An assessment of oral cancer prevention curricula in U.S. medical schools.
ABSTRACT Oral cancer is readily detectable through routine examination, but five-year survival rates remain low. Physicians bear the same responsibilities as dentists in the early detection of oral cancers, because high-risk patients utilize medical services more often than dental services.
Because physicians' practices are largely influenced by their training, this study assessed the level of oral cancer education provided to undergraduate U.S. medical students. Health history and physical diagnosis course curricula were assessed for relevant content.
The response rate from the U.S. medical schools was 63.2%. When compared with the "gold standard," the average score was 43% of the optimum. Seven percent of the schools did not require inspection of the mouth, 29% required inspection of all oral structures, and intraoral palpation was advocated by 43% of the schools. Although most schools included questions about alcohol and tobacco use, only 13% asked about sunlight exposure.
Preliminary oral cancer training in medical schools regarding physical assessment and elicitation of signs, symptoms, and high-risk behaviors lacks both adequacy and comprehensiveness.
Article: Smiles for Life: A National Oral Health Curriculum for Family Medicine. A model for curriculum development by STFM groups.[show abstract] [hide abstract]
ABSTRACT: The Society of Teachers of Family Medicine Group on Oral Health released Smiles for Life: A National Oral Health Curriculum for Family Medicine in October 2005 to address a need for high-quality residency and medical school curricula in an area of documented physician knowledge deficit. This article describes the background, planning, fund-raising, development, dissemination, and impact of the curriculum. Lessons learned, particularly in the areas of long-distance collaboration, fund-raising, and marketing are reviewed with a goal of serving as a model for future curriculum development efforts.Family medicine 03/2007; 39(2):88-90. · 1.33 Impact Factor
Article: Perspectives of San Juan healthcare practitioners on the detection deficit in oral premalignant and early cancers in Puerto Rico: a qualitative research study.[show abstract] [hide abstract]
ABSTRACT: In Puerto Rico, relative to the United States, a disparity exists in detecting oral precancers and early cancers. To identify factors leading to the deficit in early detection, we obtained the perspectives of San Juan healthcare practitioners whose practice could be involved in the detection of such oral lesions. Key informant (KI) interviews were conducted with ten clinicians practicing in or around San Juan, Puerto Rico. We then triangulated our KI interview findings with other data sources, including recent literature on oral cancer detection from various geographic areas, current curricula at the University of Puerto Rico Schools of Medicine and Dental Medicine, as well as local health insurance regulations. Key informant-identified factors that likely contribute to the detection deficit include: many practitioners are deficient in knowledge regarding oral cancer and precancer; oral cancer screening examinations are limited regarding which patients receive them and the elements included. In Puerto Rico, specialists generally perform oral biopsies, and patient referral can be delayed by various factors, including government-subsidized health insurance, often referred to as Reforma. Reforma-based issues include often inadequate clinician knowledge regarding Reforma requirements/provisions, diagnostic delays related to Reforma bureaucracy, and among primary physicians, a perceived financial disincentive in referring Reforma patients. Addressing these issues may be useful in reducing the deficit in detecting oral precancers and early oral cancer in Puerto Rico.BMC Public Health 05/2011; 11:391. · 2.00 Impact Factor