing contribution that undermines the capacity for this resource to remain current, accurate and of the highest quality. It is reasonable to encourage leaders in radiation oncology residency training to embrace an organized effort to promote contribution from both experts and trainees, so ROW continues as a dynamic educational resource. Author Disclosure: C. Curkendoll: A. Employee; Tufts Medical Center. K. Huber: A. Employee; Tufts Medical Center.
2994 Use of WikiBooks in Radiation Oncology Education C. Curkendoll and K. Huber; Tufts Medical Center, Boston, MA Purpose/Objective(s): Graduate medical educators must take into consideration how advances in technology impact patterns of resource utilization in order to best allocate support. With this in mind, it is important to know how radiation oncology trainees access educational information most efficiently. Radiation Oncology WikiBooks (ROW) was created by residents in training using the WikiBook open-access platform for organizing key educational material. The purpose of this study is to characterize the utilization of ROW and access the frequency of contribution by our trainees, as well as identify barriers and incentives for ongoing contribution. Materials/Methods: We surveyed current radiation oncology residents, applicants, and recent graduates of Accreditation Council for Graduate Medical Education accredited programs regarding their use of ROW. This cohort was asked to complete an anonymous questionnaire consisting of 17 questions. The questionnaire asked subjects about their experiences and feedback regarding their use of ROW. This study received ethics approval from our institution’s IRB. Results: Of the 104 subjects, 39% were medical students, 19% were PGY1 residents, 38% were PGY2 to PGY5 radiation oncology residents and 3% were recent graduates. Just more than half of residents report that their program provides a book fund. ROW is utilized by 97% of the respondents with 16% reporting using ROW almost every day. In addition, 38%
2995 Integrity of the Radiation Oncology National Resident Matching Program: Applicant Perspectives A. Kusano1 and C.R. Thomas2; 1University of Washington School of Medicine Seattle, WA, 2Oregon Health & Science University, Portland, OR Purpose/Objective(s): The National Resident Matching Program (NRMP) outlines a strict code of conduct for residency programs and applicants. The specific aim of this study is to examine the experiences of radiation oncology applicants and to evaluate the prevalence of behaviors that may be in conflict with established ethical standards. Materials/Methods: An IRB approved, anonymous, online survey was sent to all 2013 applicants to a single radiation oncology residency program within a NCI-Designated Cancer Center. Questionnaire items included demographics, qualitative survey of observed behaviors and opinions about the radiation oncology interview and matching process. Descriptive statistics are presented with chi-square tests performed where appropriate. Results: Questionnaires were completed by 87 of 171 applicants (51% response rate). Thirty-one percent of respondents were female. Applicants completed a median of 2 away rotations and attended a median of 12 interviews. Of respondents, 90% reported being asked at least one question in conflict with the NRMP code of conduct. The most common potentially illegal questions pertained to where else an applicant was interviewing (87%), marital/relationship status (60%), how an applicant would rank a program (28%), and having children or plans to have children (22%). Less commonly, applicants were offered incentives (8%), asked about religion (5%) and offered a position outside of the Match (1%). Seventeen percent reported being told their rank position or that they were “ranked to match” prior to Match day with 27% of these individuals indicating this information affected their ranking of programs. No significant difference in prevalence of potentially illegal questions or behaviors was observed by gender. Ethical dilemmas were common with 52% reporting unsolicited post-interview contact by programs and 36% feeling pressured to give assurances. When asked where else they were interviewing, 64% stated that this made them uncomfortable. Sixty-nine percent felt they could improve their rank position by having faculty contact programs on their behalf. Half of respondents felt applicants often make dishonest or misleading assurances with one-third reporting that desired Match outcome could be improved by deliberately misleading programs. Conclusions: Radiation oncology applicants report a high prevalence of behaviors that conflict with written NRMP policies. While this analysis is
Volume 90 Number 1S Supplement 2014 unable to discern contextual factors of these topic discussions, those involved in residency selection should be reminded of ethical expectations. Post-interview communication should be discouraged in order to enhance fairness and support the professional development of future radiation oncologists. Author Disclosure: A. Kusano: None. C.R. Thomas: None.
2996 Student Oncology Society: A Radiation OncologisteLed Approach to Exploring Careers in Oncology for Medical Students S. Byler, A. Agarwal, and A. Hirsch; Boston University School of Medicine, Boston, MA Purpose/Objective(s): Formal exposure to careers in oncology is limited during the traditional pre-clinical and clinical aspects of undergraduate medical education. Fostering students’ interest and participation in learning about various specialties through student interest groups has been well documented. At our institution, the Student Oncology Society (SOS), led by medical students interested in oncology and currently sponsored by a faculty radiation oncologist, has hosted events to help foster interest in oncology since 2006. The purpose of this descriptive analysis is to document the results of this initiative. Materials/Methods: The SOS is a student-run multidisciplinary interest group to promote and develop interest in oncology specialties, provide networking opportunities with physicians for research or shadowing experiences, discuss the different career pathways in oncology, and encourage early student involvement in cancer care. The programming features physicians from fields such surgical oncology, medical oncology, radiation oncology, and gynecology. We describe the programming that we have held through this group since its inception in 2006. Results: The SOS offers free lunchtime events for medical students. The first event of the year is typically a panel of physicians, including a medical oncologist, a surgical oncologist, and a radiation oncologist from our institution. These physicians share many of the same patients and are able to highlight the importance of an oncology team and their different roles in the progression of cancer care. The SOS also hosts a student/resident panel of fourth year medical students and residents who are interested in careers in oncology. In the spring, the SOS hosts a palliative care panel consisting of a hospice/palliative care physician, a geriatric nurse practitioner, a hospital chaplain, and a bereavement care social worker. Finally, the SOS hosts a cancer-screening day, which pairs students with physicians to provide free cancer screening and education for the community. SOS collaborates with other groups, such as the Radiology Interest Group, to host interactive case discussions that highlight diagnosis and management using specific patient cases. Growing student curiosity in radiation oncology via the SOS has sponsored the incorporation of radiation oncology seminars targeted at medical students at our institution. Conclusions: By giving students an opportunity to learn about the different fields of oncology, the SOS is able to cultivate an early interest and understanding about the multidisciplinary approach to cancer care. For students who are unsure about their career paths, a multidisciplinary interest group allows for exploration of different career pathways, including radiation oncology. Author Disclosure: S. Byler: None. A. Agarwal: None. A. Hirsch: None.
