The impact of a communal multidisciplinary tumour board on medical education.

Abstract

Introduction: Numerous challenges hinder the development of multidisciplinary medical education in a resource-constrained environment. Communal tumour boards built through networking could be a suitable model for the effective management of diseases and enhancement of medical education. This study evaluated the impact of an integrated care pathway for patients with musculoskeletal tumours via multi-institutional networking in a metropolis.

Methodology: Musculoskeletal tumours managed in different institutions in a large metropolis were included for discussion at monthly meetings, under the aegis of the Lagos Musculoskeletal Oncology Network (LAMON). The cases discussed were collated and presented by designated senior residents. The meetings ensured adherence to agreed national and international guidelines in the management of musculoskeletal tumours. Decisions about the treatment modalities were planned at the meetings. The impact on medical residency training was evaluated using the achievement of significant milestones by the residents supported by the network.

Results: The tumour board network included health professionals from various specialist hospitals in the metropolis. Within the decade (2013-2022), 1,272 patients were reviewed of which 968 patients had definitive histological diagnoses. There was an improvement in limb salvage rate and disease outcome. The tumour board supported significant milestones in graduate medical training, including the completion of 4 residents' fellowship dissertations, 22 conference presentations by residents, the publication of 12 articles by residents and the completion of an orthopaedic oncology subspecialty fellowship by 9 orthopaedic surgeons.

Conclusion: The tumour board/network improved the outcome of musculoskeletal tumours over the study period. The network improved the education of medical doctors and increased the capacity for training newer instructors in a resource-limited environment. Perhaps with appropriate social and corporate support, communal tumour boards like LAMON may translate into a good model for multidisciplinary care of diseases and capacity building in resource-limited settings.