Learning about Cancer: Medical Students’ First Year

By Nicholas Zuk

            Whether through personal experiences or the stories of others, nearly everyone has had contact with someone affected by cancer. Because of its devastating potential to harm humans, cancer is almost always associated with negativity, pain, and death. For medical students and researchers in the United States and abroad, cancer represents one of the most challenging and emotionally charged research areas. In 2024 alone, an estimated 2 million new cancer cases and 611 thousand cancer deaths were projected to occur in the United States alone (Siegel, Jemal, & Giaquinto, 2024). With the high number of patients diagnosed with some form of this disease in the U.S., researching the causes and developing treatments for all forms of cancer is a critical objective. 

            To do this, future doctors need to develop some understanding of the disease early in their training. Many medical schools integrate cancer education into a comprehensive, organ system-based curriculum where different types of cancer within each block are studied throughout medical school (American Association of Medical Colleges, 2024). This standard structured approach is designed to ensure that even students who do not intend to specialize in oncology are familiarized with the fundamental mechanisms of cancer at the molecular level and then prepared to discuss diagnoses with patients (American Association of Medical Colleges, 2024). Examining cancer education through medical students’ perspectives can offer unique insights into how cancer is being taught and approached in the medical field. By sharing these perspectives, we can get a glimpse into the promising future of cancer care and help destigmatize cancer as a subject.

            To understand how and what some medical students’ perspectives on cancer treatment and education are, it is helpful to know how medical schools design their programs. Most of the core material is taught during the first two years of medical school, and students’ time is mainly spent in classrooms. Most medical schools design their curricula for the first two years in two ways. The first way is to split organ systems into “blocks” that take 8 to 9 weeks to cover (Jubbal, 2022). Each block is dedicated to a specific organ system, such as the cardiovascular, pulmonary, lymphatic, etc. Within each block, there is generally an entire week devoted to teaching on particular cancers related to the system being studied. The second, “traditional,” approach is to split up the material into three larger content blocks, during which students first learn the normal physiology across all organ systems, then any abnormalities that can occur in the systems (pathology), and finally, how to treat any abnormalities (pharmacology). The third year of medical school is spent beginning clinical rotations in departments such as internal medicine, family medicine, general surgery, psychiatry, neurology, pediatrics, ob/gyn, and emergency medicine, and getting hands-on experience treating patients. The fourth year is similar to the third year, except students also apply for specialty residency programs during this time.

            One of the primary goals of medical school curricula is to ensure that students, regardless of what specialty they ultimately match with, have a comprehensive understanding of all aspects of medicine. While only a small subset of medical students go on to specialize in oncology, all physicians will likely encounter patients affected by cancer in their careers. By exposing students to cancer education early in medical school, students can gain a comprehensive understanding of the disease from a biological perspective, which will ultimately help them become more confident and competent in discussing the disease, exploring treatment options, and speaking with patients and their families about diagnoses. 

            For this article, two first-year medical students from Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania, shared their experiences with cancer both before and after starting medical school. The first student, Vijay Chhabra, graduated from Swarthmore College in 2024 and was a Men’s Varsity Swim Team member for all 4 years of undergraduate school. The second student, Lexi Duffy, also attended Swarthmore College, graduated in 2024, and was a member of the Women’s Varsity Swim Team all 4 years. While their expectations and background with cancer differ, their current perspectives after beginning medical school regarding the future of cancer treatment and research are both quite similar.

For Vijay, cancer has always been a somber and daunting topic. Like most of the general public, his opinions and understanding of the disease have been shaped by its portrayal as a devastating diagnosis associated with loss and tragedy. He said that while he understood the basic concepts of cancer, such as the difference between benign and malignant tumors, his knowledge of the molecular mechanisms of cancer and the research and advancements being made were limited. After beginning medical school, however, Vijay said his perspective of cancer treatment began to shift to a more positive outlook. The first system block that Sidney Kimmel covers is hematology. During this block, Vijay and his classmates were introduced to and learned about the various blood cancers. One of the most notable things he has learned has been that for some “lesser known cancers, there are highly effective treatment methods that have been developed” that make the diseases highly manageable. He no longer views cancer as a dooming diagnosis. He now realizes the incredible progress made in understanding the science behind cancer and instead views it as a biological puzzle that is becoming easier to solve. Thus far, the medical school has instilled in him a realistic but optimistic approach toward cancer. 