2997 Evaluating the Impact of a Canadian Anatomy and Radiology Contouring (ARC) Boot Camp for Radiation Oncology Residents J.K. Jaswal,1 L. D’Souza,2 M. Johnson,2 K. Willmore,2 K. Tay,3 M. Landis,3 Z. Kassam,4 A. Nichols,3 E. Leung,1 D.P. D’Souza,1 T.L. Sexton,1 and D.A. Palma1; 1London Regional Cancer Program, London, ON, Canada, 2University of Western Ontario, London, ON, Canada, 3London Health Sciences Centre - Victoria Hospital, London, ON, Canada, 4St. Joseph’s Health Care, London, ON, Canada Purpose/Objective(s): Radiation therapy treatment planning, in the modern era, has an increased focus on three-dimensional planning. Recent
Poster Viewing Abstracts S603 studies suggest a need for improved resident instruction in this area. The purpose of this study was to evaluate the effectiveness of a 2.5-day, intensive curriculum (“boot camp”) designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary team of clinical educators. Materials/Methods: The boot camp was modeled after a prior singleinstitution pilot study and a national needs assessment survey. The boot camp consisted of joint didactic lectures incorporating radiation and surgical oncologists and radiologists, with hands-on contouring instruction. Interactive small group seminars with clinical anatomists were held using cadaveric prosections and correlative axial radiographs to enhance 2D-3D spatial relationships. Educational outcomes were evaluated with pre- and post-testing, including 30 multiple-choice knowledge questions and timed contouring sessions of 18 structures (evaluated relative to a gold standard using Dice similarity metrics). Analyses of pre- vs post-test scores were done using non-parametric paired testing. Results: 29 residents from 10 universities participated including 9 postgraduate year (PGY) 3s, 12 PGY 4s and 7 PGY 5s. A majority of the students had done at least one rotation in each clinical site. 27%, 67% and 20% of residents stated that they currently receive formal instruction in anatomy, radiology and contouring, respectively. There was a significant improvement in knowledge scores (pre-test mean 60% vs post-test mean 80%, p<0.001). Across all contoured structures there was an improvement in students’ average dice score (median improvement 0.20, p <0.001). For individual contoured structures, dice improvements were evident in 10 structures contoured, with a trend (p<0.1) for three additional structures. Students self-reported improved ability to interpret radiographs and contour OARs in all clinical sites (head & neck, thorax, abdomen, male/female pelvis p<0.001). In the post-boot camp questionnaire, 92% found the multidisciplinary format effective for their learning, 93% found the boot camp more effective than other educational sessions at their own institutions, and 100% stated that they would recommend this course to others. Conclusions: The ARC boot camp is an effective strategy for improving radiation oncology residents’ knowledge of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring. Author Disclosure: J.K. Jaswal: None. L. D’Souza: None. M. Johnson: None. K. Willmore: None. K. Tay: None. M. Landis: None. Z. Kassam: None. A. Nichols: None. E. Leung: None. D.P. D’Souza: None. T.L. Sexton: None. D.A. Palma: None.
2998 Radiation Oncology in Resource-Poor Settings: Challenges and Opportunities for Humanitarian or Collaborative Cancer Care, Research, and Education W. Ngwa,1,2 M. Moreau,2 and L. Asana3; 1Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 2 University of Massachusetts Lowell, Lowell, MA, 3African Renaissance Ambassador, Orlando, FL Purpose/Objective(s): In response to a world in which cancer is a growing global health challenge, leaders in cancer policy from the USA and 14 economically diverse countries recently concluded that successful campaigns to control cancers with existing methods and to improve current strategies will increasingly depend on concerted multinational collaborations. Given the growing burden of cancer this amounts to increased urgency for more collaborative global health action, as well as support for greater effectiveness of already existing initiatives involving partners from different nations, diverse economic and cultural backgrounds. The WHO 2014 cancer report also shows a substantially higher cancer burden in resource-poor countries in Africa, which are sadly the least capable of dealing with cancer alone. This work investigates the challenges of Radiation Oncology (RadOnc) in resource-poor settings and highlights the existing models and new opportunities for humanitarian or collaborative cancer Care Research and Education (CaRE).