A Structured Approach to History and Physical Examination in Oncology for Medical Learners

In oncology, traditional H&P templates centered on a single chief complaint often fail to address the longitudinal care needs and emotional complexities of cancer patients, leaving learners unprepared for sensitive conversations such as breaking bad news or discussing treatment goals. To address this, we conducted a literature review of specialty-focused H&P tools in child psychiatry and gynecology and, drawing on our experiences as two first-year medical students in an outpatient oncology clinic, developed an oncology H&P template to guide novice clinicians. The guide incorporates structured prompts for rapport-building; detailed oncologic and family cancer history; functional independence assessments; treatment goals; emotional wellbeing; support networks; and responding to emotion. After initial pilot testing by the two developers under supervisor guidance, the template was distributed to five then ten additional students and disseminated via the ASCO online forum and Twitter. Feedback from ten oncologists and oncology trainees highlighted the template’s value in gathering review of systems, past treatment details, functional status, and cancer history. Our findings suggest that this oncology-tailored tool enhances interview flow, promotes comprehensive data collection, and supports empathetic patient engagement. Integration into routine oncology training is planned, with future adaptations for specific oncological subspecialties and potential use in other medical specialties.