On the other hand, for Lexi, cancer has been present throughout her life and has affected many people she has known. Growing up, she has had neighbors, friends, the parents of friends, and even family members who have been diagnosed with cancer. As a result, she has developed a deep understanding the emotional impact a cancer diagnosis has on patients and their families. However, her knowledge of cancer’s biology and clinical aspects was limited until beginning medical school. She said her only expectation going into medical school was that “cancer education would be approached with sensitivity.” While she says they have had lectures about compassion and addressing patients who have been diagnosed with cancer, she, like Vijay, says the priority has been on teaching the science behind cancer. It was during their first block that she says her view shifted from thinking about cancer in terms of the people she has known to something that can be understood and treated. Lexi has also found the focus on niche cancers and the research on them extremely interesting. She finds the “advancements being made encouraging” and indicative of humanity being closer to comprehensive cancer treatments for all forms of cancer. 

Despite different previous exposures to cancer, Vijay and Lexi have had complementary experiences since starting medical school that highlight how a comprehensive approach to cancer education can shape future physicians and foster scientific curiosity and empathetic patient care. For Vijay, the curriculum’s emphasis on the scientific mechanisms of cancer and the research being done on cancer has fostered a sense of optimism rooted in the tangible progress of medical research. Similarly, learning about cancer from a biological perspective has expanded Lexi’s understanding of the disease beyond its emotional impacts. 

Vijay and Lexi’s experiences illustrate how medical schools’ holistic approach to education shapes future physicians. While both Vijay and Lexi still have more to learn about different cancers and treatment methods, being exposed to the fact that cancer research is effective and that researchers are making progress in understanding the causes of cancer and developing effective treatments helps physicians in training view the future of cancer care with hope rather than pessimism. Along with future education on patient empathy, medical schools prepare physicians to be ready to treat patients and understand and believe in the medical approaches they use. 

A recurring theme in both Vijay’s and Lexi’s experiences is the gap between the public’s perception of cancer and what we know about it, and the actual medical advancements being made in cancer care. Despite remarkable progress in treatment and research, many people view a cancer diagnosis as synonymous with a death sentence. For medical students, bridging this gap represents an opportunity to provide patients with accurate information that enables them to understand their prognosis better. By sharing their perspectives, future physicians, such as Vijay and Lexi, can help dismantle outdated misconceptions and reduce the stigma surrounding cancer. Their reflections also emphasize the value of transparent communication with patients. Being taught the value of compassionately delivering diagnoses early in their education will enable the next generation of oncologists to treat cancer and change how society views it effectively. 

            The education physicians receive today will dictate how people are treated in the future. By fostering both a scientific understanding and curiosity, and learning to treat patients empathetically, medical schools can prepare future doctors to care for patients with innovative treatments that will make a cancer diagnosis less intimidating.

References

American Association of Medical Colleges. (2024). Structure of pre-clerkship curriculum. Retrieved from https://www.aamc.org/data-reports/curriculum-reports/data/structure-pre-clerkship-curriculum 

Jubbal, K. (2022). Medical School Timeline (All 4 years explained). Retrieved from https://medschoolinsiders.com/pre-med/4-years-of-medical-school-timeline/#:~:text=Other%20schools%20have%20a%20systems,%2C%20pulmonary%2C%20gastrointestinal%2C%20etc. 

Siegel, R., Jemal, A., & Giaquinto, A. (2024). Cancer statistics, 2024. Retrieved from https://pubmed.ncbi.nlm.nih.gov/38230766/#:~:text=Each%20year%2C%20the%20American%20Cancer,occur%20in%20the%20United%20States.